Trump’s new trans care Medicaid cuts leave poor families asking blue-state governors: Where’s the plan?

Toby’s grandmother helps pay for his testosterone. His mother, Melinda, is trying to preserve the appointments, blood tests, and medical supervision that make his treatment possible.Toby, a 16-year-old honor student who plays volleyball and loves to cook, is also transgender. He has lived as a boy since he was 7. He went through male puberty. His friends, other boys from school, don’t even consider that he’s trans. On Tuesday, as the Trump administration’s restrictions on federal funding for trans young people’s care took effect, his mother was trying to protect the life he has built.“That means they’re forcing my son to detransition because I am poor,” she told The Advocate. “I don’t have the income level to get private health insurance for my son.”The family’s names have been changed to protect their privacy. The Advocate is also withholding the name of the treating hospital.The rule restricts federal Medicaid and Children’s Health Insurance Program funding for gender-affirming treatments. States can still pay for those services themselves, putting pressure on governors to turn promises of protection into coverage.Related: 21 states sue over Trump’s attacks on gender-affirming care insurance coverageWhat the federal cutoff meansEffective October 13, the Trump administration prohibits federal reimbursement for specified gender-affirming treatments, including puberty blockers, hormone therapy, and surgery, for Medicaid beneficiaries younger than 18 and beneficiaries of separate CHIP programs younger than 19.States may continue claiming reimbursement for hormone therapy medications for up to six months for patients already receiving them as of Tuesday. The administration describes this as a tapering period. It excludes puberty blockers, surgeries, and new hormone therapy patients. Federal funding for mental health counseling and psychotherapy remains available.The rule does not immediately terminate every service or prohibit doctors from p