Defunding Planned Parenthood, border security: 5 provisions in the Big Beautiful Bill

4. Ban on the use of federal funds to pay for sex-change procedures

Section 44125 of the House version of the legislation and Section 71114 of the Senate version prohibit the use of federal funds under Medicaid as well as the CHIP program to pay for sex-change procedures. The House version of the legislation contains an additional provision prohibiting the designation of gender transition procedures as an essential health benefit under the Affordable Care Act beginning Jan. 1, 2027. 

Tony Perkins, president of the socially conservative advocacy organization Family Research Council, expressed concern about the watered-down provisions related to the prohibition on funding gender transition procedures in an X post on Saturday. “The current version will subject even that slimmed-down provision to a 60-vote threshold, meaning the provision will not pass the Senate, and Americans will continue to pay for gender transition experimentation on vulnerable individuals,” he warned. 

Perkins’ remarks reflect the fact that Republican leaders are working to pass the bill using the budget reconciliation process, which allows legislation to pass with a simple majority of 51 votes rather than 60.

The Senate consists of 53 Republicans and 47 Democrats, and Democrats are not expected to support the bill. Perkins’ X post comes at a time when the Senate parliamentarian has determined that several provisions of the measure do not meet the requirements for inclusion in a budget reconciliation bill.