Inside the Democratic Effort to Kill the GOP’s Gender-Affirming Care Restriction in Reconciliation

Democrats are having a hard time figuring out how to message on trans issues — but they quietly killed a provision in the reconciliation bill that would have restricted access to gender-affirming care.

Sarah McBride
Rep. Sarah McBride gives her farewell speech on the Senate floor during a Special Session at the Delaware Legislative Hall in Dover, Delaware. Carolyn Kaster/AP

When Republicans added a provision to their reconciliation bill last month that would prevent Medicaid funds from being used to cover gender-affirming care, they thought it was a done deal. Democrats had been struggling to communicate on transgender issues since the 2024 election, so the likelihood that they would oppose it, GOP lawmakers thought, was low.

“Deep down, they know they’ve lost the issue,” Rep. Dan Crenshaw, who led the provision in the House, told NOTUS at the time.

But Democrats in Congress — led by Rep. Sarah McBride and Sen. Tammy Baldwin, whose involvement was first reported by journalist Katelyn Burns — worked quietly for weeks with trans rights advocates to keep the Senate Democratic caucus coalesced around opposing the provision and to get the Senate parliamentarian to strip the ban from the bill.