CMS final rule bans federal Medicaid and CHIP funding for gender-affirming care for minors
Final ruleCMS
- Date
- Actor
- CMS / HHS
- Agency
- Centers for Medicare & Medicaid Services (CMS)
- Type
- Final rule
Summary
The final rule (91 FR, doc. 2026-16508) prohibits federal financial participation for "sex-rejecting procedures" — puberty blockers, cross-sex hormones, and related surgeries furnished to treat gender dysphoria — for Medicaid beneficiaries under 18 and CHIP beneficiaries under 19, effective October 13, 2026. States may continue coverage only with state-only funds; a six-month wind-down permits FFP for beneficiaries already on hormone therapy; DSD care, other-purpose uses, complication management, and mental-health services remain fundable. CMS finalized over more than 90% opposing comments and expressly distinguished the PFLAG/Washington injunctions as limited to EO-based funding conditions.
Status
Final rule published August 13, 2026; not yet in effect (effective October 13, 2026). No injunction identified as of August 20, 2026; litigation widely anticipated. (See also sections 10, 11.)
As recorded in the data of . Check the sources for anything newer.
Documents
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Medicaid Program; Prohibition on Federal Medicaid and Children's Health Insurance Program Funding for Sex-Rejecting Procedures Furnished to Children, 91 Fed. Reg. 52,406 (Aug. 13, 2026) (codified at 42 C.F.R. pts. 441, 457).
Sources
- cms.gov/newsroom/press-releases/cms-ends-federal-medicaid-chip-funding-sex-reje…(opens another site)
- crowell.com/en/insights/client-alerts/cmss-final-rule-bans-federal-medicaid-fun…(opens another site)
- federalregister.gov/documents/2026/08/13/2026-16508/medicaid-program-prohibitio…(opens another site)
- mcguirewoods.com/client-resources/alerts/2026/8/questions-and-answers-about-cms…(opens another site)
Cite this action
Medicaid Program; Prohibition on Federal Medicaid and Children's Health Insurance Program Funding for Sex-Rejecting Procedures Furnished to Children, 91 Fed. Reg. 52,406 (Aug. 13, 2026) (codified at 42 C.F.R. pts. 441, 457).
Short form: 91 Fed. Reg. at 52,406.