Maine will continue providing gender-affirming care despite an announcement from the Trump administration banning Medicaid from covering hormone therapy and procedures for children under 18.
The Centers for Medicare & Medicaid Services announced the rule on Tuesday, which also prohibits Children’s Health Insurance Program, or CHIP, funds from being used for this care, typically sought out by people whose gender identity is different from their sex assigned at birth.
Under CMS’s definition, gender-affirming care includes puberty blockers, cross-sex hormones, and surgical operations. The policy takes effect Oct. 13.
For children on Medicaid and CHIP who currently rely on gender-affirming hormone therapy, state plans may continue to use federal Medicaid funding for up to six months. Funds can still be used for mental health care for kids, the agency said.
“To be clear, gender-affirming care remains legal in Maine and will remain accessible to all patients at Maine Family Planning’s 18 clinics,” said Olivia Penngington, associate vice president of public affairs for the state’s largest reproductive healthcare provider.
“We will do everything in our power to provide this lifesaving care across the state and we will never turn patients away for their inability to pay or their lack of insurance coverage.”
In Maine, between 3,000-4,000 people in Maine receive gender-affirming care and 27% of those people get that funding from MaineCare, according to WMTW.
The rule is the latest in a series of actions President Donald Trump’s administration has taken to restrict gender-affirming care. Last year, Maine joined a multi-state lawsuit challenging a declaration that called treatments like puberty blockers, hormone therapy, and surgeries unsafe and ineffective for children seeking gender-affirming care.
That declaration also warned doctors that they could be excluded from federal health programs like Medicare and Medicaid if they provide those types of care. Despite the lawsuit and objections from several national medical associations that advocate for evidence-based care, the proposed Medicaid and CHIP rule has now been finalized.
“The Trump administration knows that access to this care is popular and that they can’t outright ban it,” Pennington said. “So they attack the funding sources as a backdoor ban on peoples’ personal health care decisions.”
Maine law specifically requires MaineCare, the state’s Medicaid program, to cover gender-affirming care, which means that even if this rule were to be enacted, children who rely on MaineCare would still be able to have their care covered through state funding, according to Aspen Ruhlin, community engagement manager at the Bangor-based Mabel Wadsworth Center.
The Maine Attorney General’s Office declined to comment on whether the state plans to challenge the final rule.
Much like MaineCare can still pay for abortions through state funding despite the Hyde Amendment banning federal Medicaid reimbursements to be used for the procedure, the cost of gender-affirming care for minors will shift to the state.
However, because there are a relatively small number of Maine youth seeking such care under MaineCare, Ruhlin said the cost shift would not be a big financial burden.
“I personally do not have concerns about creating some sort of financial shortfall for the state,” they said. “The concerns there are just that this is normal essential care, and the feds putting those restrictions is just really targeted intentional harm towards a marginalized community.”
The Maine Department of Health and Human Services did not respond to questions about how much gender-affirming care costs the state currently.
Some Maine providers told Maine Morning Star they’re afraid of being targeted for providing these services, which then puts this care at risk. Across the country, hospitals in both Democratic and Republican-led states have responded to Trump’s attacks on transgender health care by withdrawing care.
No Maine providers have made such announcements yet. MaineHealth said in a statement that it is “currently seeking additional information and clarification from state and federal officials with respect to this announcement,” while reinforcing its commitment to providing needed care to all patients regardless of insurance status or ability to pay.
However, Ruhlin said some patients who need hormone therapy, puberty blockers, or other types of care are foregoing it due to fear. After the announcement, staff at Mabel Wadsworth were preparing for calls from patients seeking to clarify if they could continue their treatment.
“The exceedingly anti-trans sentiments from the federal government has led to a lot of trans folks making the decision to not pursue gender-affirming hormone therapy when they otherwise feel it would be a good fit for them,” Ruhlin said.
“Because they are concerned about their safety. Not from the medications themselves — they are very safe — but because the targeting from the government keeps getting worse.”
This article was originally published by Maine Morning Star.
Featured Image: Dana DiFilippo/New Jersey Monitor
