President Donald Trump's administration said that Medicaid will stop paying for gender-affirming surgeries and hormone treatments for transgender minors and the state Children's Health Insurance Program won't pay for the treatments for those under 19.
The announcement is the latest in a series of policies from the administration aimed at transgender people that began the day Trump returned to office last year.
The policy is to take effect Oct. 13.
It is not clear how much taxpayer funding is going to cover gender-affirming treatments for transgender youth now. The Centers for Medicare and Medicaid Services did not respond to questions about the policy on Tuesday.
At least 27 states have already banned gender-affirming care for those under 18. Even in states that haven’t, many major hospitals have stopped providing some of the treatments. And gender-affirming surgeries for minors are rare. Puberty blockers and hormone treatments are more common.
The policy calls for Medicaid and CHIP to continue to pay for mental health treatment for transgender minors but phase out coverage of hormone treatments that are used both to block puberty and to produce sex-related physical changes for those already receiving them as of April 2027.
Trump said in a social media post Tuesday that he directed Dr. Mehmet Oz, the CMS administrator, to make the change.
“We are not going to pay for our innocent children to undergo these barbaric surgeries and practices, which result in unthinkable and irreversible harm to their young bodies,” Trump said in his post.
Advocates for LGBTQ+ young people look at it differently.
GLBTQ Legal Advocates and Defenders legal director Josh Rovenger said the rule “is putting up barriers between parents and their ability to make the best medical decisions for their children” and would face a legal challenge.
“The Trump administration is terrorizing trans youth and their families with these kinds of actions, and it has to stop,” Human Right Campaign President Kelley Robinson said in a statement.
HRC is already suing the administration for efforts to bar gender-affirming care coverage under federal employee benefit plans.
The American Medical Association and most other major medical organizations support access to gender-affirming care, though the American Society of Plastic Surgeons said earlier this year that it found “insufficient evidence” that the benefits of chest, genital and facial surgeries on minors experiencing gender dysphoria — or the unease a person may have because their assigned gender and gender identity don't match — outweigh the risks.
The administration has already announced it would cut off Medicaid and Medicare funding for hospitals that provide gender-affirming care for minors, along with barring transgender athletes from sports competitions for girls and women and blocking people from being able to choose male, female or X to designate their sex on passports.
It also released a report last year urging therapy only for transgender youth and not broader gender-affirming health care.
Most of the changes have faced legal challenges. The U.S. Supreme Court let the administration's passport policy stand and allowed states to enforce the sports bans. A lower court ruled against the administration's declaration that called the treatments unsafe and ineffective. A challenge over the policy targeting hospitals is still pending.
FILE - A protester is silhouetted against a trans pride flag during a pro-transgender rights protest outside of Seattle Children's Hospital, Feb. 9, 2025, in Seattle. (AP Photo/Lindsey Wasson, File)
PEREIRA, Colombia (AP) — Rescue crews and civilians in Colombia painstakingly searched through rubble Tuesday in the hopes of finding survivors trapped under debris after a powerful earthquake left thousands missing in dozens of cities and towns.
The 7.4 magnitude earthquake that hit western Colombia on Monday wreaked havoc, collapsing buildings, buckling roads, crushing cars and leaving devastated residents to console each other among the wreckage of their homes. Excavators and heavy machinery cleared heavy chunks of concrete, while buckets of rubble were passed hand-to-hand along a line of volunteers.
Rescue crews and volunteers picked through flattened concrete buildings in affected cities, searching for signs of life. They raised their hands to call for silence when they thought they heard someone beneath the piles of debris. At least one woman was retrieved — alive — from the rubble.
Colombian President Abelardo de la Espriella said the earthquake killed at least 181 people and left 2,595 more injured. He said at least 195 remained missing, but civilian-run databases suggest that number could be closer to 4,000.
Authorities said the deaths were concentrated in the cities of Cali, Pereira, Manizales and Quibdo, but local leaders and families worried about casualties and damage in rural areas, from where very little information has emerged. Aid agencies consider the first 48 to 72 hours crucial for retrieving people alive, though that threshold can be extended if they have access to food and water.
De la Espriella said more than 1,000 homes were destroyed and yet more damaged.
Standing near the remains of his brother’s collapsed apartment building in Pereira, Jairo Vargas said he made the 220-kilometer (135-mile) drive from Medellin, hoping to find him alive.
“I’m absolutely certain he’s here. Absolutely certain,” Vargas said, adding that his brother’s car was still parked outside. But he fears his sibling did not survive.
“The debris surrounding my brother is soft,” he said, as heavy machinery rumbled nearby. “It’s possible that it’s protecting him, but we can’t hear any noises anymore. I don’t know. I have little hope.”
The earthquake presents the first major test for first-time officeholder de la Espriella, who entered office just days before the natural disaster. The leader, who split the country in recent elections, now seeks to unite Colombia in its disaster response.
That challenge was particularly notable in Choco, the region at the quake’s epicenter. It is one of Colombia's poorest and most neglected regions, often beset by warring armed groups. Much of Choco is accessible only by boat, through the jungle or by airplane.
Sterling Palacios, a religious and environmental leader in the region, said Choco's capital and smaller communities along the Atrato River were devastated. Homes were reduced to rubble and aftershocks continued to rumble, terrifying residents who slept in the streets overnight.
The Colombian Geological Service said it has documented more than 100 less powerful aftershocks since the initial quake.
“There are towns where people have lost everything, where people have died, where homes have been destroyed,” he said. “We don’t have a full panorama of the damage, but we know it’s been massive.”
De la Espriella traveled to Quibdo in Choco on Monday night where he announced he was mobilizing “the entire military and police apparatus,” as well as deploying engineers, rescue workers and search dogs.
“Choco will never again be the ‘land of the forgotten,’” he said.
Palacios said the government's response has so far been “concentrated in the capital,” and that authorities were flying the wounded from Quibdo to hospitals in the city of Medellín.
The biggest challenge, he said, remains towns in rural areas only reachable by boat — journeys that can take hours or days. That response is also complicated by a toxic slate of armed groups warring for control who, during the COVID-19 pandemic, blocked healthcare workers from traveling to remote areas.
“It's a risk and it's very difficult to predict” what could happen, he said, adding it could take weeks to fully assess the devastation.
Families posted information about missing loved ones on citizen-run websites.
Dana Carolina Zamora posted an image of her missing 60-year-old uncle, Miguel Ángel Zamora, cradling his dog. The farmer was living in a rural area of El Cairo, not far from the quake's epicenter in San Jose Del Palmar.
Local authorities said 80% of El Cairo, a town of about 7,000 people, was damaged. Zamora said her uncle lived in a traditional house of sticks and mud.
“We are afraid. We hope that is not the case, that he is all right and that it is only a communication failure. But we haven’t heard anything from him,” Zamora said.
The earthquake left many people unnerved after back-to-back quakes devastated neighboring Venezuela in late June, destroying hundreds of buildings and killing more than 6,300 people.
Mónica Sánchez, who lives in Pereira, one of the worst-hit cities, said when the quake happened a wall collapsed inside her clothing factory. Sánchez and her 12 employees escaped just in time.
“It was shocking — the city fell down around us,” she said.
On Tuesday, rescue workers pulled a woman alive from the rubble. Diana Troncoso lay on a stretcher, dusty and scraped up, with her eyes closed. Observers burst into applause as she emerged, but search teams raised their hand to call for quiet so they could continue their search for survivors.
Pereira and Cali enforced curfews Monday night to prevent looting, and private vehicles were banned from the roads of Pereira so ambulances, police and rescue workers were able to navigate what's left of the roads.
The U.S. State Department has announced it would provide $15.5 million for emergency shelter, food and other aid. Governments across Latin America have also lined up to help.
“This has been a tragedy for the whole city, for thousands of families,” Pereira Mayor Mauricio Salazar told local media, his voice quavering. “But here we are, and we will continue forward with the hand of God.”
Suarez reported from Bogota, Colombia, and Janetsky reported from Mexico City. Associated Press reporter Manuel Rueda in Bogota contributed.
Rescue workers carry Diana Troncoso after pulling her from the rubble the day after an earthquake struck Cali, Colombia, Tuesday, Aug. 11, 2026. (AP Photo/Ivan Valencia) CORRECTION: Changes city to Cali, not Pereira.
Residents and rescue workers search through the rubble after an earthquake struck Cali, Colombia, Monday, Aug. 10, 2026. (AP Photo/Santiago Saldarriaga)
A neighbor rides past damaged homes a day after an earthquake struck Pereira, Colombia, Tuesday, Aug. 11, 2026. (AP Photo/Fernando Vergara)
Rescue workers carry Diana Troncoso after pulling her from the rubble the day after an earthquake struck Pereira, Colombia, Tuesday, Aug. 11, 2026. (AP Photo/Ivan Valencia)
Rescue workers and volunteers clear debris the day after an earthquake struck Pereira, Colombia, Tuesday, Aug. 11, 2026. (AP Photo/Miguel Angel Lopez)
A neighbor looks at a collapsed building the day after and earthquake struck Pereira, Colombia, Tuesday, Aug. 11, 2026. (AP Photo/Fernando Vergara)
Residentes embrace as rescue workers search through the rubble of their damaged home the day after an earthquake struck Cali, Colombia, Tuesday, Aug. 11, 2026. (AP Photo/Santiago Saldarriaga)
Rescue workers clear debris the day after an earthquake struck Pereira, Colombia, Tuesday, Aug. 11, 2026. (AP Photo/Fernando Vergara)
Rescue workers cut through debris as they search for survivors the day after an earthquake struck Cali, Colombia, Tuesday, Aug. 11, 2026. (AP Photo/Ivan Valencia)
A vehicle is crushed by debris after an earthquake struck Cali, Colombia, Monday, Aug. 10, 2026. (AP Photo/Juan Diaz)
Rescue workers and residents search through the rubble after an earthquake struck Pereira, Colombia, Monday, Aug. 10, 2026. (AP Photo/Fernando Vergara)
Rescue workers and residents search through the rubble after an earthquake struck Cali, Colombia, Monday, Aug. 10, 2026. (AP Photo/Santiago Saldarriaga)
People search through the rubble after an earthquake struck Cali, Colombia, Monday, Aug. 10, 2026. (AP Photo/Santiago Saldarriaga)
