Senate Parliamentarian Strikes Trans Medicaid Ban From GOP Megabill
In a major win for trans healthcare rights across the country, the trans Medicaid ban provision has been removed from the GOP’s megabill after advocates pressured Democrats to invoke the Byrd rule.
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Today, the Senate Parliamentarian ruled the trans Medicaid ban cannot be included within Trump’s “One, Big, Beautiful Bill” under the Byrd rule. First reported on in the context of possibly striking the trans Medicaid ban by MadyCast News and Free Radical, this rule allows for the Senate Parliamentarian, Elizabeth MacDonough, to strike the provision down on the basis of violating legislative technicality.
MadyCast News provided a template for readers to contact their Senators along with the story, prompting countless trans people and allies to push for them to raise the Byrd rule to the Parliamentarian. This pressure from across the board was important to encouraging Democrats to challenge the ruling, according to multiple sources with direct knowledge of the situation in Washington DC. All that is needed is a single Senator to argue the case in front of the Parliamentarian and then invoke it on the floor to strike down the Medicaid ban from the bill text.
Worries about the bill have been affecting those even in the most blue of states. Madison, a trans woman in Minnesota, said to MadyCast News, “Ever since it was slipped into the House bill, I've been living each day in dread. I haven't been able to shake the fear that somehow, looming ahead in the near future, is an end to what I need to live as myself. Managing my anxiety has been significantly harder. If at least the Medicaid portion of the bill could be excised, I'd feel like I'm allowed to think about my future again, if that makes sense. Right now, it feels like all I have is 'right now.'”
Residents of other blue states report having even less security. Emily, a trans woman from Connecticut, said to MadyCast News ,“While our state is arguably more "progressive" than many others in the U.S., the state political representatives and reps at offices through Social Services have frequently been quite cagey/dodgy in their replies when I have levied questions about future coverage and legislative support. As such, I have a fairly strong suspicion that a federal Medicaid ban would be quite likely to affect my personal coverage in spite of the supposed level of support that our government officials may offer forth.”
Those from red states report feeling very similar. Logan, a trans man from Alaska who is also a personal friend of this article’s author, said to MadyCast News that “there’d be a risk” to his care if this ban went into effect, and that while Alaska’s state Constitutional rights to privacy may help combat state level bans, it may not be enough. “While I don't know if it would get affected, Alaska is still a pretty red state and they have made exceptions to core principles just to fuck over trans people before. I’d be very, very relieved if [the ban] were struck down,” he said.
Last weekend, the Byrd rule was debated by Democratic Senators, and today ranking Budget Committee Sen. Jeff Merkley announced the provision had been struck, among other provisions.
The implications of the Byrd rule are broad. While preventing the Medicaid ban is a significant part of its impact, other provisions to be targeted include tax credits that would harm lower income workers, according to Politico.
The Medicaid ban, if it had stayed in the bill and the bill passed into law, would have stripped thousands of trans people of their healthcare. Trans people, particularly disabled, Black, and Indigenous trans people of color, disproportionately rely on Medicaid for essential medical care. This would have stripped care for both adults and minors, in line with expectations from Trump’s Project 2025, which signals that he aims to restrict all gender affirming care, or in his words, end “transgender for everybody."
The Parliamentarian ruling could be overruled by a 60 vote waiver vote, which is unlikely to pass considering that even conservative anti-trans Democrats like Gallego have voiced opposition to the measure. The GOP could also invoke the “nuclear option" to overturn the filibuster entirely with 51 votes, but so far there has been no information to suggest the majority party plans to overturn any of the Parliamentarian’s Byrd rulings.
The ACA EHB provisions was not present in the Senate bill, though a similar HHS rule was finalized by HHS earlier this week.
Jess, a trans woman from Pennsylvania, describes this overruling as a “relief,” but adds that “these attempts aren’t going to stop here.” She continues, “I'm hopeful that we're able to slow the worst anti-trans legislation, and if we get through next year without a federal all-ages ban I'd be very relieved. But I've also been trying to be pragmatic that we're the only ones who are gonna save ourselves - I've been stockpiling since the election, I've been investigating DIY, and I've been trying to be more involved with my local communities.”
Nevertheless, while this move is substantially positive for the trans community, it does not provide permanent protections for queer healthcare. The Trump administration’s relentless attacks on gender affirming care are not going to stop with this ban. They have routinely shown a disregard for the law, and numerous healthcare providers are already complying in advance without solid legal basis.
Naomi, a trans woman from Illinois, concurred with this thought to MadyCast News, “I think that in the next few months, the Trump administration will direct the Justice Department to actually attempt to prosecute some gender-affirming care provider, probably in a big blue city, in a blue state, in an attempt to intimidate all gender-affirming care providers into stopping. And that might work because… nobody wants to get rounded up by the Gestapo. You know, that really sucks. It's hard to blame somebody for being like, well, you're threatening me with imprisonment… I live in fear every day that they will try and force me to detransition. And I'd rather die than do that.”
The only sustainable and long term path for the queer community is radical community solidarity in the face of fascism’s growing threat. There will always be hope for us, and there are ways forward with people already laying the foundation for a better society. The way ahead is simple -- we need to fight, and we need to push back at every turn. Liberation for all of us, and not just a few.
—Edited by Mady Castigan
What about if they fire the parliamentarian?