On April 3, 2025, Maine Senator Susan Collins voted to confirm Mehmet Oz to run the Centers for Medicare and Medicaid Services, and in August 2026 his agency finalized a rule ending federal Medicaid and CHIP funding for puberty blockers, hormones and surgery for transgender young people. The rule falls hardest in states like Maine that have no ban, where MaineCare must now pay for the care with state money alone.
Collins also voted to confirm Attorney General Pam Bondi, whose Justice Department subpoenaed doctors and clinics that treat transgender youth, Veterans Affairs Secretary Doug Collins, whose department phased out gender-affirming care for veterans, Personnel Director Scott Kupor, whose office dropped the care from federal employees' health plans, and Secretary of State Marco Rubio, whose department now issues passports only with the sex assigned at birth.
Susan Collins's Confirmation Votes and the Rollback of LGBTQ Protections
- Collins Voted to Confirm Mehmet Oz, Whose Agency Cut Off Federal Medicaid Funds for Transgender Youth Care. On April 3, 2025, Susan Collins voted to confirm Mehmet Oz as administrator of the Centers for Medicare and Medicaid Services, and he was confirmed 53 to 45. In August 2026 Oz's agency finalized a rule that prohibits federal matching funds for puberty blockers, cross-sex hormone therapy, and surgical interventions for transgender patients under 18 on Medicaid and under 19 on CHIP. KFF counted about 130,000 young trans people with Medicaid or CHIP coverage in states without their own restrictions and found that dozens of providers have ceased to offer services. In June 2025 the agency had also ruled that insurers are prohibited from covering gender affirming care as an essential health benefit in ACA plans starting in 2026.
- Collins Voted to Confirm Pam Bondi, Whose Justice Department Subpoenaed Doctors Who Treat Transgender Youth. On February 4, 2025, Susan Collins voted to confirm Pam Bondi as attorney general. In July 2025 Bondi's department issued more than 20 subpoenas to doctors and clinics providing young people with gender-affirming care, KFF reported, and by 2026 at least 40 health care institutions have walked back the provision of gender-affirming care. Collins also voted to confirm civil rights chief Harmeet Dhillon on April 3, 2025, and in a transgender prisoner's lawsuit in Georgia the Division announced it withdrew that statement of interest in her support, while in Florida's Medicaid case the Division withdrew its brief with no explanation, Red Line for Civil Rights reported.
- Collins Voted to Confirm Doug Collins, Whose VA Phased Out Care for Transgender Veterans. On February 4, 2025, Susan Collins voted to confirm Doug Collins as secretary of veterans affairs, and he was confirmed 77 to 23. In March 2025 the VA announced that it would phase out providing gender affirming care for transgender veterans, KFF reported.
- Collins Voted to Confirm Scott Kupor, Whose Office Dropped Gender-Affirming Care From Federal Employees' Health Plans. On July 9, 2025, Susan Collins voted to confirm Scott Kupor as director of the Office of Personnel Management, and he was confirmed 49 to 46. Kupor's office removed the coverage from federal employee health plans for 2026, and for 2027 carriers must remove any exceptions process that had protected people already in treatment, according to KFF.
- Collins Voted to Confirm Marco Rubio, Whose State Department Now Issues Passports Only With the Sex Assigned at Birth. On January 20, 2025, Susan Collins voted to confirm Marco Rubio as secretary of state, and he was confirmed 99 to 0. On November 6, 2025, the Supreme Court granted a request from the Trump administration to enforce its policy of issuing passports only with the sex assigned at birth. A transgender plaintiff in the ACLU's case said the policy left them "forcibly outed every time I used my passport".
- Collins Voted to Confirm Robert F. Kennedy Jr., Whose Department Shut the LGBTQ Youth Suicide Line for 14 Months. On February 13, 2025, Susan Collins voted to confirm Robert F. Kennedy Jr. as secretary of health and human services. Kennedy's department ended the 988 crisis line's service for LGBTQ young people in July 2025, a line that had received over 1.5 million contacts since its start. The harm was transient: It was revived over a year later, on September 30, 2026, after pressure from Congress, KFF reported.
What the LGBTQ Rollbacks Under Susan Collins's Confirmations Mean for Maine
- MaineCare. Maine has no ban on gender-affirming care for minors, so the Oz rule's effect lands directly on MaineCare: from October 13, 2026, the state can cover this care for young MaineCare members only by using state-only funds to cover these services, according to Maine's Office of MaineCare Services. KFF notes that The rule's impact would be most significantly felt in states without a ban.
- Coverage for LGBTQ adults. LGBTQ+ adults are twice as likely as non-LGBTQ+ adults to use Medicaid as their main coverage, according to Williams Institute data reported by them, so the federal rollbacks reach many LGBTQ Mainers through MaineCare.
Frequently Asked Questions About Susan Collins on LGBTQ rights
What is Susan Collins's record on LGBTQ rights under Trump?
Susan Collins voted to confirm Mehmet Oz, whose agency barred federal Medicaid funds for gender-affirming care for young people, and Pam Bondi, whose Justice Department subpoenaed providers. She also voted to confirm Doug Collins, Scott Kupor and Marco Rubio, whose agencies ended the care at the VA, dropped it from federal employee plans and stopped issuing passports that match a person's gender identity. In Maine, MaineCare must now pay for this care for young people with state money alone.
What does the Medicaid rule from the agency Susan Collins confirmed mean for transgender youth in Maine?
Susan Collins voted to confirm Mehmet Oz in April 2025, and the August 2026 rule from his agency ends the federal share of Medicaid payments for puberty blockers, hormones and surgery for young people. Maine law keeps the care covered, so MaineCare now pays for it using state-only funds, leaving Maine taxpayers with the full cost.
Did Susan Collins vote to confirm the officials behind the transgender passport policy?
Yes. Susan Collins voted on January 20, 2025 to confirm Marco Rubio as secretary of state, and Rubio's department enforces the passport policy that the Supreme Court allowed to take effect in November 2025.
Last updated: 2026-10-25