Faefyx Collington (They/Them)December 21, 2025, 4:41 pm ESTMay 14, 2024; New York, NY, USA; Speaker of the House Mike Johnson (center), and Vivek Ramaswamy (right) look on while former President Donald Trump speaks to the media alongside his lawyer Todd Blanche before his criminal trial at Manhattan criminal court at the New York State Supreme Court on May 14, 2024. Mandatory Credit: Justin Lane/Pool via USA TODAY NETWORK | Justin Lane/Pool via USA TODAY N
Yesterday’s announcement from Donald Trump’s Department of Health and Human Services (HHS) shows just why the 2026 midterms will matter so much, and why the 11 months of waiting to get there could be so disastrous. We need a Congress that will stand up and snatch back the purse strings as the Founding Fathers originally intended.
In the United States Constitution, Congress is granted the power of the purse: the right to decide how much to spend and on what. Also, importantly, it gets to decide when to remove funding. In the 70s, that was used to pull funding from the Vietnam War. That power does not belong with the Executive Branch, which the Constitution says must “take Care that the Laws be faithfully executed.”
Unfortunately, the Founders likely never imagined people like House Speaker Mike Johnson (R-LA) or Senate Majority Leader John Thune (R-SD), who have been willing to roll over and allow Trump to usurp their power, in violation of the basic concepts behind the checks and balances built into the Constitution.
Trump has been doing plenty of ruling by threatening public funding. But the Trump administration’s new plan to block gender-affirming care for trans youth is possibly the most egregious example so far.
Congress is already working to block gender-affirming care. This week, the House of Representatives passed two gender-affirming care bans for minors, one from Rep. Marjorie Taylor Greene (R-GA) and one from Rep. Dan Crenshaw (R-TX). Those bans are horrific, and we can only pray that the Senate will stop them, but they are at least going through some sort of democratic process.
The Trump administration has a way to move towards a gender-affirming care ban if that is in line with the will of the people and democracy. The HHS proposal doesn’t represent a ban; instead, it’s an end-run on democracy, hoping to conduct a scorched-earth funding pull that they should have no authority to do.
HHS hopes to pull federal funding for any hospitals that provide gender-affirming care to minors. HHS has coined the term “sex-rejecting procedures,” an inaccurate piece of nomenclature carefully designed to target only trans people, and not affect cis people, who actually receive the majority of gender-affirming healthcare.
The HHS funding blocking proposal would pull all federal funding from any institution that conducts any gender-affirming care for trans people, even if patients pay for it without using federal funds. Hospitals will have to either comply with the HHS plans by ceasing gender-affirming care or risk losing all federal funding for all other treatments. Major hospital systems have already cut their programs because of these sorts of threats.
Trans youth and their families would be left seeking institutions that only provide gender-affirming care and forgo all government funding, if such a place even exists. Additionally, the removal of Medicaid coverage could see prices rise.
There will certainly be pushback against this plan, especially from cities and states that have marked themselves as trans sanctuaries. But those challenges will take time, and a small interruption in care or even just the threat of it does huge damage to trans youth. Denial of care has been linked to increased rates of depression and anxiety, and for those who have begun puberty, the physical changes that can happen in a short time can be extremely upsetting.
Trump keeps using threats of pulling federal funding to power his authoritarianism. That tactic is only working because Congress isn’t stopping him and saying, “No, that’s our job.” When Nixon pulled federal funds as a way to end programs with the Environmental Protection Agency (a process called impoundment), Congress passed the Congressional Budget and Impoundment Control Act, which closed loopholes and ensured that the president couldn’t rule this way. The Supreme Court went on to rule in 1975 that the president did not have the power to overrule Congress by impounding funds.
Michael Dorf, a constitutional law professor at Cornell University Law School, spoke with ABC News early in the Trump presidency, when he first started using this trick. “If Congress says you’re spending that much money on the federal programs, that’s how much is being spent. The president cannot stop it even temporarily,” he said. “Congress passed this statue this very particular rules of what exactly the president has to do if he wants to not spend money on money Congress has spent. He can ask Congress to for a recission, but there is a 45-day clock and a bunch of procedures, none of which have been followed by Trump.”
Congress’ move here wasn’t just granting itself new powers, but providing a safeguard to ensure that the power of the purse remained where the Constitution had put it. Republicans are quick to wheel out the Constitution and the will of the Founding Fathers, but all of that seems forgotten under Trump. Instead, Congress is leaving decisions to be drawn out in protracted judicial battles, which ultimately run the risk of landing in the Trump-packed Supreme Court.
(While we’re at it, Congress is also the institution that has the power to do things like rename The John F. Kennedy Memorial Center for the Performing Arts. But they seem to have forgotten that bit of power too.)
All of those federal funding threats work well for Trump, as he and his administration can wave their hands and claim that they’re standing by their promise to cut bloated government spending (all while spending millions in taxpayer money on golfing and Kid Rock). But it all relies on a tactic that shouldn’t even be part of the presidential toolkit.
There might be a lot of justifiable hope in 2026 that things will work out. Elections this year have already shown a big swing away from Trump’s party. Republicans are resigning, opening more seats that the party could lose between now and 2027. And while Congress might be voting on gender-affirming care bans themselves, it took a capitulation to a hardline anti-trans Republican as she was heading out the door to get that to happen.
But we’re only halfway to those midterms, and there’s going to be a lot of pain if the current Congress can’t remember why they’re there for another year.
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Trump’s gender-affirming care ban is why we need Congress to grow a spine
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