Trump’s ‘big beautiful bill’ includes an attack on trans healthcare

The US House of Representatives narrowly passed a sweeping tax and spending bill – the One Big Beautiful Bill Act – that adds trillions to the national debt and cuts access to healthcare for trans people on insurance programmes. 

After divisive debate the One Big Beautiful Bill Act, a more than 1,000 page piece of legislation, was passed on Thursday (22 May) in the Republican-controlled House with a tight 215-214 vote. 

The megabill sets out tax cuts, billions in funding for the military and border security but also cuts to federal health care programmes, including stripping gender affirming care access. 

Under the bill, Medicaid and CHIP, which both provide healthcare to low income people, will no longer be able to reimburse people of all ages for gender–affirming care. Alongside this, another provision states Obamacare cannot cover “gender transition procedures” as an “essential health benefit”. 

Figures from the Williams Institute at UCLA School of Law show that around 276,000 trans adults are enrolled on Medicaid with 14 per cent (38,000) of these people living in states where there are express bans on gender affirming care being covered. 

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