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Senate passes $895 billion defense bill with controversial gender-affirming care restriction

By Kaia Hubbard

December 18, 2024 / 1:11 PM EST / CBS News

Washington — The Senate approved the mammoth $895 billion National Defense Authorization Act on Wednesday, despite concern from some Democrats over a controversial policy restricting gender-affirming care for children of servicemembers. 

In a 85 to 14 vote, the Senate approved the legislation, which the House passed last week. Eleven Democrats and three Republicans voted against it in the upper chamber. The bill now heads to President Biden's desk for his signature. 

The 1,800 page national security legislation to authorize funding for the Defense Department for fiscal year 2025. But the bill includes a handful of controversial policies, like the gender-affirming care restriction, and lost support from the majority of Democrats in the House. 

The Democratic-controlled Senate pushed forward with the measure nonetheless. Senate Majority Leader Chuck Schumer noted that while the NDAA "isn't perfect," it still "includes some very good things that Democrats fought for" — citing provisions aimed at standing up against the Chinese Communist Party, boosting the use of artificial intelligence for national defense and expanding domestic tech innovation.

"Congress has passed the NDAA on a bipartisan basis for over six straight decades, and this year will be no different," Schumer said ahead of the vote on Wednesday. "We're passing the NDAA and that's a very good thing."

Sen. Ed Markey, a Massachusetts Democrat, derided the gender-affirming care restriction earlier this week, calling it "the product of a nationwide campaign against trans rights" and arguing that the legislation's approval would mark "the first anti-LGBTQ law passed by Congress in decades."

Still, the outcome of the vote was all but guaranteed after the Senate advanced the measure on Monday in a 83-12 procedural vote. 

Sen. Roger Wicker of Mississippi, the ranking Republican on the Senate Armed Services Committee, celebrated the NDAA's "immense accomplishments," including a 14.5% pay raise for junior service members and investments in recruitment capabilities. But he said Congress "missed an opportunity to strengthen the president-elect's hand as he takes office in a precarious world situation."

Wicker outlined that the Armed Services Committee proposed $25 billion for modernization programs, including for missile defense, ship building and counter-drone technology, saying "this should have been part of the bill today."

Sen. Jack Reed, a Rhode Island Democrat who chairs the Armed Services Committee, called the legislation a "strong, forward looking bill that we can all be proud of." But he said he "strongly" disagrees with the inclusion of the gender-affirming care provision, calling it a "misguided provision." 

"I share many of my colleagues' frustrations that the bill includes a provision that would prohibit gender-affirming health care for minors under certain circumstances," Reed noted, adding that he voted against the provision in committee. "We will continue to work to ensure the health care rights of all military personnel and their dependents."

Kaia Hubbard is a politics reporter for CBS News Digital, based in Washington, D.C.

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House passes massive defense bill with ban on gender-affirming care for transgender kids

WASHINGTON — A massive defense policy bill that cleared the House on Wednesday includes a ban on gender-affirming care for children of service members — a provision that sparked opposition from the top Democrat on the House Armed Services Committee and many others in the party.

The bill passed 281-140. Two hundred Republicans and 81 Democrats voted yes, while 124 Democrats and 16 Republicans voted no.

The sweeping must-pass bill — known as the National Defense Authorization Act, or NDAA — authorizes spending for the Defense Department and sets defense policies before they expire at the end of the year. It now heads to the Democratic-controlled Senate and must be signed by President Joe Biden to become law.

The bill was negotiated between senior House and Senate lawmakers. But Rep. Adam Smith, D-Wash., the former Armed Services chairman who is now the panel’s ranking member, said he would oppose passage of the NDAA because it includes the ban on gender-affirming care.

“[B]lanketly denying health care to people who need it — just because of a biased notion against transgender people — is wrong,” Smith said in a statement Tuesday. “The inclusion of this harmful provision puts the lives of children at risk and may force thousands of service members to make the choice of continuing their military service or leaving to ensure their child can get the health care they need.”

Speaker Mike Johnson, R-La., had pushed publicly and behind the scenes to include the controversial provision in the package. In a statement after the vote, Johnson said the NDAA refocuses "the Pentagon on military lethality, not radical woke ideology. This legislation permanently bans transgender treatment for minors, prohibits critical race theory in military academies, ends the DEI bureaucracy, and combats antisemitism.”

Smith accused Johnson in his statement of fighting for the ban to appease conservatives in his conference ahead of the Jan. 3 vote to keep him as speaker for two more years.

"Rather than take that [bipartisan] path and ensure service members and military families get the support they need and deserve, he chose to pander to the most extreme elements of his party in an attempt to retain his speakership,” Smith said.

Congress typically passes the NDAA with big, bipartisan votes. House Minority Leader Hakeem Jeffries, D-N.Y., told reporters before the vote that his team was not whipping or urging rank-and-file Democratic members to vote one way or the other. And his leadership team split over the issue: Jeffries, along with Democratic Caucus Chair Pete Aguilar, D-Calif., and Vice Chair Ted Lieu, D-Calif., voted for the defense bill, while Minority Whip Katherine Clark, D-Mass., and Assistant Democratic Leader Joe Neguse, D-Colo., voted no.

The provision in question, which specifically applies to Tricare, the military’s health care program, would prohibit “medical treatment for military dependents under the age of 18 who are diagnosed with gender dysphoria.”

Republicans believe their attacks on transgender rights during the 2024 campaign helped propel them to victory. And they’re now doubling down on that strategy. After the election, Johnson issued a new policy barring transgender women from using women’s bathrooms in the House — directly targeting Rep.-elect Sarah McBride, D-Del., the first openly transgender person elected to Congress.

Johnson also played a role in the fight over a provision that would have expanded Tricare coverage to include in vitro fertilization treatment. He “made dropping it a red line demand during negotiations,” according to a Senate aide familiar with the talks.

But the speaker's office said the disagreement was more nuanced. Both the House and the Senate Armed Services committees had passed separate NDAAs that included provisions to make it easier for military families to access IVF treatment. However, House and Senate negotiators couldn't agree on "sufficient pro-life protections," the speaker's office said.

"The Speaker remains pro-IVF and has encouraged states to take up the issue responsibly and ethically," a Johnson spokesman said.

Despite representing a broad constituency of military families in San Diego, Rep. Sara Jacobs was among the Democrats who voted against the NDAA.

“Unfortunately, because Speaker Johnson added these poison pills, I am forced to vote against a bill that I would otherwise happily have supported,” Jacobs told NBC News, referring to the ban on gender-affirming care.

Jacobs said the policy would affect “thousands” of families. “I get lots of phone calls from service members. ... They care about the fact that they can’t find child care, that their housing is inadequate, that they’re having to go to the food bank,” she said.

No calls, she said, are about culture war issues, like “whether they’re going to drag shows.”

Jacobs, a progressive Democrat and member of leadership, also worked across the chamber, and across the aisle, to insert language in the package that would have expanded coverage of fertility treatments, including IVF, to service members. 

Johnson stripped the provision out of the bill, Jacobs said, because “there were some people in his caucus who were uncomfortable with it.”

“The military is having a recruitment and retention problem," she continued. "And the idea that we would not be giving them [access to IVF] that is going to be a standard across the federal workforce, to me, makes no sense.”

Scott Wong is a senior congressional reporter for NBC News.

Frank Thorp V is a producer and off-air reporter covering Congress for NBC News, managing coverage of the Senate.

Kyle Stewart is a field producer covering Congress for NBC News.

Julie Tsirkin is a correspondent covering Capitol Hill.

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House Passes Defense Bill Denying Transgender Health Coverage for Minors

The $895 billion measure was approved over the opposition of most Democrats, who rejected a provision inserted by Republicans to deny the coverage to the minor children of military personnel.

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By Karoun Demirjian

Reporting from the Capitol

A divided House on Wednesday passed a defense policy bill that would direct $895 billion to the Pentagon and other military operations, moving over the opposition of Democrats who objected to a provision denying coverage for transgender health care for the children of service members.

Republicans banded together to support the annual defense measure, which included a 14.5 percent pay raise for junior enlisted service members. But many Democrats refused to back the normally bipartisan legislation, chiding the G.O.P. for including the limitation on transgender care, which they argued was discriminatory and politically motivated.

The provision in question would bar TRICARE, the military’s health care plan, from covering “medical interventions for the treatment of gender dysphoria that could result in sterilization” for children under 18.

“We banned TRICARE from prescribing treatments that would ultimately sterilize our kids,” Speaker Mike Johnson, Republican of Louisiana, told reporters this week. The speaker insisted at the last minute that he would not bring a defense bill to the floor without the provision, according to aides who spoke on the condition of anonymity to discuss private negotiations.

But Democrats argued that the measure was too draconian. They also said that the language was dangerously broad, and might be used to deny minors treatments to deal with the anxiety, depression and suicidal ideation that many transgender children experience.

“We are doing it because of ignorant, bigoted reasons against the trans community,” Representative Adam Smith of Washington, the top Democrat on the Armed Services Committee, said on the House floor, adding that the provision “taints an otherwise excellent piece of legislation.”

The vote was 281 to 140, with 124 Democrats and 16 Republicans voting against the bill.

Republicans had pressed for a far more expansive ban on transgender health care coverage, pushing through legislation in June that would deny such treatment for service members or anyone covered under the military’s insurance plan. The provision was narrowed in negotiations with the Democratic-led Senate, which is expected to take up and pass the measure in the coming days.

But the fact that it survived to be included in the measure was a departure from previous years, when Republicans and Democrats strove to keep contentious social issues out of the defense bill altogether. The break with tradition, both Republican and Democratic aides said, reflected the G.O.P.’s sweeping election wins, which handed the party full control of Congress and President-elect Donald J. Trump a second term.

Some Republicans expressed discomfort about the move. Representative Mike D. Rogers, Republican of Alabama and the chairman of the Armed Services Committee, questioned why it was necessary to include the provision at all when Mr. Trump was already planning to bar all federal coverage of transgender care upon taking office.

“I don’t know why this is in the bill when on Jan. 20, it’s a moot point,” he told reporters, adding, “This stuff does not belong in our bill.”

During Wednesday’s floor debate, Mr. Rogers made no mention of the provision, calling the defense policy legislation “a good bill, a fair compromise.”

Senate Democrats beat back a number of other conservative social policy changes demanded by Republicans. The final defense bill omitted House-passed provisions limiting access to abortion services and pared back restrictions on the Pentagon’s diversity, equity and inclusion programs, though it did impose a one-year hiring freeze for positions related to those programs.

House Republican leaders also insisted on dropping a provision to expand access to in vitro fertilization that had been included in both the House’s and the Senate’s initial versions of the bill. In vitro fertilization is currently available to service members only if their infertility issues were caused by illnesses or injuries sustained while on active duty. Lawmakers had sought to allow coverage for I.V.F. treatments regardless of why they were needed.

Mr. Johnson intervened to kill the expansion, according to aides familiar with the negotiations, despite Republicans’ election-season pledges to protect access to I.V.F., and Mr. Trump’s campaign trail promise to force insurance companies to cover such treatments for all Americans.

Some Democrats expressed concern that the provision concerning transgender minors — and the fallout over it — threatened to overshadow the other parts of the bill, which sets policy and pay levels, and directs priorities for the Defense Department’s nearly three million military and civilian employees.

“This is the most important piece of legislation of the entire 118th Congress, and with this bill in law our nation will be more secure, our servicemen and women more resolved to face the global challenges of tomorrow,” Representative Chrissy Houlahan, Democrat of Pennsylvania, said on the House floor. She said she would support the bill despite her “severe disappointment in those colleagues who chose to sully this bill” with the provision on transgender children.

The bill includes a 14.5 percent pay raise for junior enlisted service members and a 4.5 percent pay raise for all other service members.

It also authorizes a Taiwan Security Cooperation Initiative, modeled after a similar program dedicated to improving Ukraine’s military preparedness, that would help Taipei shore up its ability to defend against a potential invasion by China.

An earlier version of this article misstated the total of the defense bill passed by the House. It is $895 billion, not $883.7 billion.

When we learn of a mistake, we acknowledge it with a correction. If you spot an error, please let us know at [email protected] . Learn more

Karoun Demirjian covers Congress with a focus on defense, foreign policy, intelligence, immigration, and trade and technology. More about Karoun Demirjian

• July 18, 2023

SENATOR VANCE INTRODUCES LEGISLATION TO BAN GENDER REASSIGNMENT PROCEDURES ON MINORS

WASHINGTON, D.C. –  Senator JD Vance (R-OH) has introduced the  Protect Children’s Innocence Act , which would ban the genital mutilation, chemical castration, and sterilization of innocent children by classifying the performance of so-called “gender-affirming care” on a minor as a Class C felony.

The legislation would also cease all taxpayer funding for such actions, including under government-sponsored healthcare plans of the Affordable Care Act, prohibit institutions of higher education from providing instruction on “gender-affirming care,” and would deem aliens who have performed “gender-affirming care” on a minor ineligible to receive visas or admittance to the United States.

“Under no circumstances should doctors be allowed to perform these gruesome, irreversible operations on underage children,” said Senator Vance . “With this legislation, we have an opportunity to save countless young Americans from a lifetime of suffering and regret. I want to thank Congresswoman Marjorie Taylor Greene for leading on this issue, and I look forward to working with my Senate colleagues to protect children from these life-altering procedures.”

Read the legislation here . Read more from The Daily Caller here .

For Background:

• This Senate bill is companion legislation to  H.R. 1399 . Originally introduced by Congresswoman Marjorie Taylor Greene, H.R. 1399 is cosponsored by 44 members of the House of Representatives.
• “Gender-affirming care,” even when limited to non-surgical interventions such as puberty blockers and hormone treatment, causes irreversible mental and physical damage, negatively impacting those who are treated for the rest of their lives. 
• American children are being targeted and indoctrinated with gender ideologies on social media platforms – children also face pressures from radical teachers, mental health counselors, and healthcare providers, often without receiving proper warning of associated risks.
• Recognizing the risks posed to patients, peer nations in Europe have significantly restricted access to the forms of “gender-affirming care” that are widely practiced in the United States.