The Administration of Massachusetts Democratic Governor Maura Healey has announced that it will use state funds to maintain coverage for hormonal treatments for minors with gender dysphoria after the Donald Trump Administration approved a rule eliminating federal funding for these procedures through Medicaid and the Children’s Health Insurance Program (CHIP). The decision comes just days after Healey signed a reform that also expands the legal framework for abortion after 24 weeks of gestation.
The Centers for Medicare and Medicaid Services (CMS) announced on August 11 the final approval of the new regulation, scheduled to take effect on October 13. The measure prohibits the use of federal Medicaid and CHIP funds to finance procedures included by the Trump Administration within medical treatments for sexual transition in minors.
Massachusetts will assume the cost with state funds
The Healey Administration has announced that it intends to cover with its own resources the funding that Washington will no longer provide for minors enrolled in the two public programs.
«The Healey-Driscoll Administration is committed to ensuring that all Massachusetts residents have access to the gender-affirming healthcare they need and deserve,» a state government spokesperson said, according to WBUR.
The state Executive also stated that it will work with healthcare providers to ensure they can continue offering these services when the new federal regulation takes effect.
According to WBUR, Massachusetts plans to assume the full cost of hormonal therapy and psychological care for children and adolescents affected by the federal measure. To do so, it may draw on the so-called Affirming Health Care Trust Fund, which had approximately $8.5 million as of the end of July.
The state allocated approximately $3.6 million in 2024 for this type of care for minors through its public programs. For now, the Healey Administration has not specified how much additional funding it will need to provide once federal funding disappears.
Trump withdraws federal funds
The regulation approved by CMS is part of the measures promoted by the Trump Administration to restrict medical interventions for sexual transition in children and adolescents.
The rule establishes that Medicaid and CHIP will no longer provide federal funds for the procedures outlined in it. In the case of minors currently receiving hormonal treatments, funding will be allowed for a gradual withdrawal period of up to six months from the regulation’s effective date.
The decision does not affect coverage for mental health services. CMS has clarified that minors who meet Medicaid and CHIP eligibility requirements will continue to have access to the psychological and psychiatric care provided under federal law.
«Children deserve our protection, not experimental interventions that pose serious risks and offer no proven benefits,» CMS Administrator Mehmet Oz said when presenting the measure.
The agency maintains that a review of national and international research conducted by the Department of Health and Human Services has identified significant gaps in the available evidence and safety concerns related to these treatments.
Massachusetts will take the measure to court
Massachusetts’s response will not be limited to replacing funds from Washington. State Attorney General Andrea Campbell plans to challenge the new federal regulation in court.
Massachusetts has approved various measures in recent years aimed at legally protecting patients and healthcare professionals involved in gender transition treatments, a policy that has placed the state in direct opposition to the restrictions promoted by the Trump Administration.
The uncertainty caused by the federal measures has already affected some healthcare centers. Baystate Health, one of the main hospital systems in western Massachusetts, stopped providing most medical transition treatments to minors this year due to potential consequences for its federal funding.
Healey also expanded abortion legislation this month
The governor’s decision comes just days after another reform promoted in Massachusetts in a matter of particular bioethical relevance.
As InfoVaticana reported on August 14, Healey signed a law that eliminates the specific medical causes that previously conditioned the practice of abortion after 24 weeks of gestation and replaces them with the physician’s «professional judgment.» The legislation also eliminates the requirement that such abortions be performed in a hospital.
Read also: Abortion up to birth: Massachusetts eliminates medical limits after 24 weeks
These are two decisions adopted in different legal areas. In the case of minor transition treatments, the Massachusetts government intends to maintain through state resources coverage that Washington has decided to stop funding with federal funds.
The debate on transition treatments in minors
The use of puberty blockers, cross-sex hormones, and surgical procedures in minors with gender dysphoria continues to be the subject of medical and political debate, with significant differences between policies adopted in the United States and reviews conducted in several European countries.
The Trump Administration maintains that the available evidence does not justify federal health programs funding these interventions in minors. CMS also points to the possible irreversible effects of some treatments and specifically cites international reviews, including the Cass Report prepared in the United Kingdom.
The independent review led by British pediatrician Hilary Cass and published in 2024 concluded that the scientific evidence available on certain medical interventions for children and adolescents with gender dysphoria was of low quality and recommended a broader and more cautious care model.
Massachusetts maintains a different policy. While the Trump Administration will withdraw federal Medicaid and CHIP funding for these procedures starting in October, the Healey Administration has announced that it will use state funds to maintain coverage for affected minors and will challenge the measure in court.