Senate Parliamentarian Blocks Key Provision to Defund Gender-Affirming Care in Major Republican Bill

WASHINGTON D.C. – A significant legislative effort to eliminate federal funding for gender-affirming care faced a major setback this week as the Senate parliamentarian ruled against a key provision within the Republican-backed "One Big, Beautiful Bill Act." The ruling, citing a violation of the Byrd Rule, prevents the measure from moving forward in the current budget reconciliation package, which requires provisions to have a direct budgetary impact. This development comes amidst ongoing calls from activists, including a recent tweet from "Boris Spider," urging citizens to contact Republican senators to prioritize defunding such care.

The "One Big, Beautiful Bill Act," designated as HR 1, was narrowly passed by the House of Representatives on May 22 with a 215-214 vote. This comprehensive budget reconciliation bill aims to implement deep cuts across various federal programs, including Medicaid, the Affordable Care Act (ACA), and the Supplemental Nutrition Assistance Program (SNAP), while also providing tax cuts for the wealthy. The bill, a signature legislative push, has been a central focus for the current administration.

A contentious element of the House-passed bill was a provision that sought to prohibit federal financial participation in gender-affirming care through Medicaid and the Children’s Health Insurance Program (CHIP) for individuals of all ages. Initially, the provision targeted only minors, but it was expanded to include adults just before the House vote. Additionally, the bill proposed amending the ACA to exclude "gender transition procedures" from essential health benefits, potentially increasing out-of-pocket costs for patients.

However, the Senate parliamentarian, Elizabeth MacDonough, determined that the ban on federal funding for gender-affirming care violated the Byrd Rule, which dictates that provisions in budget reconciliation bills must have a direct and non-incidental budgetary effect. This ruling represents a significant victory for LGBTQ+ advocates and a blow to conservative lawmakers seeking to restrict access to such medical services. Despite this setback, the broader Republican agenda continues to include efforts to limit funding and access to gender-affirming care.

The push to defund gender-affirming care has been a rallying point for some conservative groups. A tweet by "Boris Spider" specifically called for action, stating, > "We need people to contact these key Republican Senators with phone calls and comments on their web pages to let them know that defunding GAC in the Big Beautiful Bill is a priority." The tweet listed several prominent Republican senators, including Jim Banks (IN), Marsha Blackburn (TN), Lindsay Graham (SC), Josh Hawley (MO), Ron Johnson (WI), James Lankford (OK), Mike Lee (UT), Rick Scott (FL), and Roger Marshall (KS), as targets for these lobbying efforts.

Advocacy groups like the Human Rights Campaign (HRC) and the American Civil Liberties Union (ACLU) have consistently opposed these legislative attempts, emphasizing the medical necessity of gender-affirming care and its critical role for many transgender individuals. They argue that such cuts disproportionately harm low-income LGBTQ+ people who rely on federal programs like Medicaid. While the parliamentarian's ruling offers a temporary reprieve, the debate over federal funding for gender-affirming care is expected to persist as the bill continues its journey through Congress.