US HB498

Amends Title XIX of the Social Security Act to prohibit federal Medicaid payments for "specified gender transition procedures" for individuals under 18 years of age, including administrative costs of state programs providing such procedures

Prohibited procedures include over 20 types of surgeries (castration, hysterectomy, mastectomy, vaginoplasty, phalloplasty, facial feminization/masculinization surgeries, etc.), chest implants, gluteal implants, puberty-blocking drugs (GnRH analogues), and supraphysiologic doses of testosterone, estrogen, or progesterone

Exceptions permit Medicaid funding for treatment of precocious puberty, medically verifiable genetic disorders of sex development (such as chromosomal abnormalities), abnormal hormone production confirmed by genetic/biochemical testing, and treatment of physical disorders placing the individual in imminent danger of death or major bodily impairment

Additional exception allows procedures to restore the body to correspond with biological sex after previous gender transition procedures, including removal of pseudo phallus or breast augmentation

Passed the House of Representatives on December 18, 2025