California Scrambles for Emergency Funding to Preserve Gender-Affirming Care for Medi-Cal Youth

California lawmakers are seeking an emergency $10 million appropriation to keep gender-affirming care available to roughly 1,500 low-income children on Medi-Cal after a federal rule bars reimbursement for such services to minors. The rule is slated to take effect in October, giving the state only weeks to create a separate, state-only funding pathway. Without it, puberty blockers, hormones and related treatments could be interrupted.

Calmatters

The policy change stems from a Trump-administration rule announced in December and finalized this summer, which targets payments for gender-affirming services for youths. Advocates warned the state for eight months that a funding shortfall was imminent. In June, the state budget earmarked $56 million for gender-affirming services and reproductive health, but officials later removed language that would have dedicated any portion to a Medi-Cal backfill. The Department of Health Care Services, which runs Medi-Cal, has not clarified why the earmark was omitted, and a finance spokesperson said the administration is “aware of this particular issue” but offered no timeline.

Calmatters

Assemblymember Chris Ward, chair of the LGBTQ caucus, emphasized that Medi-Cal is the “lifeline” for low-income families needing this care. The Department of Finance declined to provide further details, directing inquiries back to the health agency.

Calmatters

• “They’re low-income Californians who need support arguably the most, and Medi-Cal is their lifeline to access that care,” — Assemblymember Chris Ward, Democrat, San Diego

Calmatters

• “In the end, not a penny of it is going to backfill Medi-Cal at all,” — Arne Johnson, organizer, Rainbow Families Action

Calmatters

• “It’s been very frustrating to see California say in many words that it’s supportive of trans people, and be so unprepared for something we all knew was about to happen,” — Arne Johnson, organizer, Rainbow Families Action

Calmatters

• “The bigger question is how is California going to ensure that whatever they set up is going to be available on Oct. 13 when these rules go into effect?” — Laura Sheckler, budget and policy director, California Primary Care Association

Calmatters