Trump's proposed budget for 2026 eliminates health insurance coverage for transgender federal employees

The Trump administration's fiscal 2026 budget proposal includes a provision to end the federal workforce's insurance coverage for gender affirming care, marking an escalation in its efforts to restrict such care for public servants.

The proposal, published on Friday, states that no funds can be used for gender affirming care in the Federal Employees Health Benefits program (FEHBP), including surgical procedures or hormone therapy. This move follows the Office of Personnel Management's (OPM) instruction to insurance carriers to cease covering gender affirming care for FEHBP beneficiaries under the age of 19 by 2026, a decision made in February.

The budget proposal's provision against gender affirming care is among a list of government-wide provisions in a 1,200-page appendix. It is not the first time the Trump administration has shown hostility towards trans public servants. Since January, the administration has moved to ban trans people from serving in the U.S. military, leading to the ousting of more than 4,000 current service members.

The House Republicans made a late change to their budget reconciliation package, expanding the ban on funds for pediatric and adult gender affirming care. The initial budget reconciliation package barred Medicaid or CHIP funds going toward pediatric gender affirming care, but the change now includes a ban for adults as well.

The FEHBP has covered gender affirming care treatments since 2016, when the OPM prohibited insurance carriers from excluding services or drugs to treat gender dysphoria from FEHBP coverage. However, the Trump administration's actions against gender affirming care extend beyond just the FEHBP, as they have also moved to ban trans people from serving in the U.S. military.

It is unclear which authority discontinued the federal employee health package insurance cost estimates for gender-affirming treatments on the instructions of the Trump administration's fiscal year 2026 program. There are no search results indicating this information.

In 2019, the Trump administration's actions against gender affirming care for public servants marked an escalation in its efforts to restrict such care for public servants. In 2016, the OPM had prohibited insurance carriers from excluding services or drugs to treat gender dysphoria from FEHBP coverage. However, the recent actions by the administration have further limited the availability of gender affirming care for public servants.

The budget proposal does not provide coverage for gender affirming care for FEHBP beneficiaries. This means that trans public servants may face significant barriers in accessing the care they need. The full impact of the budget proposal's provision against gender affirming care is yet to be seen, but it is clear that the Trump administration's actions have had a significant impact on the lives of trans public servants.

Trump's proposed budget for 2026 eliminates health insurance coverage for transgender federal employees