Trump’s ‘big beautiful bill’ includes attack on trans healthcre

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 is express bans on gender affirming care being covered.

Democrat Sarah McBride, who is the first out trans congresswoman, told The Independent the bill is “one more example of health care that they’re trying to rip away” whilst fellow Dem Mark Pocan said the “entire thing’s a s*** show”.

“There’s so much that’s problematic, but I’m counting on the adults in the Senate to fix what the House Republicans have screwed up,” Pocan added.

In response to the bill’s passage, and the impact it will have on countless trans folks, Human Rights Campaign president Kelley Robinson labelled it as “cruel”.

“People in this country want policies and solutions that make life better and expand access to the American Dream. Instead, anti-equality lawmakers voted to give  handouts to billionaires built on the backs of hardworking people – with devastating consequences for the LGBTQ+ community,” she said.

“If the cuts to programs like Medicaid and SNAP or resources like Planned Parenthood clinics weren’t devastating enough, House Republicans added a last minute provision that expands its attacks on access to best practice health care to transgender adults.

“This cruel addition shows their priorities have never been about lowering costs or expanding health care access–but in targeting people simply for who they are.

“These lawmakers have abandoned their constituents, and as they head back to their districts, know this: they will hear from us.

On his social platform Truth Social, US president Donald Trump said: “This is arguably the most significant piece of Legislation that will ever be signed in the History of our Country!

“Great job by Speaker Mike Johnson, and the House Leadership, and thank you to every Republican who voted YES on this Historic Bill! Now, it’s time for our friends in the United States Senate to get to work, and send this Bill to my desk AS SOON AS POSSIBLE!”

The passage of the bill comes amid increasing anti-trans rhetoric in the US under the Trump administration.

The president has invoked a litany of anti-trans policies including proclaiming that the official policy of the US is that there are “only two sexes”, banning transgender people from serving in the military, barring trans women from female sport and restricting gender-affirming healthcare for trans youngsters under the age 19. He has also moved to eliminate diversity, equity and inclusion programmes across the government and in the military.

However, this is not the first time coverage of gender affirming care for trans people has been blocked by the US government.

Back in December, before Trump returned to the White House for his second term, the Senate passed the National Defense Authorization Act for Fiscal Year 2025 – the most recent iteration of the National Defense Authorization Act (NDAA) – which is an annual piece of legislation which outlines military spending and budgets.

The bill granted wage increases for military personnel and funding for new military equipment but also included an anti-trans clause which would stop Tricare – the US military’s healthcare plan for service members – from issuing “medical interventions” to those under the age of 18 “for the treatment of gender dysphoria that could result in sterilisation”.