Help Make Sure Trans Kids Get Medicaid in CA

The Centers for Medicaid and Medicare has published a rule banning Medicaid payments for gender affirming care for minors, and Rainbow Families Action is demanding that the CHHS and Governor Newsom act immediately to establish a state-only Medi-Cal billing pathway to ensure uninterrupted coverage for transgender youth before end of session, and for healthcare providers to continue gender-affirming care. 

The state must meet its legal and ethical obligation to continue this medically necessary care for all Medi-Cal patients, with no "granting" alternatives that risk disruption to care for patients or payments for providers on or after October 13, 2026.

We hold hospitals, health systems and state and city governments accountable for caring for our children. The federal government has made it clear they will try anything, no matter how illegal or unethical, to erase our families' existence. We need our state government to act with the same persistence, foresight and dedication on behalf of our children

Take Action!

Please contact the members of CHHS and the Governor’s office demanding a solid, legal plan for gender-affirming care before patients lose access on October 13th.

The following templates for email and telephone a can be copied and pasted, personalized or otherwise adapted. 

Please choose whichever way of reaching out feels most comfortable to you. MORE INFO at the bottom of this page if you want more context.

EMAIL TEMPLATES

1. Email the California Health and Human Services Agency

Please reach out to the following CHHS leadership to demand they establish a permanent state-only Medi-Cal billing pathway for gender affirming care minors.

• Corrin Buchanan — Corrin.Buchanan@CHHS.CA.GOV

• Kim Johnson — kim.johnson@chhs.ca.gov

Subject Line: Please Keep Gender Affirming Care for Youth within Medi-Cal! 

We are demanding that CHHS take immediate action to ensure that transgender minors are protected with a Medi-Cal billing pathway when a federal government rule attacking their care goes into effect October 13!

Despite the fact that new Medicaid rule to end federal coverage for Gender Affirming Care for children on October 13th has been in the works since last year, the state of California and the Department of Health Care Services do not have a plan for how to deliver this care without federal funding. 

The legislature allocated $1 Million for the purpose of setting up a Medi-Cal billing pathway, but DHCS did not proactively set up the state pathway to provide this care to Medi-Cal covered children. This care is required by CA state nondiscrimination law. Without decisive action, California's most vulnerable trans youth will lose their healthcare. 

The situation is dire, but we're being told that DHCS can't or won't set up this pathway by October 13 and are instead proposing to fund GAC for Medi-Cal youth under an interim grant program. This is not an acceptable option. I'm especially concerned that:

• If providers are unable to get reimbursed simply and easily through Medi-Cal, they may shutter their services. As we’ve learned, hospitals and clinics are already jumpy, looking to leave transgender minors in the cold at the first loud noise.

• Moving to a grant funding system dismantles protections for both providers and patients that are built into Medi-Cal. These include medical review, appeals for denials of care, and standards of care that protect providers (prior authorization, letters of medical necessity, etc.). Moving GAC for minors to a grant program would be a huge step backwards, wiping out decades of work to build coverage for these services.

GAC for minors is protected under state law. Setting a precedent to exclude benefits for a population opens the door to future illegal discrimination. If California takes an entire population out of Medi-Cal, the same can happen to other populations.

California covers many other services through state-only funds, keeping these patients and services protected under our Medi-Cal program. There is no reason for gender-affirming care to be excluded for transgender youth.

As transgender communities are aggressively being targeted by our federal administration, and access to this safe, medically-necessary care is rapidly eroding across the country, California must lead the way In preserving equitable access to this life saving care. We are counting on CalHHS to take a stand and firmly protect healthcare for trans youth within our Medi-Cal program.

Anything but a state-only Medi-Cal billing pathway greatly risks disrupting continuity of care, and sets a dangerous precedent for care exclusions based on discriminatory political pressure. Any bandaid that results in a gap in health care services for our state's most vulnerable is unacceptable.

Children are counting on you to fix this problem.

2. Email the Governor’s Office

Ask the Governor’s Office to support the emergency $10 million appropriation and commit to developing a sustainable state-only reimbursement pathway:

• Paula Villescaz — Paula.Villescaz@gov.ca.gov

• Richard Figueroa — Richard.Figueroa@GOV.CA.GOV

Subject Line: Please Protect Gender Affirming Care for Medi-Cal Youth! 

We are demanding that CHHS take immediate action to ensure that transgender minors are protected with a Medi-Cal billing pathway when a federal government rule attacking their care goes into effect October 13!

Despite the fact that new Medicaid rule to end federal coverage for Gender Affirming Care for children on October 13th has been in the works since last year, the state of California and the Department of Health Care Services do not have a plan for how to deliver this care without federal funding. 

The legislature allocated $1 Million for the purpose of setting up a Medi-Cal billing pathway, but DHCS did not proactively set up the state pathway to provide this care to Medi-Cal-covered children. This care is required by CA state nondiscrimination law. Without decisive action, California's most vulnerable trans youth will lose their healthcare. 

The situation is dire, but we're being told that DHCS can't or won't set up this pathway by October 13 and are instead proposing to fund GAC for Medi-Cal youth under an interim grant program. This is not an acceptable option. I'm especially concerned that:

• If providers are unable to get reimbursed simply and easily through Medi-Cal, they may shutter their services. As we’ve learned, hospitals and clinics are already jumpy, looking to leave transgender minors in the cold at the first loud noise.

• Moving to a grant funding system dismantles protections for both providers and patients that are built into Medi-Cal. These include medical review, appeals for denials of care, and standards of care that protect providers (prior authorization, letters of medical necessity, etc.). Moving GAC for minors to a grant program would be a huge step backwards, wiping out decades of work to build coverage for these services.

GAC for minors is protected under state law. Setting a precedent to exclude benefits for a population opens the door to future illegal discrimination. If California takes an entire population out of Medi-Cal, the same can happen to other populations.

California covers many other services through state-only funds, keeping these patients and services protected under our Medi-Cal program. There is no reason for gender-affirming care to be excluded for transgender youth.

As transgender communities are aggressively being targeted by our federal administration, and access to this safe, medically-necessary care is rapidly eroding across the country, California must lead the way In preserving equitable access to this life saving care. We are counting on CalHHS to take a stand and firmly protect healthcare for trans youth within our Medi-Cal program.

We are asking the Governor to support the reimbursement pathway. Anything but a state-only Medi-Cal billing pathway greatly risks disrupting continuity of care, and sets a dangerous precedent for care exclusions based on discriminatory political pressure. Any bandaid that results in a gap in health care services for our state's most vulnerable is unacceptable.

Children are counting on you to fix this problem.

MAKE A CALL

1. Call the California Health and Human Services Agency And Governor’s Office

• Corrin Buchanan, CHHS (916) 654-3454

• Kim Johnson, CHHS (916) 324-9775 

• Paula Villescaz, Gov’s Office — (916) 445-2841

• Richard Figueroa, Gov’s Office —(916) 445-2481

Despite the fact that new Medicaid rules to end federal coverage for Gender Affirming Care for children on October 13th have been in the works since last year, the state of California and the Department of Health Care Services have failed to create a Medi-Cal billing pathway to seamlessly provide this funding. 

• If providers are unable to get reimbursed simply and easily through Medi-Cal, they may shutter their services. As we’ve learned, hospitals and clinics are already jumpy, looking to leave transgender minors in the cold at the first loud noise.

• Moving to a grant funding system dismantles protections for both providers and patients that are built into Medi-Cal. These include medical review, appeals for denials of care, and standards of care that protect providers (prior authorization, letters of medical necessity, etc.). Moving GAC for minors to a grant program would be a huge step backwards, wiping out decades of work to build coverage for these services.

Without quick action, come October 13, families receiving Medi-Cal may not be able to access Gender Affirming Care at all. These are families that can't pay out of pocket, even if they desperately need this essential health benefit. Continuity in treatment is particularly important in Gender Affirming Care for patient well-being and mental health. Disruptions in care would be devastating for youth and their families.

Anything but a state-only Medi-Cal billing pathway greatly risks disrupting continuity of care, and sets a dangerous precedent for care exclusions based on discriminatory political pressure. Any bandaid that results in a gap in health care services for our state's most vulnerable is unacceptable.

(this is why the issue is important to me)

We’re counting on you to make this right for Medi-Cal recipients.

Additional Information

Grant Program Erodes Security of GAC for Transgender Youth

This approach provides only one year of funding, removes patient and provider protections, and introduces the burden of an entirely new program structure outside of Medi-Cal that could reduce the number of providers statewide. These hurdles threaten the care for families of trans youth who count on Medi-Cal support.

Medicaid is an entitlement program: 

• anyone who is income-eligible is entitled to Medicaid

• full range of services

• no cap to cost or type of services - money doesn’t run out for services

• no “using up” benefits

A Grant Program Sets a Dangerous Precedent

• Removing these services for transgender youth undermines and endangers youth access to care statewide

• Grant funding doesn’t guarantee ongoing annual funding - requires yearly renewal through the state budget process

• Amounts could vary by year or circumstances, or go unfunded

• Eliminates the infrastructure that has been built over decades, based on the international standards of care (WPATH “SOC 8”)

• Sets a precedent in targeting and excluding care for a specific population; other politically targeted services or populations could be excluded from Medi-Cal in the future

Our Ask

Many families who rely on Medi-Cal for GAC are out of options; they are at immediate risk of losing care in less than eight weeks.

Rainbow Families Action asks that the DHCS and the Governor act immediately to establish a state-only Medi-Cal billing pathway to ensure uninterrupted coverage for transgender youth before end of session, and for healthcare providers to continue gender-affirming care. 

We demand that the state meet its legal obligation to continue this medically necessary care for all Medi-Cal patients, with no disruption to care for patients or payments for providers on or after October 13, 2026.

We hold hospitals, health systems, and state and city governments accountable for caring for our children. The federal government has made it clear they will try anything, no matter how illegal or unethical, to erase our families' existence. We need our state government to act with the same persistence, foresight and dedication on behalf of our children.