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Idaho Legislature just banned using public funds or facilities for gender-affirming care

The Idaho State Capitol in Boise, Idaho, is seen on June 13, 2019.
Keith Ridler
The Idaho State Capitol in Boise, Idaho, is seen on June 13, 2019.

The GOP-led Idaho Legislature has passed a bill that would ban the use of any public funds for gender-affirming care, including for state employees using work health insurance and for adults covered by Medicaid.

The Senate overwhelmingly approved the measure Friday after it previously passed through the House. It will be sent to Republican Gov. Brad Little’s desk, where he is expected to sign it into law. The governor has said repeatedly he does not believe public funds should be used for gender-affirming care.

If the legislation is enacted, Idaho would become at least the 10th state to ban Medicaid funding for gender-affirming care for people of all ages, according to the advocacy and information organization Movement Advancement Project. The laws are part of an ongoing national battle over the rights of LGBTQ+ Americans.

The American Civil Liberties Union of Idaho in a statement Friday condemned the Senate’s decision.

“Idaho’s state senators have once again decided to cave in to the hateful demands of far-right extremists at the expense of the safety, security, and health of Idaho’s transgender community," the statement said, adding that lawmakers could simply choose to allow transgender people in Idaho to make their own medical decisions in peace.

The ACLU and other opponents of the Idaho bill say it almost certainly will lead to a lawsuit in federal court. The state is already embroiled in lawsuits over attempts to deny gender-affirming care to transgender residents and so far has not had much success defending them.

In one case, the state was ordered to provide a transgender inmate with gender-transition surgery, and the inmate was later awarded roughly $2.5 million in legal fees.

A federal judge barred Idaho last year from enforcing its newly enacted ban on gender-affirming medical care for minors until a lawsuit brought by transgender youth and their families is resolved. A different federal judge denied the state’s motion to dismiss a separate lawsuit filed by adults in 2022 who said Medicaid officials wrongly denied coverage for their medically necessary gender-affirming treatment.

“This bill violates the 14th Amendment equal protections clause” and the federal Medicaid Act, Boise attorney Howard Belodoff told lawmakers last week during a hearing.

One of the bill’s sponsors, Republican Rep. Bruce Skaug, described it as a taxpayer protection bill, suggesting that without it the state could end up paying millions for gender-affirming care. About 70% of Idaho’s Medicaid program is federally funded.

Some who testified against the bill suggested it could have a far larger reach than intended by eliminating gender-affirming care for even privately insured residents living in rural areas with only state-funded medical centers.

The punishment for violating the law would include fines ranging from $300 to $10,000 and imprisonment between one and 14 years.

At least 23 states including Idaho have passed laws banning gender-affirming care for minors. Some states also have considered policies that experts say make it more difficult for transgender adults to receive care, such as eliminating telehealth options or requiring repeated psychological examinations for continued gender-affirming treatment.

Major medical groups, including the American Medical Association and the American Academy of Pediatrics, oppose gender-affirming care bans and have endorsed such care, saying it is safe when administered properly.

While courts have blocked the enforcement of gender-affirming care bans for minors in Idaho, Montana and Arkansas, they have allowed enforcement in Alabama and Georgia.

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