Use of public funds or facilities for gender-affirming care banned by GOP-led Idaho legislature

BOISE, Idaho — The GOP-led Idaho Legislature has passed a bill that would prohibit the use of public funds for gender-affirming care, including for state employees using occupational health insurance and adults covered by Medicaid.

The Senate overwhelmingly approved the measure Friday after it first passed the House. It will be sent to the desk of Republican Gov. Brad Littles, where he is expected to sign it into law. The governor has repeatedly said he does not believe public funds should be used for gender-affirming care.

If enacted, the legislation would make Idaho at least the 10th state to ban Medicaid funding for gender-affirming care for people of all ages, according to the advocacy and information organization Movement Advancement Project. The laws are part of an ongoing national battle for the rights of LGBTQ+ Americans.

The American Civil Liberties Union of Idaho in a statement Friday condemned the Senate’s decision.

Idaho State Senators have once again decided to give in to the hateful demands of far-right extremists at the expense of the safety, security and health of Idaho’s transgender community,” the statement said, and He adds that lawmakers could simply choose to allow transgender people in Idaho to make their own medical decisions in peace.

The ACLU and other opponents of the Idaho bill say it will almost certainly lead to a lawsuit in federal court. The state is already mired in lawsuits over attempts to deny gender-affirming care to transgender residents and has so far had little success defending them.

In one case, the state was ordered to provide a transgender inmate with gender transition surgery, and the inmate was later awarded about $2.5 million in legal fees.

A federal judge last year barred Idaho from enforcing its newly enacted ban on gender-affirming medical care for minors until a lawsuit filed by transgender youth and their families is resolved. A different federal judge denied the states’ motion to dismiss a separate lawsuit filed by adults in 2022 who said Medicaid officials wrongly denied coverage for their medically necessary gender affirmation treatment.

That bill violates the Equal Protection Clause of the 14th Amendment and the federal Medicaid Act, Boise attorney Howard Belodoff told lawmakers last week during a hearing.

One of the bill’s sponsors, Republican Rep. Bruce Skaug, described it as a taxpayer protection bill, suggesting that without it the state could end up paying millions for gender care. About 70% of Idaho’s Medicaid program is federally funded.

Some who testified against the bill suggested it could have far more reach than intended by eliminating gender-affirming care even for privately insured residents living in rural areas with only state-funded medical centers.

Punishment for violating the law would include fines ranging from $300 to $10,000 and prison terms of one to 14 years.

At least 23 states, including Idaho, have passed laws banning care for gender-affirming minors. Some states have also considered policies that experts say make it harder for transgender adults to receive care, such as eliminating telehealth options or requiring repeated psychological exams for ongoing gender-affirmation treatment.

Major medical groups, including the American Medical Association and the American Academy of Pediatrics, oppose bans on gender-affirming care and have endorsed such care, saying it is safe when properly administered.

While courts have blocked enforcement of gender-affirming child care bans in Idaho, Montana and Arkansas, they have allowed enforcement in Alabama and Georgia.

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