Likely helped
- No clear beneficiaries surfaced yet.
H.R. 498 (119th)Bill Overview
Do No Harm in Medicaid Act
Health|Child healthHealth
Current stageCommittee
Referred to the House Committee on Energy and Commerce.
Introduced
Committee
Floor
President
Law
01 · The brief
<p><strong>Do No Harm in Medicaid Act</strong></p><p>This bill prohibits federal Medicaid payment for specified gender transition procedures for individuals under the age of 18.
The bill defines these procedures to mean those that are intended to change the body of an individual to no longer correspond to the individual's biological sex (male or female), including specified surgeries, implants, and medications (e.g., hormones).</p><p>The bill excludes procedures that are provided to an individual under the age of 18 with the consent of a parent or legal guardian and that are intended to (1) rectify early puberty, genetic disorders, or chromosomal abnormalities; (2) reverse prior gender transition procedures; or (3) prevent imminent death or impairment of a major bodily function.</p>
Passage65/100
This bill has already passed one chamber, which is a stronger signal than introduction alone but still leaves another major hurdle ahead.
CredibilityPartial
How solid the drafting looks.
Contention62/100
The main political fault lines are not fully surfaced yet, so coalition durability is still unclear.
02 · What it does
Who stands to gain, and who may push back.
Who this appears to help vs burden0% / 100%
Likely helpedLikely burdened
Likely burdened
- No clear downsides surfaced yet.
03 · Why people split
Why the argument around this bill splits.
The main political fault lines are not fully surfaced yet, so coalition durability is still unclear.
Progressive—
The main political fault lines are not fully surfaced yet, so coalition durability is still unclear.
Centrist—
The main political fault lines are not fully surfaced yet, so coalition durability is still unclear.
Conservative—
The main political fault lines are not fully surfaced yet, so coalition durability is still unclear.
04 · Can it pass?
The path through Congress.
Introduced
Reached or meaningfully advanced
Committee
Reached or meaningfully advanced
Floor
Still ahead
President
Still ahead
Law
Still ahead
Passage likelihood65/100
This bill has already passed one chamber, which is a stronger signal than introduction alone but still leaves another major hurdle ahead.
Why this could stall
- The next hurdle is reproducing that support in the other chamber.
05 · Recent votes
Recent votes on the bill.
HOUSE · Dec 18, 2025
215 yes · 201 noPassed
On Passage
Yes 52% No 48%
Against party line
Aaron Bean (FL)RR · Yes
Abraham J. Hamadeh (AZ)RR · Yes
Adam Gray (CA)DD · No
Adam Smith (WA)DD · No
Addison P. McDowell (NC)RR · Yes
Showing a quick cross-section of legislators, with followed members first when available.
HOUSE · Dec 18, 2025
204 yes · 212 noFailed
On Motion to Recommit
Yes 49% No 51%
Aaron Bean (FL)RR · No
Abraham J. Hamadeh (AZ)RR · No
Adam Gray (CA)DD · Yes
Adam Smith (WA)DD · Yes
Adelita S. Grijalva (AZ)DD · Yes
Showing a quick cross-section of legislators, with followed members first when available.
06 · Go deeper
Go deeper than the headline read.
Included on this page
The main political fault lines are not fully surfaced yet, so coalition durability is still unclear.
This bill has already passed one chamber, which is a stronger signal than introduction alone but still leaves another major hurdle ahead.
Unlocked analysis
Pro readers get the full perspective split, passage barriers, legislative design review, stakeholder impact map, and lens-based policy tradeoff analysis for Do No Harm in Medicaid Act.
Go beyond the headline summary with full stakeholder mapping, legislative design analysis, passage barriers, and lens-by-lens tradeoff breakdowns.
Perspective breakdownsPassage barriersLegislative design reviewStakeholder impact map
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