Republican lawmakers are under increasing pressure from the White House to ensure that they block federal funding from going towards gender-affirming care for transgender people, as Congress works through the appropriations process.
The GOP frantically passed President Donald Trump’s reconciliation bill but without a provision that would have banned Medicaid from covering gender-affirming care due to the Senate’s budget rules. Conservatives had hoped that would have been the start of federal restrictions on care for transgender people and now, all eyes are on appropriators to put a ban in place through the process funding the government.
Now, at least six House appropriation bills for the 2026 fiscal year contain provisions to ban federal money from supporting gender-affirming care.
“The president is very committed to this and, as far as I know, the Republicans in the House … are very committed to this,” Rep. Robert Aderholt, chair of the Appropriations Subcommittee on Labor, Health and Human Services and Education, told NOTUS. “I don’t think that’s an issue that’s really negotiable.”
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A senior administration official pointed to the president’s 2026 budget proposal, to suggest that the ban is indeed a priority for Trump, as it contains a clause saying that no appropriated funds “may be used for social transitioning, or for drugs or surgery that alter bodily sex traits as interventions for gender dysphoria.” It also contains a provision to explicitly end federal workers’ insurance coverage of gender-affirming care.
Appropriations Chair Tom Cole — and other House GOP appropriators — directed NOTUS to Aderholt, for questions around gender-affirming care funding restrictions.
Lawmakers haven’t passed all 12 appropriation bills since 1997. While some of the bills have been written to include a gender-affirming care ban, restrictions on transgender care have never made it into the continuing resolutions Congress typically adopts to keep the government funded. But with a GOP majority and a White House that considers the issue essential, Aderholt said he’s committed to getting a provision into a broader appropriations bill, be it a continuing resolution or an omnibus.
“We want to see the prohibition in there,”Aderholt said, adding that it would be an “anomaly” in a possible 2026 continuing resolution.
But unlike reconciliation bills, which only need a simple majority in the Senate to pass, appropriations bills require 60 votes — and bipartisan support. Aderholt said that it’s “possible” that gender-affirming care funding bans would not be a major roadblock for Senate Democrats, considering polls show that the issue is relatively unpopular. (A May AP-NORC poll found that most adults “oppose public health insurance coverage for gender affirming care”.)
Other House appropriators, however, are not so sure. Rep. Mario Díaz-Balart told NOTUS that even with pressure from the Trump administration to defund gender-affirming care, “we can’t get everything because it requires 60 votes.”
“Look, if you ask the American people, ‘Should a biological man be able to go to a women’s bathroom, that’s a 95% issue, right?,” Díaz-Balart said. “But again, to get that passed, it still requires 60 votes.”
In a letter to Senate Appropriations Chair Susan Collins, Office of Management and Budget Director Russell Vought proposed cutting multiple administration projects that, he argued, support a “radical gender ideology.” If an appropriations bill with a gender-affirming care funding ban were to pass, it would mark the first anti-trans legislation to pass in the 119th Congress.
Collins told NOTUS that gender-affirming care funding “hasn’t even been discussed in any discussion I’ve had with either Democrats or Republicans,” but the restrictions already have hit some roadblocks in the chamber.
The Senate Appropriations Committee has approved six appropriations bills so far. The House versions of two of those bills had funding restrictions on gender-affirming care, but the Senate bills left those out. Senators said House GOP riders were not added to ensure they pass the committee in a bipartisan manner.
The Fiscal Year 2026 Military Construction, Veterans Affairs, and Related Agencies Appropriations Act — which advanced on a 90-8 procedural vote last week — originally had a clause would have prohibited federal funds that were allocated for the Departments of Defense and Veterans Affairs from being used on “surgical procedures or hormone therapies for the purposes of gender affirming care,” but the provision was taken out.
“We produced a bill that I think can get overwhelming bipartisan support in the Senate,” Democratic Sen. Jon Ossoff, Appropriations MilCon-VA Subcommittee ranking member, told NOTUS. “Military quality of life and national security shouldn’t be about partisan culture war issues, it should be about our national interests.”
The House version of the Fiscal Year 2026 Commerce, Justice, Science, and Related Agencies Appropriations Act also has a clause banning the use of federal funds to sue states with anti-trans laws in place. However, the Senate’s version lacks the provision.
Democratic Appropriations Vice Chair Patty Murray said in a statement to NOTUS that Republicans are trying to “hijack our bipartisan appropriations bills to attack trans people and rip away their health care.”
“I’ll fight tooth and nail to prevent new poison pill riders from being added into our appropriations bills, let alone any harmful rider that would rip away access to gender-affirming health care for people who need it,” Murray added.
Sen. Chris Murphy, another Senate appropriator, said that there has “generally been an understanding” that these “riders can’t survive the Senate.”
“Senate [Democrats] are not going to vote for these partisan House riders,” Murphy added.
But some Senate Republicans are leaving the door open for those restrictions to come back once the bills head to the floor.
“The Senate is different than the House in the sense that it’s not majority rules, we need 60 votes to get it passed, and even in our committee itself, … it would be difficult to even pass it out of committee to go forward,” said Sen. John Boozman, who chairs the Appropriations MilCon-VA Subcommittee.
“What we’ve always said in the past is, you know, let’s not do that in committee. … If somebody wants to bring one of those amendments to the floor for us to vote, well, we all vote on it,” Boozman continued. “The idea is to get it on the floor and then, you know, let the will of the entire Senate work.”
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