The lawmakers in Idaho will be voting this week on a proposal that would prohibit the utilization of public funds for gender-confirming medical treatments, such as for state workers utilizing their work health insurance and for eligible adults enrolled in Medicaid.

The bill has been approved by the House and now awaits approval from the majority Republican Senate before it can be sent to Governor Brad Little for final approval. It is expected that the governor, who is also a Republican, will sign the bill into law, as he has expressed his opposition to the use of public funds for gender-affirming medical services.

Should the bill be passed, Idaho would be at least the 10th state to prohibit the use of Medicaid funds for gender-affirming procedures for individuals of any age. This is reported by the advocacy group Movement Advancement Project, which provides information on social and political issues. These laws are an integral part of the ongoing nationwide struggle for the rights of LGBTQ+ individuals.

Critics of the Idaho legislation argue that it is highly likely to result in a legal challenge in the federal court system. In the past, the state has faced numerous lawsuits for its efforts to deny transgender individuals access to gender-confirming treatment, with limited success in defending itself against these lawsuits.

In a particular scenario, the government was instructed to offer gender-transition surgery to a transgender prisoner, resulting in the prisoner being granted approximately $2.5 million in legal expenses after the fact.

In 2021, a federal judge prohibited Idaho from implementing its recently passed ban on medical care that affirms gender identity for minors, pending the outcome of a lawsuit filed by transgender youth and their families. Another federal judge rejected the state’s attempt to dismiss a lawsuit brought by adults in 2022, claiming that their medically necessary gender-affirming treatment was wrongly denied by Medicaid officials.

Howard Belodoff, a Boise attorney, stated during a hearing on Thursday that this legislation goes against both the equal protections clause of the 14th Amendment and the federal Medicaid Act.

Belodoff represents the transgender adults who sued the state over what they said were discriminatory Medicaid policies excluding coverage for genital reconstruction surgery.

“The bill goes against the Medicaid Act by not differentiating in the provision of care based on diagnosis, type of illness, or condition,” Belodoff stated.

According to Republican Representative Bruce Skaug, the creation of the bill was prompted by lawsuits.

According to Skaug, this legislation is aimed at protecting taxpayers. He suggests that without it, the state may have to cover the cost of gender-affirming care, possibly amounting to millions of dollars. Approximately 70% of Idaho’s Medicaid program is financed by the federal government.

Certain individuals who provided testimony against the bill proposed that it may have an impact beyond the original intention of restricting gender-affirming healthcare for those with private insurance in rural areas where state-funded medical facilities are the only option.

Some employees at the Idaho Department of Correction, including Isaac Craghtten, work long shifts of 12 to 16 hours. As a result, they may need to take prescribed medications, such as hormone therapy, during their shifts.

According to Craghtten, the law prohibits the use of state property, facilities, or buildings for performing surgery or providing medical treatments. This could result in employees facing legal consequences if they take their legally prescribed medication while in a break room.

Violating the law could result in fines ranging from $300 to $10,000 and imprisonment ranging from one to 14 years.

At least 23 states, including Idaho, have implemented legislation that prohibits gender-affirming care for minors. Additionally, some states have proposed policies that could impede transgender adults from accessing necessary care, such as eliminating telehealth resources or mandating repetitive psychological evaluations in order to continue receiving gender-affirming treatment.

Prominent medical organizations, such as the American Medical Association and the American Academy of Pediatrics, reject restrictions on gender-affirming treatment and have backed its safety when administered correctly.

Although courts have prohibited the implementation of bans on gender-affirming care for minors in the states of Idaho, Montana, and Arkansas, they have permitted the enforcement in Alabama and Georgia.

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This report was contributed to by Associated Press writers Geoff Mulvihill of Cherry Hill, New Jersey, Hannah Schoenbaum of Salt Lake City, and John Hanna of Topeka, Kansas.