By Jen Schumann | Rocky Mountain Voice
The U.S. House passed two bills this month aimed at restricting federal involvement in medical transition procedures for minors. They used different enforcement tools. And they produced different voting coalitions.
One bill passed without a single Republican voting against it and drew limited Democratic support. The vote on the second bill was closer, with some crossover support and a number of members listed as not voting.
Republican Rep. Gabe Evans (CD-8) backed the funding restriction but rejected the felony approach. The difference lies in how each bill was written to be enforced.
Two bills, two approaches
H.R. 498, the Do No Harm in Medicaid Act, is a funding bill tied to how Medicaid dollars are used. It bars Medicaid and CHIP dollars from covering certain gender transition procedures involving minors—without creating new criminal penalties for doctors or parents.
H.R. 498 passed the House without any Republican votes against it and drew four Democratic yes votes, including Texas Rep. Henry Cuellar. A noticeable number of lawmakers didn’t vote at all—eight Democrats and nine Republicans—among them Rep. Marjorie Taylor Greene, who introduced the separate felony bill, and Reps. Eric Swalwell and Elise Stefanik.
On H.R. 498, Evans voted yes at each step. He supported the rule that brought the bill forward, opposed a motion to send it back to committee and voted for it on final passage.
By contrast, MTG’s Protect Children’s Innocence Act, H.R. 3492, used a different legislative approach. It amends federal criminal law under 18 U.S.C. §116 to make certain procedures federal felonies punishable by up to 10 years in prison. It expands federal jurisdiction through interstate commerce provisions and narrows what qualifies as medical necessity by excluding mental or emotional distress.
On final passage, H.R. 3492 passed 216–211. Three Democrats voted yes. Four Republicans voted no, including Evans. A number of members in both parties didn’t vote, including Reps. Paul Gosar and Eric Swalwell.
These were not companion bills. One limited the use of federal dollars. The other imposed federal felony penalties.
How Colorado’s delegation voted
The difference in enforcement tools produced different splits within Colorado’s eight-member congressional delegation.
On H.R. 498, all four Colorado Republicans voted yes. All four Colorado Democrats voted no.
On H.R. 3492, Republicans Lauren Boebert, Jeff Crank and Jeff Hurd voted yes. Evans voted no. All four Colorado Democrats again voted no.
That made Evans the only Colorado Republican to oppose the felony-based approach, even as he supported the funding restriction backed by every other Republican in the state.
Evans on funding bans and felony penalties
When asked about his vote, Evans’ office pointed to a single statement that laid out what he supports—and where he draws the line. While Evans referenced the Medicaid funding bill by name, his concern about turning doctors into federal felons mirrors the criminal-law structure used in H.R. 3492.
In a statement provided by his office, Evans said:
“I am fully supportive of banning these procedures on minors, which is why I have voted for Do No Harm in Medicaid Act that will prohibit funding for child sex change surgeries, cross-sex hormones, and puberty blockers. I’ve also voted for appropriations bills and defense authorization legislation that ban these procedures. As a former cop for ten years I had concerns with the provisions of the bill that turned doctors into federal felons. As a father of two young boys, I remain committed to supporting common-sense legislation that bans these irreversible, woke pseudoscience procedures, and that protects our children—as I have consistently done.”
Alignment with the Trump administration’s policy framework
Evans’ vote in favor of H.R. 498 mirrors the approach taken by the Trump administration.
In January, President Trump signed an executive order that set a framework for limiting federal funding and regulation connected to certain medical procedures for minors.
HHS moved in the same direction soon after. The Department of Health and Human Services announced steps to bar hospitals from performing specified procedures on children through Medicaid participation rules and regulatory enforcement. HHS later compiled a public roundup of media coverage and reactions to its actions, reflecting broad national attention to the administration’s funding- and regulation-based approach.
That shift was evident last week when senior HHS leadership publicly stated that “men are men” and “women are women,” adding that men cannot become women and women cannot become men — remarks that drew wide attention precisely because they came from a federal agency long at the center of this debate.
How House leadership framed the Medicaid bill
House Energy & Commerce Committee leaders described H.R. 498 as a funding and program-integrity measure.
Committee Chairman Brett Guthrie said the bill “helps strengthen, sustain, and secure our Medicaid program by ensuring federal Medicaid funding is not used for medically unnecessary care for minors.”
The bill’s sponsor, Dan Crenshaw, said, “Using Medicaid for unscientific, irreversible procedures on minors is an abominable betrayal of our most vulnerable.”
Crenshaw’s case for drawing a hard funding line
Crenshaw expanded on that argument in remarks posted to X, urging colleagues to focus directly on how taxpayer funding is used.
“Your constituents don’t want children to undergo gender transformations,” Crenshaw said. “And even if you’re uncertain about that, they definitely don’t want their tax dollars to pay for it.”
“This debate is so often buried under euphemisms,” he said. “Strip away the language. Here’s the reality: healthy children are being placed on drugs that halt normal development and permanently alter their bodies.”
“The Do No Harm in Medicaid Act draws a very clear moral line,” Crenshaw added. “The government will not participate in, endorse, or normalize irreversible gender surgeries and chemical interventions on minors.”
Crenshaw’s remarks reflect the strongest argument for the funding-based approach Evans supported, even as Republicans disagreed internally about whether federal criminal penalties should accompany it.
Public opinion and the broader context
Public opinion suggests broad support for restricting procedures for minors, alongside disagreement over enforcement.
A Pew Research Center analysis found that Americans have grown more supportive of restrictions on medical transition for minors, while remaining divided over how far government should go in regulating healthcare decisions.
That divide is reflected in Congress. H.R. 498 passed with bipartisan tolerance and no Republican opposition. H.R. 3492 passed with dissent from both parties.
Shared goals, different tools
Evans’ votes reflect a distinction increasingly visible in Washington. One approach relies on federal spending power and regulatory authority to set boundaries. The other relies on federal criminal law and prison sentences.
By backing the Do No Harm in Medicaid Act, Evans aligned with the Trump administration’s strategy of restricting funding and relying on agency enforcement. By opposing the Protect Children’s Innocence Act, he drew a line at expanding federal criminal law into medical decision-making, a concern he raised in his statement.
Both bills have since advanced to the Senate for consideration, reflecting broad agreement on the policy goal with limited disagreement over approach.
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