The Trump administration is studying whether it has the authority to kick children’s hospitals out of Medicaid if they provide gender-reassignment surgery to patients under 18.
Mehmet Oz, the celebrity doctor that President Donald Trump tapped to head the Centers for Medicare and Medicaid Services, sent a letter to nine children’s hospitals demanding data related to sex-reassignment surgeries, hormone therapy and puberty blockers.
“President Trump has been clear: America will protect kids from life-altering and experimental procedures,” Oz wrote. “CMS has warned hospitals and state Medicaid programs about these dangers—and is taking regulatory enforcement actions.”
The letter provided a 30-day response deadline that passed Saturday, prompting the administration to look for ways to cut off funds to the hospitals, The Wall Street Journal reported.
The letter didn’t threaten any specific actions against the hospitals, but CMS officials told the Journal they think they can stop funding gender treatments for minors through Medicaid and Marketplace insurance plans.
The agency is also reviewing whether it can kick the hospitals out of Medicaid entirely if they don’t stop providing the surgeries, according to the Journal.
The Daily Beast has reached out of the Department of Health and Human Services for comment.
Hospitals in Boston, Los Angeles and Seattle told CMS they would respond the letter but haven’t done so yet, sources told the Journal. Two other hospitals in Colorado and Ohio also told the paper they planned to respond.
The letter has put the hospitals in a bind because many children’s hospitals are financially dependent on Medicaid.
Children’s Hospital of Los Angeles receives 65 percent of its annual revenue from federal sources and was forced to close its gender-related care program in response to the Trump administration’s threats, according to the Journal. Otherwise, it was at risk of shutting down.
“The hospital has been left with no viable path forward,” hospital leaders wrote in a June 12 letter to staff.
Other hospitals are being forced to navigate thorny legal issues.
In January, the White House issued an executive order saying the U.S. would no longer “fund, sponsor, promote, assist or support the so-called ‘transition’ of a child from one sex to the other.”
But some states’ laws—including Massachusetts’—requires hospitals to provide gender-affirming care.
“We uphold this responsibility with the utmost seriousness,” a spokesperson for Boston Children’s Hospital told the Journal. The hospital is still reviewing the recent CMS letter.
The Daily Beast has asked HHS what legal authority would potentially allow CMS to kick the hospitals off of Medicaid despite the state laws, and whether that authority would extend to abortion and other politically divisive medical issues.
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