Idaho Gov. Little signed H0668, barring public funds and Medicaid coverage for gender-transition care

On March 27, 2024, Idaho Gov. Brad Little signed House Bill 668 into law, enacting a broad prohibition on the use of public funds for gender-transition care. The bill, brought by the House State Affairs Committee, passed the House 58-11 on March 11 and the Senate 26-8 on March 22 before Little signed it as Session Law Chapter 209, effective July 1, 2024.

The law added a new Chapter 89 to Title 18 of the Idaho Code and a new Section 56-270 to Title 56. It bars state, county, and local public funds from being used, granted, paid, or distributed to any entity or individual for surgical operations or medical interventions performed to affirm a person's gender identity, whether the recipient is a minor or an adult. It further provides that the Idaho Medicaid program shall not reimburse or cover such care, makes related expenditures non-tax-deductible, bars physicians and other health-care professionals from providing the care within the course and scope of state, county, or local government employment, and prohibits the use of any state property, facility, or building to provide it. The statute exempts care deemed medically necessary for reasons unrelated to gender affirmation and care for documented disorders of sex development.

Under the law, an intentional violation by a public officer or public employee is treated as a misuse of public moneys punishable under Idaho Code Section 18-5702. Bill sponsors argued the measure ensures taxpayer dollars are not used for the procedures, while opponents testified that major medical organizations regard gender-affirming care as medically necessary and warned the exclusion singles out transgender Idahoans.

Updates

2024-06-29 — Federal judge temporarily blocked enforcement for seven Medicaid plaintiffs [5]

A federal judge issued a temporary restraining order blocking enforcement of HB 668 against seven transgender and nonbinary Medicaid plaintiffs days before the law's July 1 effective date, "to preserve the status quo" pending further review; the block applied only to the named plaintiffs.

2024-12-31 — Federal judge denied preliminary injunction; case proceeded on the merits [6]

A federal judge denied the plaintiffs' request for a preliminary injunction, finding they had not shown irreparable injury after allowing the earlier restraining order to expire; the case continued toward a ruling on the merits, and Idaho's attorney general separately asked the U.S. Supreme Court to hear the case directly.