New federal rule bars Medicaid/CHIP payments for sex-rejecting procedures for minors

The U.S. Department of Health and Human Services issued a final rule that changes how states can use federal Medicaid and CHIP money for certain services involving minors.

Under the rule, a State Medicaid plan must say the Medicaid agency will not pay for “sex-rejecting procedures” for children under 18, and states are also prohibited from using federal Medicaid dollars for those procedures for anyone under 18.

The rule also applies to CHIP. A State CHIP plan must say the CHIP agency will not pay for “sex-rejecting procedures” for children under 19, and states cannot use federal CHIP dollars for those procedures for anyone under 19.

For Medicaid and CHIP beneficiaries who are already receiving cross-sex hormone therapy, the rule allows states to continue claiming federal financial participation for the hormone therapy medications for up to 6 months after the rule’s effective date.

For the official details, see the Federal Register notice: https://www.federalregister.gov/documents/2026/08/13/2026-16508/medicaid-program-prohibition-on-federal-medicaid-and-childrens-health-insurance-program-funding-for