Trump directed Mehmet Oz, the television physician and former Senate candidate who now serves as Administrator of the Centers for Medicare and Medicaid Services, to end Medicaid funding for gender transition procedures for minors, per Fox News’s confirmed reporting today. The directive puts Dr. Oz in charge of executing a significant Medicaid policy change affecting an unknown number of minors across the country who currently receive transition-related care through the program that covers one in five Americans, administers $900 billion in annual spending, and is now run by the former host of “The Dr. Oz Show.”
Oz’s CMS appointment was one of the more unusual confirmations of Trump’s second term. He is a cardiothoracic surgeon with genuine medical credentials, an Emmy Award, and a history of promoting supplements, alternative treatments, and health products on television that the medical and scientific communities have repeatedly characterized as lacking sufficient evidence. A 2014 congressional hearing featured Sen. Claire McCaskill telling Oz that his promotion of products as “miracles” and “magic” was “not a scientific community.” He agreed, in that hearing, to be more careful. His television show continued. His Senate race in Pennsylvania, which he lost to Sen. John Fetterman in 2022 despite Trump’s endorsement, produced an extensive examination of his product endorsements and residency claims. Trump then made him the administrator of the agency that runs Medicare and Medicaid.
The gender transition funding directive positions CMS as a policy actor on the cultural issues that have defined the Republican domestic agenda since at least 2022. The prohibition on transition care for minors is the law in more than twenty states, following a wave of legislation that the Supreme Court has partially upheld. The Medicaid directive extends the federal government’s reach into this area beyond the states that have already legislated it, using the mechanism of funding conditions rather than direct prohibition. States that receive Medicaid funding are required to comply with federal Medicaid regulations, which gives CMS substantial leverage over state medical practice even in states that have not passed their own restrictions.
The practical question is how many minors currently receive transition-related care through Medicaid, what that care consists of, and what happens to those patients when the funding is removed. Medicaid covers low-income populations including many minors in households that would have no other coverage for the affected procedures. CMS has not published an estimate of the affected population. Oz has not publicly addressed the directive’s implications for currently receiving patients. The directive was issued. The coverage change will follow.
El-Sayed, the Democratic Senate nominee in Michigan who is running against Rogers in November, supports expanding gender-affirming care coverage. Oz is the administrator eliminating it from Medicaid. Both are physicians. They have reached different conclusions about what their medical training implies for policy.
When the television doctor who sold miracle cures eliminates Medicaid coverage for a medical procedure, what exactly is the policy based on?
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