| |  | Executive Health Brief | The Trump administration is moving to ban hospitals from federal health insurance programs if they provide gender transition care to minors, including hormone treatments and puberty blockers, or procedures such as mastectomies, reports Paige Winfield Cunningham in The Washington Post newsroom. → The proposal — part of the Department of Health and Human Services’ efforts announced Thursday targeting transgender care — could have sweeping implications for health care providers across the nation, almost all of which accept patients covered by Medicare or Medicaid. “This action is designed to ensure that the U.S. government will not be in business with organizations that intentionally or unintentionally inflict permanent harm on children,” according to a release from HHS. The American Hospital Association, which represents about 5,000 hospitals and health systems, tells me that it is reviewing the proposed rule and will be providing comments to the agency. A separate notice of proposed rulemaking would ban Medicaid and the Children’s Health Insurance Program from paying for transition care for those under 18 and 19, respectively. → Comments on both proposals are due by Feb. 17. The Centers for Medicare and Medicaid Services said that it identified $31 million in Medicaid and CHIP spending for gender-affirming care for children ages 6 to 18 in 2023 — mostly on prescription hormone therapy. The rules, if finalized, would also dramatically curtail access to care for transgender children and teenagers that some providers say is critical to their overall health. Medical groups have defended providing children with treatment for gender dysphoria, arguing it is linked to lower instances of depression and suicidal ideation. CMS said that the evidence of the long-term benefits of “gender-rejecting procedures” is scant, pointing to studies that favor therapy. In a press conference, Health Secretary Robert F. Kennedy Jr. said he expected litigation over the proposals. “That’s going to happen,” Kennedy told a reporter when asked whether he was worried about the actions being tied up in litigation. “We know what we’re doing is legal. If people sue us, they're welcome to, but we’re going to win the lawsuits.” The Food and Drug Administration is also sending warning letters to a dozen manufacturers and retailers of breast binders, which are used to flatten the chest, alleging that they have engaged in “illegal marketing” of the products to children to treat gender dysphoria. Breast binders, considered medical devices, are also used to help people recover from breast cancer surgeries. “Make no mistake, these rules aim to completely cut off medically necessary care from children no matter where in this country they live. It’s the Trump administration dictating who gets their prescription filled and who has their next appointment canceled altogether,” said Kelley Robinson, the president of the Human Rights Campaign, an LGBTQ+ advocacy group. Robinson urged people to push back against the proposals. State scan — David Ovalle sends this dispatch from The Washington Post newsroom: OnPoint NYC, the nation’s first government-sanctioned overdose prevention centers program, has served nearly 7,000 participants and intervened in nearly 2,000 overdoses, the nonprofit said in an announcement to mark its four-year anniversary operating in New York City. The group said it’s helped to reduce deaths among the city’s Black and Hispanic population. → Harm-reduction centers such as the two facilities run by OnPoint NYC are places where users can ingest illicit drugs under the supervision of staff trained to reverse overdoses. They can also house needle-exchange programs, where drug users swap out old needles for new ones to prevent the spread of infection. Why it matters: Public health advocates have lauded harm-reduction programs such as OnPoint NYC, which gets support from the New York City health department. A state-authorized overdose prevention center also operates in Rhode Island. But the Trump administration has publicly decried harm reduction programs and such centers, asserting they enable drug use and are illegal under federal law. And the concept has received pushback from elected officials and resident groups in some communities, including in Philadelphia, where the Justice Department under the first Trump administration sued to block the creation of an overdose-prevention center. → However, since Trump took office again in January, the Justice Department has not moved to shut down OnPoint NYC. A Justice Department spokesperson, in a response to a Post inquiry, did not provide the agency’s position on OnPoint NYC but said “any organization encouraging the use of any deadly substance is irresponsible and should rethink how best to help those struggling with addiction.” “We haven’t heard anything” from the Justice Department, OnPoint NYC Executive Director Sam Rivera said during a press conference Thursday. “No one has contacted us.” Rivera said the organization is focusing on providing critical health services for users. The facilities also provide showers, clothes and medical services. Impact on the health industry: The program has generated an estimated $55.5 million in cost savings related to emergency and hospital care, among other expenses, according to OnPoint NYC. | 
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