December 18, 2025 · House · RC 362

Do No Harm in Medicaid Act

House Bill, H.R. 498

What it did

The Do No Harm in Medicaid Act, sponsored by Rep. Dan Crenshaw (R-TX), prohibits federal Medicaid and Children's Health Insurance Program (CHIP) payment for gender-transition care for anyone under 18. The exceptions are narrow (early puberty, genetic disorders, reversal of earlier procedures, or treatment to prevent death or loss of a major bodily function).

The ban falls only on families who rely on public coverage, since families who can pay privately are untouched. The American Academy of Pediatrics and the American Psychiatric Association oppose blanket bans of this kind because the young people affected carry sharply elevated rates of depression and suicide attempts when care is cut off.

The CBO scored the bill as saving $445 million over ten years. A yes vote imposed the ban.

A no vote kept the decision between a child, a parent, and a doctor.

The House passed it 215-201 on December 18, 2025 (Roll Call 362), with Republicans 211-0 and Democrats 4-201.

At the time of this vote, about 38 million American children were insured through Medicaid and CHIP.

Result: Passed 215-201

At the time of this vote: ~38,000,000 US children insured through Medicaid and CHIP; 2,000,000 fewer kids on Medicaid since Trump took office

The humane vote: No (NAY)

Official roll-call record

Members in this record who voted inhumanely (208)

Members in this record who voted humanely (197)