Democrats demand taxpayers fund transgender surgeries to keep Obamacare alive
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Lost in the debate over extending Obamacare’s enhanced subsidies are specific treatments and services subsidized by federal money. President Donald Trump acknowledged as much recently, posting on social media that Senate Democrats would “force taxpayers to fund transgender surgery for minors.” Indeed, continuing to enhance Obamacare subsidies would provide additional taxpayer dollars to insurance plans covering procedures that many Americans find morally wrong.
According to the Movement Advancement Project, 24 states require insurers to cover transgender procedures. For example, its Division of Insurance notes that in 2023, “Colorado became the first state in the nation to explicitly include gender-affirming care services in its benchmark health insurance plan for essential health benefits.” A spreadsheet lists the services offered: All individual and small group plans in Colorado cover nose reshaping, “facial feminization surgery” and implantation of testicular prostheses, among many other genital and non-genital surgeries. Nowhere on its website does Colorado indicate that such surgeries can only be offered to enrollees over the age of 18.
In states that require coverage for transgender procedures, all Exchange enrollees purchase this coverage with their plan. Subsidies offsetting premium costs for most enrollees represent federal dollars funding transgender treatments. And Senate Democrats’ proposed spending bill, which would permanently extend a subsidy increase first passed in 2021, represents forced taxpayer funding of gender reassignment procedures, as the president noted.
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In June, the Trump administration attempted to limit federal funding for transgender procedures, removing “specified sexual trait modification procedures” from Obamacare’s essential health benefits. But this regulatory measure has inherent limitations. For starters, as the rule itself admitted, removing these procedures from essential health benefits would only shift costs from the federal government to the respective states; taxpayers would still fund care, although at the state rather than federal level. Even this scenario depends on the rule taking effect despite legal challenges. If the rule is enforced, a future Democratic administration will almost certainly withdraw it upon taking office.
And blue states continue to use federal Obamacare subsidies to advance the transgender agenda, despite the Trump administration’s actions. A California law that took effect in March requires insurance plans and medical providers to complete “cultural competency training.” Training sessions must address “the distinction between personal values and professional responsibilities” in terms of transgender approaches.
The sessions, which focus on “the lasting impact of historical and contemporary exclusion, microaggressions and oppression” on the transgender community, also require “facilitation by [transgender, gender diverse, or intersex]- at the service of organizations. »Forcing insurance company personnel to participate in this type of indoctrination under the auspices of “cultural competency training” not only violates the First Amendment and federal conscience protections surrounding sterilization procedures. It also amounts to a transfer of funds, through insurers’ receipt of Obamacare subsidies, from federal taxpayers to groups promoting ideological goals.
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In many ways, the debate over Obamacare subsidies represents a repeat of last year’s presidential campaign. In tying the expansion of Obamacare’s enhanced subsidies to government spending legislation, Senate Democrats are also emphasizing, as the president put it, “strength.”[ing] “Taxpayers will fund transgender surgery for minors” as the price of reopening the government. They are doing so even though Kamala Harris admitted that Trump’s famous ad during last year’s campaign represented a “winning message” for the former and future president.
The wording of this ad – “Kamala Harris is for them, President Trump is for you” – now defines the stakes. Republicans can extend Obamacare’s enhanced subsidies or refuse to dedicate more public funds to the transgender program. Which side will they choose?
