CMS Final Rule Bars Federal Medicaid, CHIP Funds for Pediatric Gender-Affirming Care

CMS issued a final rule prohibiting federal Medicaid and CHIP matching funds for gender-affirming care for minors, including puberty blockers, hormone therapy, and related surgeries such as mastectomies. The rule takes effect October 13, 2026. States will no longer receive federal financial participation for these services furnished to children enrolled in Medicaid or CHIP. The policy represents a federal prohibition on a category of care previously covered under state Medicaid programs' Early and Periodic Screening, Diagnostic and Treatment benefit and other authorities.

Behavioral Health · CHIP · Managed Care