Washington, D.C. – After a gruelling 26-hour session of debate, Congressman Dan Crenshaw (TX-02) emerged from the House Energy & Commerce Committee’s budget reconciliation markup with three major wins for conservative health policy. Crenshaw, an E&C Committee member, championed provisions to impose work requirements on Medicaid, prohibit federal health programs from funding gender-transition procedures for minors, and delay looming cuts to safety-net hospital funding through 2026. Each measure, now included in the committee’s reconciliation package, reflects Crenshaw’s commitment to personal responsibility, protecting children, and sustaining community healthcare.
Provisions Included:
Work Requirements in Medicaid – Empowerment and Accountability: Crenshaw’s first provision adds a community engagement (work) requirement for able-bodied, working-age adults on Medicaid. Under this policy, beneficiaries without dependents must work, volunteer, or attend education/training for at least 80 hours per month to maintain coverage. Exceptions are included for those truly unable to work – such as pregnant women, the elderly, individuals with disabilities, and caregivers.
- This reform is projected to save taxpayers over $300 billion in the next decade, strengthening Medicaid’s finances.
- It also enjoys broad public support – a recent Axios/Ipsos survey found 63% of Americans (including nearly half of Democrats) support work requirements for programs like Medicaid.
- By reducing reliance on government assistance, the measure preserves resources for children, seniors, and people with disabilities who truly need care, reflecting a core GOP belief in personal responsibility leading to uplift.
“Do No Harm” to Kids — The Crenshaw Amendment: In a move to safeguard minors and uphold medical integrity, Rep. Crenshaw successfully pushed for a ban on federal health dollars being used for gender-transition procedures on anyone under 18. His provision – modeled after his proposed Do No Harm in Medicaid Act – prohibits Medicaid and CHIP from covering sex reassignment surgeries, cross-sex hormones, or puberty blockers for minors, and similarly bars Affordable Care Act plans from making such procedures an essential health.
Safeguarding Hospitals – Relief from DSH Cuts: The third Crenshaw-backed provision provides critical relief to hospitals that serve low-income communities. It delays impending cuts to Medicaid Disproportionate Share Hospital (DSH) payments until 2029, effectively staving off reductions that were scheduled to begin in fiscal year 2026. DSH payments are lifelines for safety-net hospitals, compensating them for care provided to uninsured and underinsured patients.
- Without this delay, hospitals nationwide were facing $8 billion per year in funding reductions for FY2026–2028 under current law. Texas hospitals in particular stood to lose roughly $778 million in 2025 alone (a 32% cut) if the cuts proceeded.
- By ensuring the continuation of DSH support through 2026, the amendment protects patients from potential service cuts or hospital closures.
Next Steps:
All three provisions backed by Rep. Crenshaw were adopted in the Energy & Commerce Committee’s reconciliation recommendations this week. The package now advances to the Budget Committee and will ultimately be folded into a broader House budget reconciliation bill aimed at reducing federal spending by roughly $880 billion over ten years.