Bill to block trans Kentuckians from using Medicaid for gender-affirming health care now law
Kentucky Republicans voted to override the governor’s veto of a controversial bill that blocks the state’s Medicaid program from funding gender-affirming health care for transgender Kentuckians and rolls back the governor’s order restricting funding for the discredited practice of conversion therapy.
Republicans in the House and Senate voted along party lines Thursday to enact House Bill 495 over Democratic Gov. Andy Beshear’s veto. Because it has an emergency clause, it takes effect immediately.
The governor, in his veto message, said conversion therapy “has no basis in medicine or science, and causes significant long-term damage to our kids.”
Though he vetoed this measure, Beshear let a second GOP-backed bill to restrict trans people’s access to gender-affirming health care into law without his signature.
Senate Bill 2 prohibits trans people incarcerated in Kentucky from accessing gender-affirming health care. There were 67 trans inmates in Kentucky’s jails and prisons an attorney for the Justice and Public Safety Cabinet told lawmakers in January — a population that accounted for less than 1% of the total incarcerated population in the state.
When asked Thursday why he didn’t veto Senate Bill 2, too, Beshear said, because trans Kentuckians who aren’t incarcerated can’t use Medicaid to pay for gender-affirming surgeries, he doesn’t think “convicted felons” should have “better health care options than law-abiding citizens.”
House Bill 495, from Rep. David Hale, R-Wellington, initially sought to protect mental health professionals from discrimination for providing conversion therapy, a type of widely-discredited form of counseling attempting to change a person’s sexual orientation, gender identity or gender expression.
The bill would “ensure Kentuckians across the commonwealth have access to mental health care they choose, (and) it protects mental health care professionals . . . and ordained members of the clergy from discrimination when providing counseling services,” Hale said in early March.
The bill has changed shape since Hale filed it. That day, he swapped out and replaced the initial language with an order to overturn Democratic God. Andy Beshear’s 2024 executive order banning the use of tax dollars to pay for conversion therapy.
The bill was amended once more in a committee meeting the following week to additionally outlaw the use of Medicaid to pay for gender-affirming health care for transgender adults.
Eleven health care providers in Kentucky, including some who prescribe gender-affirming medication to trans adult patients, called the new law “inhumane” in a Herald-Leader op-ed column.
“Make no mistake — cutting off Medicaid funding is effectively prohibiting essential health care for most, if not all gender diverse Medicaid recipients. Many of our patients, as Kentucky citizens, who work multiple jobs to support themselves and their families, rely on Medicaid to provide for a full spectrum of healthcare services,” they wrote.
“Gender dysphoria and gender incongruence are conditions recognized by all major medical specialties and allied health organizations, as well as the International Classification for Diseases. Hormone therapy (and surgical therapy) for these conditions is evidence-based to improve mental health and reduce suicidal thoughts and actions.”
They added, “Government interference in personal medical decisions informed by health professionals with years of training . . . sets a very concerning precedent of usurping the autonomy of adult citizens who have the right to their own bodies, minds and health.”
The Family Foundation, a conservative Christian lobbying group that championed the bill, praised its final passage early Thursday evening as a “win for free speech, religious liberty and for fiscal and moral sanity.”
Beshear’s order on conversion therapy “directly attacked free speech and Christian convictions,” Family Foundation Executive Director David Walls said.
“Overturning this unconstitutional order ensures that Kentucky counselors and pastors can once again share the truth about God’s design for gender and sexuality.”
Walls praised the bill’s prohibition on Medicaid covering gender-affirming hormone therapy, because, “it’s not possible to change a person’s sex, and government has no place in promoting or subsidizing such madness.”
Nick Spencer, policy director for the Family Foundation, previously spoke in favor of the bill in a committee hearing, saying the worthwhile purpose of conversion therapy is to “fix what is broken.”
Trans Kentuckians and their allies rebuked this narrative, calling Walls and Spencer “absolute ghouls” and “fringe weirdos.”
“I’ve found myself comforting trans Kentuckians and their families who love this commonwealth with all they’ve got, but have been told by their government that this commonwealth does not love them back,” Lexington Councilwoman Emma Curtis, who is trans, told a crowd in the Capitol rotunda at a “trans joy party” and visibility march.
People like Walls, “want you to believe that you do not exist. But take a look around you,” Curtis said. “We exist. Our existence is not up for debate.”
Just before the House GOP voted to solidify the override, Lexington Democratic Rep. Chad Aull said, “We continue to pick on certain people across the commonwealth who are the least among us. This bill is not going to help anyone, but it is going to harm those in our society who are most vulnerable.”
