In a significant move, the House has passed a sweeping tax bill that bans Medicaid from covering gender-affirming care for transgender individuals, marking a controversial step that many activists are condemning as a targeted attack on trans health access. This legislation, supported by Republicans, aims to cut all Medicaid gender transition care in a last-minute amendment, raising fears about the impact on millions of Americans, including 86,000 individuals in Iowa alone. Critics argue that such measures are part of a broader agenda to erase transgender healthcare options, while proponents claim it is necessary for fiscal responsibility. As the Senate prepares for a critical showdown over the bill, the implications for LGBTQ+ health care coverage remain uncertain.