The U.S. Capitol. surrounded by fog, on Tuesday, Dec. 10, 2024. (Photo by Jennifer Shutt/States Newsroom)

WASHINGTON — The U.S. House handily approved the annual defense policy bill Wednesday, despite late opposition from Democrats over a provision that bans military health insurance coverage for service members’ children seeking transgender care.

Lawmakers passed the historically bipartisan package 241-180. In the end, 81 Democrats supported the bill, and 16 Republicans voted against it. The measure now heads to the Senate.

Congress has approved the must-pass legislation for 63 years straight. President Joe Biden has not issued a statement yet on whether he will sign it into law.

The $884.9 billion bill includes a 4.5% pay increase for all troops, and an additional 10% bump for the military’s most junior enlisted ranks, from private to corporal. The bill also outlines improvements in military housing and child care.

The massive package is a policy bill, meaning it does not provide the Pentagon with funding but rather enshrines the Defense Department’s goals for the upcoming fiscal year. Congressional appropriators still need to approve any actual spending.

‘Lives of thousands of children at risk’

Among the Democrats who opposed the final legislation was the House Armed Services Committee’s top Democrat, Rep. Adam Smith. In a statement after the vote, Smith said he couldn’t vote yes, though there was “much to celebrate” in the text.

“However, the corrosive effect of Speaker Johnson’s insistence on including a harmful provision puts the lives of thousands of children at risk by denying them health care and may force thousands of service members to choose between continuing their military service or leaving to ensure their child can get the health care they need. This will be felt for generations to come,” Smith, of Washington state, said.

All Democrats present for a procedural step to advance the bill Tuesday voted against the defense package.

A four-line provision into the 1,800-page bill bans military TRICARE health insurance coverage for service members’ children who seek “medical interventions for the treatment of gender dysphoria that could result in sterilization.”

Treatment for gender dysphoria — an incongruence between a person’s sex assigned at birth and current gender expression — includes mental health measures, hormone therapy and surgery. The bill does not define which treatments are banned.

Smith, on the floor ahead of the vote, said the measure was included for “ignorant, bigoted reasons against the trans community,” and that it “taints an otherwise excellent piece of legislation.”

House speaker touts ban

Alabama’s Rep. Mike Rogers, chair of the House Armed Services Committee, told reporters on Capitol Hill Tuesday that House Speaker Mike Johnson “didn’t talk to me about it” before including the provision in the final text.

Johnson, of Louisiana, touted the measure Tuesday, as well as other provisions that freeze hiring of diversity, equity and inclusion positions, and prohibit federal funds for certain race relations education in Defense Department institutions.

Human Rights Campaign President Kelley Robinson criticized the House’s approval of the measure in the final bill, saying military members were used as “bargaining chips” for the issue.

“Military servicemembers and their families wake up every day and sacrifice more than most of us will ever understand. Those families protect our right to live freely and with dignity – they deserve that same right, and the freedom to access the care their children need,” Robinson said. 

“Today, politicians in the House betrayed our nation’s promise to those who serve. Not since the ‘Defense of Marriage Act’ passed almost 30 years ago has an anti-LGBTQ+ policy been enshrined into federal law. For the thousands of families impacted, this isn’t about politics. It’s about young people who deserve our support,” the campaign’s president continued.

Space Force controversy

Another provision in the bill will transfer certain Air National Guard functions and personnel to Space Force without permission from state governors — a measure that stirred opposition.

Roughly 1,000 Air National Guard space professionals serve in 14 units across seven states, according to the National Guard Association of the United States, which panned the measure.

The move could affect up to 33 personnel in Alaska, 126 in California, 119 in Colorado, 75 in Florida, 130 in Hawaii and 69 in Ohio.

Retired Maj. Gen. Francis M. McGinn, president of the National Guard Association, said in a statement Monday that the provision is an “existential threat to state authority over the National Guard.”

An amendment to strike the provision offered by Democratic Rep. Joe Neguse of Colorado failed in the House Rules Committee on Monday.

New requirements for blast exposure

The final bill also included a measure to prevent, assess and treat conditions, including traumatic brain injuries, suffered by service members repeatedly exposed to explosion pressure waves.

The legislation requires the Defense Department to establish the Defense Intrepid Network for Traumatic Brain Injury and Brain Health no later than Jan. 1, 2026. Other mandates include creating safety thresholds for blast exposure by early 2027, and establishing policies to encourage service members to seek treatment, without fear of retaliation, for brain trauma.

The department will also be required to report back to Congress on the safety initiatives and numbers of service members who seek treatment, among other data.

The safety provisions were championed this year by Sens. Joni Ernst, an Iowa Republican, and Elizabeth Warren, a Massachusetts Democrat, as well as House Democrat Ro Khanna of California.

States Newsroom interviewed a Washington state Purple Heart recipient in May who was among more than 100 troops who suffered traumatic brain injuries following an Iranian air strike on the U.S. Al Asad Airbase in Iraq in January 2020.

On the campaign trail in October, President-elect Donald Trump downplayed those troops’ injuries as “headaches.” That was not the first time Trump had disparaged the troops’ injuries stemming from the 2020 attack.