California lawmakers hear pleas to stabilize gender-affirming care as hospitals withdraw services

A joint Senate Budget Subcommittee No. 3 and Assembly Subcommittee No. 1 hearing on access to gender‑affirming care on April 1 focused on legal fights with the federal government, shrinking provider networks and a coalition request for a $26 million one‑time state investment to preserve services.

Deputy Attorney General Crystal Adams told lawmakers the Department of Justice is litigating multiple fronts against federal actions that, in DOJ’s view, threaten care: a multistate challenge to an executive order cited as the denial‑of‑care order (executive order 14187), a challenge to a declaration by the U.S. Department of Health and Human Services’ secretary, and a suit to block Rady Children’s Hospital San Diego from terminating gender‑affirming services after the hospital agreed to conditions tied to a merger. "We are taking action to make sure hospitals are following their obligations," Adams said.

State agencies described how those federal proposals could affect the local health system. Tyler Sadrith, state Medicaid director at the Department of Health Care Services, said Medi‑Cal continues to cover medically necessary gender‑affirming services and the agency is preparing contingency plans if federal rules are finalized. Mary Watanabe, director of the Department of Managed Health Care, explained that her agency requires licensed commercial plans…