A divided House on Wednesday passed a defense policy bill that would direct $883.7 billion to the Pentagon and other military operations, moving over the opposition of Democrats who objected to a provision denying coverage for transgender health care for the children of service members.
Republicans banded together to support the annual defense measure, which included a 14.5 percent pay raise for junior enlisted service members. But many Democrats refused to back the normally bipartisan legislation, chiding the G.O.P. for including the limitation on transgender care, which they argued was discriminatory and politically motivated.
The provision in question would bar TRICARE, the military’s health care plan, from covering “medical interventions for the treatment of gender dysphoria that could result in sterilization” for children under 18.
“We banned TRICARE from prescribing treatments that would ultimately sterilize our kids,” Speaker Mike Johnson, Republican of Louisiana, told reporters this week. The speaker insisted at the last minute that he would not bring a defense bill to the floor without the provision, according to aides who spoke on the condition of anonymity to discuss private negotiations.
But Democrats argued that the measure was too draconian. They also said that the language was dangerously broad, and might be used to deny minors treatments to deal with the anxiety, depression and suicidal ideation that many transgender children experience.
“We are doing it because of ignorant, bigoted reasons against the trans community,” Representative Adam Smith of Washington, the top Democrat on the Armed Services Committee, said on the House floor, adding that the provision “taints an otherwise excellent piece of legislation.”
The vote was 281 to 140, with 124 Democrats and 16 Republicans voting against the bill.
Republicans had pressed for a far more expansive ban on transgender health care coverage, pushing through legislation in June that would deny such treatment for service members or anyone covered under the military’s insurance plan. The provision was narrowed in negotiations with the Democratic-led Senate, which is expected to take up and pass the measure in the coming days.
But the fact that it survived to be included in the measure was a departure from previous years, when Republicans and Democrats strove to keep contentious social issues out of the defense bill altogether. The break with tradition, both Republican and Democratic aides said, reflected the G.O.P.’s sweeping election wins, which handed the party full control of Congress and President-elect Donald J. Trump a second term.
Some Republicans expressed discomfort about the move. Representative Mike Rogers, Republican of Alabama and the chairman of the Armed Services Committee, questioned why it was necessary to include the provision at all when Mr. Trump was already planning to bar all federal coverage of transgender care upon taking office.
“I don’t know why this is in the bill when on Jan. 20, it’s a moot point,” he told reporters, adding, “This stuff does not belong in our bill.”
During Wednesday’s floor debate, Mr. Rogers made no mention of the provision, calling the defense policy legislation “a good bill, a fair compromise.”
Senate Democrats beat back a number of other conservative social policy changes demanded by Republicans. The final defense bill omitted House-passed provisions limiting access to abortion services and pared back restrictions on the Pentagon’s diversity, equity and inclusion programs, though it did impose a one-year hiring freeze for positions related to those programs.
House Republican leaders also insisted on dropping a provision to expand access to in vitro fertilization that had been included in both the House’s and the Senate’s initial versions of the bill. In vitro fertilization is currently available to service members only if their infertility issues were caused by illnesses or injuries sustained while on active duty. Lawmakers had sought to allow coverage for I.V.F. treatments regardless of why they were needed.
Mr. Johnson intervened to kill the expansion, according to aides familiar with the negotiations, despite Republicans’ election-season pledges to protect access to I.V.F., and Mr. Trump’s campaign trail promise to force insurance companies to cover such treatments for all Americans.
Some Democrats expressed concern that the provision concerning transgender minors — and the fallout over it — threatened to overshadow the other parts of the bill, which sets policy and pay levels, and directs priorities for the Defense Department’s nearly three million military and civilian employees.
“This is the most important piece of legislation of the entire 118th Congress, and with this bill in law our nation will be more secure, our servicemen and women more resolved to face the global challenges of tomorrow,” Representative Chrissy Houlahan, Democrat of Pennsylvania, said on the House floor. She said she would support the bill despite her “severe disappointment in those colleagues who chose to sully this bill” with the provision on transgender children.
The bill includes a 14.5 percent pay raise for junior enlisted service members and a 4.5 percent pay raise for all other service members.
It also authorizes a Taiwan Security Cooperation Initiative, modeled after a similar program dedicated to improving Ukraine’s military preparedness, that would help Taipei shore up its ability to defend against a potential invasion by China.
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