Trump’s fiscal 2026 budget would strip trans federal workers of insurance coverage

The Trump administration continued its campaign against LGBTQ+ Americans, when its budget proposal for fiscal 2026, published in full Friday, included a provision to end the federal workforce’s insurance coverage for gender affirming care.

The White House first released its “skinny” iteration of the budget earlier this month. In the 1,200-page appendix released Friday, the proposal appeared among a laundry list of government-wide provisions.

“None of the funds made available by this act or any other act may be provided for insurance plans in the Federal Employees Health Benefits program to cover the cost of surgical procedures or puberty blockers or hormone therapy for the purpose of gender affirming care,” the budget states.

The proposal marks an escalation of the administration’s hostility toward trans public servants. Since taking office in January, the Trump administration has moved to ban trans people from serving in the U.S. military, including the ouster of more than 4,000 current service members, and in February the Office of Personnel Management instructed insurance carriers to cease covering gender affirming care for FEHBP beneficiaries under the age of 19 by 2026.

The proposal also comes just a week after House Republicans made a late change to their budget reconciliation package, which initially would have barred Medicaid or CHIP funds going toward pediatric gender affirming care, to ban federal funds going to those treatments for adults as well.

FEHBP coverage of gender affirming care treatments dates back to 2016, when OPM first banned insurance carriers from excluding services or drugs to treat gender dysphoria from coverage. In 2024, OPM stipulated that no carrier “may categorically exclude from coverage services related to gender affirming care.”