What to Know About the CMS Rules Update

An article by NPR on July 14,2026 reported they had obtained a leaked document that impacts one of the two 2025 proposed agency rules from the Centers for Medicare & Medicaid Services (CMS) for Pediatric Medicaid Healthcare and Funding. This confidential document indicated a change in one of the proposed rules progress, Rule 1: the Conditions of Participation Rule. Had it been finalized, the Conditions of Participation rule would have withheld any Medicaid/Medicare dollars to entire hospitals if they provided the care, pushing our providers to have to provide care outside of those institutions. 

What were the proposed rules in 2025? 

(Rule 1) Conditions of Participation in Medicaid Rule: The Federal Government Medicaid Agency threatened to withhold all Medicaid and Medicare funding for an entire hospital system if it offered gender affirming care services to youth. 

(Rule 2) Federal Pediatric Claim Reimbursement Rule: Threatens to cut off federal funding reimbursement for pediatric gender affirming care claims.   

We have been monitoring these proposed rules closely since 2025. Nationally, 65,000 comments were gathered, including comments you submitted to BRO protesting both of these rules in early 2026. Thank you for your submissions, they do matter.  

That leaked document was not linked in their article, but what the public could see was a change in the federal website that stated final actions wouldn’t take place on the rule until 2028, which is the last month of this administration’s term. This indicates they have shelved the rule for now.  

After the news broke nationally, the rules website changed once more to December 2026. There are currently many speculations that that action was solely an attempt at maintaining social pressure on institutions without the ability to realistically formalize this action by December due to comments and issues identified with the rule.

We will continue to monitor these changes and shifts. Your public comments truly make a difference. Thank you for raising your voices from Oregon. We will continue to fight off these policies that impact our access to care. 

Seth Johnstone (Policy & Research Director) and Congresswoman Maxine Dexter advocating for gender-affirming healthcare at Portland Pride.