Here’s How Much It Would Cost the Military to Provide Transition Care to Transgender Troops

As the U.S. military studies the implications of lifting a ban on transgender people serving in the armed forces, a new study says that the cost of providing transition-related health care to those service members would be about $5.6 million a year, or “little more than a rounding error in the military's $47.8 billion annual health care budget.”
After U.S. Defense Secretary Ashton Carter announced in mid-July that that Department of Defense would look into lifting the ban, opponents expressed concern about the potential high costs of providing care to transgender individuals. In last week’s debate among Republican presidential candidates, former Arkansas Gov. Mike Huckabee said he wasn’t sure “how paying for transgender surgery for soldiers, sailors, airmen, Marines makes our country safer.”
Related: The Surprising Way the Military Could Save Millions
The new study published in The New England Journal of Medicine estimated that 12,800 transgender troops currently serve and are eligible for health care in the U.S., but only 188 transgender service members would require transition-related care annually. Aaron Belkin, the San Francisco State University researcher who conducted the survey, checked for accuracy using data from the Australian military, which already covers transition-related care, and compared costs with insurance plans offered to University of California employees and their dependents.
Belkin emphasized that costs could be lower than expected for several reasons. Among those, transition-related care would mitigate other serious and potentially costly conditions, such as suicidal thoughts, and might improve job performance.
Acknowledging that the costs might be higher than he estimates, Belkin still says they would be too low to matter and shouldn’t be a factor in deciding whether the ban is lifted or not.
In June, the American Medical Association said there is “no medically valid reason” to prohibit transgender individuals from serving in the military.
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GOP Tax Cuts Getting Less Popular, Poll Finds
Friday marked the six-month anniversary of President Trump’s signing the Republican tax overhaul into law, and public opinion of the law is moving in the wrong direction for the GOP. A Monmouth University survey conducted earlier this month found that 34 percent of the public approves of the tax reform passed by Republicans late last year, while 41 percent disapprove. Approval has fallen by 6 points since late April and disapproval has slipped 3 points. The percentage of people who aren’t sure how they feel about the plan has risen from 16 percent in April to 24 percent this month.
Other findings from the poll of 806 U.S. adults:
- 19 percent approve of the job Congress is doing; 67 percent disapprove
- 40 percent say the country is heading in the right direction, up from 33 percent in April
- Democrats hold a 7-point edge in a generic House ballot
Special Tax Break Zones Defined for All 50 States

The U.S. Treasury has approved the final group of opportunity zones, which offer tax incentives for investments made in low-income areas. The zones were created by the tax law signed in December.
Bill Lucia of Route Fifty has some details: “Treasury says that nearly 35 million people live in the designated zones and that census tracts in the zones have an average poverty rate of about 32 percent based on figures from 2011 to 2015, compared to a rate of 17 percent for the average U.S. census tract.”
Click here to explore the dynamic map of the zones on the U.S. Treasury website.
Map of the Day: Affordable Care Act Premiums Since 2014
Axios breaks down how monthly premiums on benchmark Affordable Care Act policies have risen state by state since 2014. The average increase: $481.
Obamacare Repeal Would Lead to 17.1 Million More Uninsured in 2019: Study

A new analysis by the Urban Institute finds that if the Affordable Care Act were eliminated entirely, the number of uninsured would rise by 17.1 million — or 50 percent — in 2019. The study also found that federal spending would be reduced by almost $147 billion next year if the ACA were fully repealed.
Your Tax Dollars at Work

Mick Mulvaney has been running the Consumer Financial Protection Bureau since last November, and by all accounts the South Carolina conservative is none too happy with the agency charged with protecting citizens from fraud in the financial industry. The Hill recently wrote up “five ways Mulvaney is cracking down on his own agency,” and they include dropping cases against payday lenders, dismissing three advisory boards and an effort to rebrand the operation as the Bureau of Consumer Financial Protection — a move critics say is intended to deemphasize the consumer part of the agency’s mission.
Mulvaney recently scored a small victory on the last point, changing the sign in the agency’s building to the new initials. “The Consumer Financial Protection Bureau does not exist,” Mulvaney told Congress in April, and now he’s proven the point, at least when it comes to the sign in his lobby (h/t to Vox and thanks to Alan Zibel of Public Citizen for the photo, via Twitter).