BOISE, Idaho – Idaho lawmakers are expected to vote this week on a bill that would ban the use of any state funds for gender-affirming care, including for state workers using occupational health insurance and adults covered by Medicaid.
The bill has already passed the House of Representatives and only needs to clear the Republican Senate majority before being sent to Gov. Brad Little’s desk, where it is likely to be signed into law. The Republican governor has repeatedly said he does not believe public funds should be used for gender-affirming care.
If the legislation goes into effect, Idaho would become at least the 10th state to ban Medicaid funding for gender-affirming care for people of all ages, according to the Movement Development Project. It’s part of an ongoing national battle over the laws Rights of LGBTQ Americans.
Opponents of the Idaho bill say it would almost certainly lead to a lawsuit in federal court. The state has already been sued multiple times for trying to deny gender-affirming care to transgender residents, and so far hasn’t had much success defending the lawsuits.
In one case, the state a. assigned to provide transgender prisoner underwent gender reassignment surgery, and the inmate was later awarded nearly $2.5 million in legal fees.
Last year, a federal judge barred Idaho from enforcing the newly enacted ban sex-affirming medical care for minors until a lawsuit filed by transgender youth and their families is resolved. A different federal judge denied the state’s 2022 request to dismiss a separate lawsuit brought by adults who say Medicaid officials wrongly denied them coverage for medically necessary sex-affirming treatments.
“This bill violates the equal protection clause of the 14th Amendment” and the federal Medicaid Act, Boise attorney Howard Belodoff told lawmakers during a hearing Thursday.
Belodoff represents transgender adults suing the state over discriminatory Medicaid policies that exclude coverage for genital reassignment surgery.
“You can’t differentiate care based on diagnosis, type of disease or condition,” Belodoff said. “This bill is just that: It violates the Medicaid Act.”
One of the bill’s sponsors, Republican Rep. Bruce Skaug, said those allegations prompted the creation of the bill.
“This is a taxpayer protection bill in my opinion,” Skaug said, suggesting the state could be paying millions for gender-affirming care without it. About 70% of the Idaho Medicaid program is federally funded.
Some who testified against the bill suggested it could have broader coverage than intended by eliminating gender-affirming care only for privately insured residents in rural areas with publicly funded medical centers.
Isaac Craxtten of the Idaho Department of Corrections noted that many corrections officers work 12- to 16-hour shifts, which may require them to take certain prescribed medications, such as hormone therapy, while on the job.
But the legislation prohibits the use of any state property, facility or building for surgical procedures or medical interventions, which would mean employees could face criminal penalties for taking their legally prescribed medication in the break room, Craghten said.
Penalties for violating the law include fines of $300 to $10,000 and one to 14 years in prison.
At least 23 states, including Idaho, have passed laws banning it gender-affirming care for minors. Some states too reviewed policies experts say it will be more difficult for transgender adults to take care of elimination of telehealth options or repeated psychological examinations are required for continued gender-affirming treatment.
Major medical groups including the American Medical Association American Academy of Pediatricsopposes bans on gender-affirming care and affirms that such care is safe when administered properly.
The courts prevented its implementation gender-affirming care bans Idaho, Montana and minors Arkansasthey authorized enforcement in Alabama and Georgia.