NEGATIVE LGBTQ+ Rights 119th Congress

H.R.498 Do No Harm in Medicaid Act

Bans Medicaid from covering gender-affirming healthcare including hormones and surgical care for transgender patients (119th Congress)

View on Congress.gov

Legal & Constitutional Grounding

AMA recognizes gender-affirming care as medically necessary; Medicaid ban denies documented evidence-based treatment.

AMA Policy H-185.950: gender-affirming care is medically necessary treatment supported by clinical evidence

Endocrine Society (2017): hormone therapy guidelines for transgender individuals
U.S. Const. amend. XIV — Equal Protection Clause

Who Lobbied on This Bill

$180K combined quarterly activity

3 lobbying firms

3 clients represented

2025-fourth_quarter–2026-first_quarter filing period

Policy Areas Covered

Civil Rights/Civil Liberties Family issues/Abortion/Adoption Health Issues

Government Entities Lobbied

Administration for Children & Families (ACF)
Agriculture, Dept of (USDA)
Centers For Disease Control & Prevention (CDC)
Centers For Medicare and Medicaid Services (CMS)
Consumer Product Safety Commission (CPSC)
Drug Enforcement Administration (DEA)
Environmental Protection Agency (EPA)
Food & Drug Administration (FDA)
HOUSE OF REPRESENTATIVES
Health & Human Services, Dept of (HHS)
Health Resources & Services Administration (HRSA)
Housing & Urban Development, Dept of (HUD)
Indian Health Service
Interior, Dept of (DOI)
Natl Institutes of Health (NIH)
Office of the Comptroller of the Currency (OCC)
SENATE
Social Security Administration (SSA)
State, Dept of (DOS)
U.S. Agency for International Development (USAID)

Who Hired the Lobbyists

AMERICAN CIVIL LIBERTIES UNION Protecting civil liberties
AMERICAN ACADEMY OF PEDIATRICS
ALLIANCE DEFENDING FREEDOM Religious Liberty, Life, Parental Rights, Free Speech

Source: Senate LDA filings · Dollar figures are combined quarterly totals for all lobbying by each firm, not bill-specific spend.

Do No Harm in Medicaid Act — bans Medicaid coverage of gender-affirming care. The bill denies documented medically necessary treatment endorsed by the AMA and Endocrine Society to transgender Medicaid patients.