HR 498 United States House · 119th Congress

Do No Harm in Medicaid Act

HR 498, the "Do No Harm in Medicaid Act," prohibits federal Medicaid funding for gender transition procedures for individuals under 18 years old. The bill amends the Social Security Act to define "specified gender transition procedures" broadly, including surgeries, hormone treatments, and certain medications, and bans federal Medicaid coverage for these services for minors. Exceptions are made only for medically necessary treatments related to precocious puberty, genetic disorders of sex development, or urgent medical conditions requiring bodily correction (like infections or injuries from prior procedures). This directly affects minors enrolled in Medicaid state plans, as states would no longer receive federal funds for these specific covered services.
Bill status passed 3 of 5 stages cleared
Introduction
Jan 2025
Committee Review
Dec 2025
House Passage
Dec 2025
Senate Passage
President
Introduced Jan 16, 2025 Last action Dec 18, 2025
Maddy AI version diff · 1 comparison

What changed between versions

Introduced in House Engrossed in House · 1 edit · Dec 18, 2025
MINOR
The changes between the Introduced and Engrossed versions of HR 498 are entirely formatting and whitespace adjustments, including adding spaces after section numbers and inserting blank lines between subsections for readability. No substantive policy language was added, removed, or modified.
TECHNICAL

Spacing was standardized throughout the bill: a space was added after section numbers (e.g., '2.' became ' 2.') and blank lines were inserted between subsections to improve visual separation. No policy content changed.

Floor votes · House Dec 18, 2025

How they voted

215201
Passed · 17 other
Total votes 433
Dec 18, 2025
D Democratic213
4 Yea 201 Nay 8
94% Nay
I Independent1
1 Yea
100% Yea
R Republican219
210 Yea 9
95% Yea
Vote distribution
All Yea All Nay Mixed No data
Full legislative history

Actions timeline

Total actions
16
Key actions
4
Committee
4
Dec 18, 2025
Committee
Received in the Senate and Read twice and referred to the Committee on Finance.
upper
Dec 18, 2025
Lower · Passed
On passage Passed by the Yeas and Nays: 215 - 201 (Roll no. 362). (text: CR H6057)
lower
Dec 18, 2025
Lower · Passed
Passed/agreed to in House: On passage Passed by the Yeas and Nays: 215 - 201 (Roll no. 362).
lower
Dec 18, 2025
Lower · Passed
Mr. Soto moved to recommit to the Committee on Energy and Commerce. (text: CR H6065)
lower
Dec 17, 2025
Lower · Passed
Rules Committee Resolution H. Res. 953 Reported to House. Rule provides for consideration of H.R. 6703, H.R. 498 and H.R. 3492. The resolution provides for consideration of H.R. 6703 and H.R. 498 under a closed rule and H.R. 3492 under a structured rule with one hour of general debate and one motion to recommit on each bill.
lower
Jan 16, 2025
Committee
Referred to the House Committee on Energy and Commerce.
lower
Jan 16, 2025
Introduced
Introduced in House
lower
1 primary · 6 co-sponsors

Sponsors