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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

Bill activity

Introduced Jan 16, 2025 by Dan Crenshaw (R-TX) with 1 original cosponsor. 6 cosponsors as of Jan 21, 2026. Passed the House Dec 18, 2025, 215-201.

  • Reached the House floor under a special rule from the Rules Committee (H.Res.953).
Rep. Pat Ryan (D-NY-18) is not listed among the cosponsors of this bill. Rep. Pat Ryan (D-NY-18) voted nay on the House roll call counted in grades (roll no. 362, Dec 18, 2025).
  1. IntroducedJan 16, 2025
  2. Passed HouseDec 18, 2025
  3. Passed Senate 
  4. To President 
  5. Became Law 

Latest action Dec 18, 2025: Received in the Senate and Read twice and referred to the Senate Committee on Finance.

Sponsor Dan Crenshaw (R-TX)

6 cosponsors (1 original):

Cosponsorship closed Dec 18, 2025 (119th Congress): the House took up the bill under H.Res.953.

Anna Paulina Luna (R-FL): Recorded by Congress.gov on Jan 21, 2026, after cosponsorship closed on Dec 18, 2025. These sign-ons are listed in the log and table but not drawn. Confirmed in the Congressional Record, Jan 21, 2026, House, ADDITIONAL SPONSORS (page H1173): "H.R. 498: Mrs. Luna." (under clause 7 of rule XII).

Activity log

Source: Congress.gov actions
  1. Introduced in House
  2. Referred to the House Committee on Energy and Commerce.
  3. Marjorie Taylor Greene cosponsored (R-GA, original)
  4. Randy K. Weber Sr. cosponsored (R-TX)
  5. W. Gregory Steube cosponsored (R-FL)
  6. Warren Davidson cosponsored (R-OH)
  7. House floor day: vote on the rule (H.Res.953) (3 steps)
    1. Rules Committee Resolution H. Res. 953 Reported to House. Rule provides for consideration of H.R. 6703, H.R. 498 and H.R. 3492. The resolution provides for consideration of H.R. 6703 and H.R. 498 under a closed rule and H.R....
    2. On ordering the previous question Agreed to by the Yeas and Nays: 204 - 203 (Roll no. 343).
    3. Passed/agreed to in House: On agreeing to the resolution Agreed to by recorded vote: 213 - 209 (Roll no. 344).
  8. House floor day: motion to recommit, passage (10 steps)
    1. Considered under the provisions of rule H. Res. 953.
    2. Rule provides for consideration of H.R. 6703, H.R. 498 and H.R. 3492. The resolution provides for consideration of H.R. 6703 and H.R. 498 under a closed rule and H.R. 3492 under a structured rule with one hour of general...
    3. DEBATE - The House proceeded with one hour of debate on H.R. 498.
    4. The previous question was ordered pursuant to the rule.
    5. Mr. Soto moved to recommit to the House Committee on Energy and Commerce.
    6. The previous question on the motion to recommit was ordered pursuant to clause 2(b) of rule XIX.
    7. POSTPONED PROCEEDINGS - At the conclusion of debate on H.R. 498, the Chair put the question on motion to recommit and by voice vote announced that the noes had prevailed. Mr. Soto demanded the yeas and nays and the Chair...
    8. Considered as unfinished business.
    9. On motion to recommit Failed by the Yeas and Nays: 204 - 212 (Roll no. 361).
    10. On passage Passed by the Yeas and Nays: 215 - 201 (Roll no. 362).
  9. House vote: Passage of the billCounted in grades
    Passed, 215-201
    Of 6 cosponsors: 5 voted yea, 0 voted nay, 1 not voting.
    Member breakdown · Official House roll call 362
  10. Received in the Senate and Read twice and referred to the Senate Committee on Finance.
  11. Glenn Grothman cosponsored (R-WI)
  12. Anna Paulina Luna cosponsored (R-FL)
    Recorded by Congress.gov on Jan 21, 2026, after cosponsorship closed on Dec 18, 2025.

Votes on this bill

4 votes: 4 recorded roll calls and 0 decided without a recorded vote, 0 of them on amendments. Votes counted in grades are marked.

Dec 17, 202510:52 amHouseVote to end debate on the rule (ordering the previous question)
H.Res.953On ordering the previous question Agreed to by the Yeas and Nays: 204 - 203 (Roll no. 343).Agreed to204-203Nay
PartyYeaNayPresentNot voting
Democratic0203010
Republican2040016
Independent0000
Total204203026
Official House roll call
Dec 17, 202511:07 amHouseVote on the rule (H.Res.953)On agreeing to the resolution Agreed to by recorded vote: 213 - 209 (Roll no. 344).Agreed to213-209Nay
PartyYeaNayPresentNot voting
Democratic020805
Republican213106
Independent0000
Total213209011
Official House roll call
Dec 18, 20252:56 pmHouseMotion to recommit (send the bill back to committee)On motion to recommit Failed by the Yeas and Nays: 204 - 212 (Roll no. 361).Failed204-212Yea
PartyYeaNayPresentNot voting
Democratic204009
Republican021208
Independent0000
Total204212017
Official House roll call
Dec 18, 20253:00 pmHousePassage of the billCounted in gradesOn passage Passed by the Yeas and Nays: 215 - 201 (Roll no. 362).Passed215-201Nay

Counted in grades

Of 6 cosponsors: 5 voted yea, 0 voted nay, 1 not voting. Question voted on: Passage of the bill

PartyYeaNayPresentNot voting
Democratic420108
Republican211009
Independent0000
Total215201017
Official House roll call

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.