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Tipsheet

There's a Backdoor Effort in the Works That Would Undermine Trump's Executive Order

AP Photo/Jacquelyn Martin

Last week, President Donald Trump signed an executive order ending all federal funding for the medical mutilation of minors. However, as Trump continues to crack down on gender ideologues ensconced in our institutions, particularly those preying upon vulnerable children, resistance is rising at the state level.

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There's a backdoor effort gaining momentum in states across the country that allows taxpayer-subsidized funding for "sex change" procedures to be performed on pediatric patients. 

340B, a cost-saving federal program, lets certain hospitals and clinics ("covered entities" or CEs) serving as "safety net" providers to low-income and uninsured patients obtain drugs at government-mandated discounted prices from pharmaceutical manufacturers. As the U.S. Health Resources and Services Administration (HRSA) phrases it, the purpose of the 340B pricing program is to "stretch scarce federal resources as far as possible."

Consequently, resulting revenue can then be used to effectively subsidize so-called "gender-affirming treatments," such as hormone therapy and "sex reassignment" surgery.

A host of federally qualified health centers (FQHCs) have advertised these subsidized procedures, even for kids, saying that 340B savings cover the cost.

Callen-Lorde Community Health Center, which treats "New York's lesbian, gay, bisexual, and transgender communities — in all their diversity — regardless of ability to pay," especially "street-involved and unstably housed LGBTQ youth," touts online how they are able to "integrat[e] hormone therapy within primary care," thanks to revenue generated from 340B savings, "a significant source of support for unfunded services at Callen-Lorde."

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Funding derived from 340B is "a vital lifeline for Callen-Lorde," the clinic says, used to "reinvest" in such "affirmation" services like Health Outreach to Teens (HOTT), a "confidential" program designed specifically for "LGBTQ adolescents" as young as 13-years-old. All of HOTT's offerings, including individual counseling on one's "gender identity," are free-of-charge or low cost. HOTT is accessible at Callen-Lorde's "youth-only" medical suite as well as a mobile medical unit that travels throughout all five New York City boroughs to meet teens on the streets.

According to Chicago-based Howard Brown Health's 340B impact profile, the FQHC's "transgender and non-binary" teams provide "gender-affirming care," including cross-sex hormones and "surgical navigation," as part of expanded programming, which otherwise would not be able to operate without funding from 340B savings. Howard Brown Health, which is "rooted in LGBTQ+ liberation" and "mobilizes for social justice," has 30.2 percent of patients on Medicaid. 21.9 percent are uninsured or self-pay and 17 percent qualify for sliding scale fees. Nearly 3 percent of Howard Brown Health's patients are aged 18 and under.

Trillium Health, an FQHC look-alike regarded as the "leading LGBTQ+ healthcare provider in Rochester," also depends on 340B to provide "transgender care" at little-to-no-cost. This includes referrals for "gender-affirming" surgeries, hormonal injections, and a "binder finder." Chest binders, which women wear to flatten their breasts, are girdle-like garments that can cause bone breakage, bruising, difficulty breathing leading to lung build-up, heat exhaustion, and skin damage.

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Here's how the process plays out: Omaha-headquartered Amber Specialty Pharmacy (a.k.a. Amber Enterprises, Inc), whose pharmacists are trained in endocrinology (the study of hormones), contracts with Rush University Medical Center, a 340B CE in Chicago that "specializes" in "feminizing hormone therapy," which they admittedly perform on "transgender youth" both in the throes of puberty and who are prepubescent.

"If identified early, we can provide puberty blockers, also called hormone blockers, to suppress puberty," Rush says. "And you can start estrogen therapy when puberty is naturally expected." On the hospital's "gender affirmation surgery" page, which outlines operations Rush offers, including double mastectomies, vaginoplasty, phalloplasty, and hysterectomies, the medical center says they can "connect" gender dysphoric children with other providers.

Several state legislatures are seeking to expand 340B. Utah, Nebraska, North Dakota, and Kentucky all have pending legislation on the 340B program that would strengthen it, and these 304B-related bills are advancing in their respective legislative sessions.

Utah's SB 69 — set to take effect on May 7, 2025 — bans interference with a pharmaceutical entity's acquisition of a 340B-designated drug. Nebraska's LB 168, currently in committee, adopts the 340B Contract Pharmacy Protection Act, which would prohibit drug distributors from denying CEs access to 340B drugs. North Dakota's HB 1473, also in committee, amends state restrictions on 340B, protecting access to discounted drugs and preventing drugmakers from "creating barriers to the 340B program's implementation." Kentucky's SB 14, currently in committee, would establish a new section of Kentucky law that prohibits "discrimination" (i.e. discriminatory pricing practices) against 340B CEs and authorizes the state's attorney general to investigate violations of this provision.

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Gov. Glenn Youngkin (R-VA) rejected a version of the legislation in the Old Dominion last year. Youngkin spokesman Christian Martinez told Townhall that the governor was "deeply concerned about the federal 340B program and how it could be exploited to provide taxpayer-subsidized healthcare to illegal immigrants."

Younkin's veto of Virginia's SB119 is leading the way, and 340B watchdogs are hoping that other GOP leaders will follow suit.

RealClearPolitics exposed how healthcare providers in the deep-blue state of New York are exploiting 340B to subsidize "costs of care for [the] undocumented."

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