RFA Endorses Essential Budget Ask for GAC

Rainbow Families Action, knowing we are in a desperate fight for our children’s authentic selves, supports all the tools available for all kids. Our friends at EQCA and other organizations are putting forward a budget that will help backfill the gaps that the federal government is opening up in the care of our children. We heartily support this effort. As EQCA states:

To prevent further collapse of California’s gender-affirming care delivery system and ensure compliance with state law, we respectfully request a $26 million one-time General Fund appropriation to establish a state-backed continuity and provider stabilization framework. This investment would provide immediate, time-limited support to maintain access to care while federal uncertainty persists:

State-Only Medi-Cal Coverage and Billing Pathway — $1 Million

Enable DHCS to establish a state-only Medi-Cal coverage and reimbursement pathway for gender-affirming care separate from federal financial participation. This would include claims submission processes, audit protections, and administrative guidance to ensure providers can continue delivering medically necessary, legally protected care to Medi-Cal beneficiaries without fear of federal enforcement. This pathway is essential to maintain continuity of care for Medi-Cal beneficiaries and prevent further erosion of the provider network.

Provider Network Stabilization and Uncompensated Care Grants — $25 Million

Provide targeted grants to stabilize, rebuild, and expand California’s gender-affirming care provider network, particularly for transgender youth, while offsetting the growing burden of uncompensated care caused by recent federal actions. Funding would be distributed using geographic equity considerations to ensure resources reach providers serving both rural and urban communities and address regional gaps in care. Allowable uses of funds would include:

● Staffing, infrastructure, and capacity support to sustain and scale care delivery;

● Operational support for clinics and community health centers absorbing displaced patients;

● Targeted malpractice insurance support for providers who opt to open stand-alone clinics, addressing a major financial barrier to entry and expanding access to care outside of hospitals;

● Workforce recruitment and retention in a high-risk care environment; and

● Reimbursement for uncompensated care delivered to individuals earning up to 400 percent of the federal poverty level who are enrolled in health plans with coverage exclusions.

This one-time, narrowly targeted investment would serve as a critical bridge to stabilize California’s gender-affirming care delivery system—preventing irreversible provider withdrawals, protecting patients from dangerous gaps in care, and ensuring continued compliance with California’s nondiscrimination and coverage mandates.