The Centers for Medicare & Medicaid Services has issued a rule prohibiting state Medicaid programs from covering gender-affirming medical treatments for children under age 18, effective October 13. The ban also extends to the Children’s Health Insurance Program, which cannot use federal funds for such care for youth under 19.

The restriction blocks payment for puberty blockers, cross-sex hormones, and surgical procedures classified as gender-affirming care. Existing patients currently enrolled in Medicaid hormone therapy may continue receiving coverage for up to six months after the rule takes effect, but no new patients will qualify for federal reimbursement.

Mental health services for children remain eligible for Medicaid and CHIP funding under the new policy.

HHS Secretary Robert F. Kennedy Jr. defended the decision, saying gender-affirming procedures “carry serious risks and can cause irreversible harm.” The rule represents a significant shift in federal health policy and affects state Medicaid administrators nationwide, including Idaho’s program, as first reported by the Idaho Capital Sun.

The American Academy of Pediatrics has challenged the characterization of these treatments as risky. Dr. Susan Kressly, then president of the organization, told the Idaho Capital Sun that the federal action amounts to political interference. “These rules are a baseless intrusion into the patient-physician relationship,” Kressly said. “Patients, their families, and their physicians — not politicians or government officials — should be the ones to make decisions together about what care is best for them.”

The American Medical Association similarly affirms the safety profile of gender-affirming medical care in minors.

Idaho has already moved to restrict access to gender-affirming treatments through state law, making the federal Medicaid ban largely redundant within the state. However, the federal prohibition establishes a uniform standard across all state Medicaid programs and represents an explicit federal position on the issue.

The ruling comes as Idaho continues to reshape its Medicaid program under new work requirements and other policy changes. Idaho Medicaid Work Rules Set for January 2027 Launch as Officials Say Most Enrollees Already Qualify represents another significant shift in how the state manages its health coverage programs.