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A pair of extreme new Trump administration rules aimed at functionally banning gender-affirming healthcare for transgender youth could force even more hospitals to close down.

NPR reported Thursday that the Department of Health and Human Services (HHS) drafted a proposed rule that would prohibit federal Medicaid reimbursement for medical care provided to transgender patients younger than 18 and prohibit the same from the Children’s Health Insurance Program (CHIP) for patients under 19.

Another proposed rule goes even further, blocking all Medicaid and Medicare funding to hospitals that provide gender-affirming care to youth.

As Erin Reed, an independent journalist who reports on LGBTQ+ rights, explained, this “would effectively eliminate access to such care nationwide, except at the few private clinics able to forgo Medicaid entirely, a rarity in transgender youth medicine.”

The policies are of a piece with the Trump administration and the broader Republican Party’s efforts to eliminate transgender healthcare for youth across the country.

Bans on gender-affirming care for those under 18 have already been passed in 27 states, despite evidence that early access to treatments like puberty blockers and hormones can save lives.

As Reed pointed out, a Cornell University review of more than 51 studies shows that access to such care dramatically reduces the risk of suicide and the rates of anxiety and depression among transgender adolescents.

The new HHS rules are being prepared for public release in November and would not be finalized for several more months.

But if passed, the ramifications could extend far beyond transgender people, impacting the entire healthcare system, for which federal funding from Medicare and Medicaid is a load-bearing piece. According to a report last year from the American Hospital Association, 96% of hospitals in the US have more than half their inpatient days paid for by Medicare and Medicaid.

It is already becoming apparent what happens when even some of that funding is taken away. As a result of the massive GOP budget law passed in July, an estimated $1 trillion is expected to be cut from Medicaid over the next decade. According to an analysis released Thursday by Protect Our Care, which maintains a Hospital Crisis Watch database, more than 500 healthcare providers across the country are already at risk of shutting down due to the budget cuts.

Tyler Hack, the executive director of the Christopher Street Project, a transgender rights organization, said that the newly proposed HHS rule would be “forcing hospitals to choose between providing lifesaving care for trans people or maintaining the ability to serve patients through Medicare and Medicaid.”

“Today’s news marks a dangerous overreach by the executive branch, pitting trans people, low-income families, disabled people, and seniors against each other and making hospitals choose which vulnerable populations to serve,” Hack said. “If these rules become law, it will kill people.”

Kentucky Gov. Andy Beshear spooked CNN's Kate Bolduan by describing how nearly a Louisville plane crash could have been exponentially worse.

A UPS plane crashed Tuesday evening as it departed Louisville Muhammad Ali International Airport for Honolulu, killing at least three crew members and at least six other people and sending up an enormous fireball and thick clouds of black smoke, and the Democratic governor told "CNN This Morning" the death toll would likely rise.

"We do think it's going to grow, sadly," Beshear said. "But the search and rescue mission went through the night has been able to intensify today, so hopefully it won't grow by much. We also have two individuals in critical care at U of L hospital. We're praying for them and for their recovery. It's hard to lose nine plus people in such a violent way."

However, Beshear said the crash could have been far worse.

"This plane barely missed a restaurant bar," he said. "It was very close to a very large Ford plant with hundreds, if not a thousand-plus workers. It was very close to our convention center that's having a big livestock show that people were arriving for. So really tough, but recognize it could be worse."

Bolduan was stunned by the disclosure.

"That just gave me chills thinking about all of the people that were right in the line of this crash," she said. "I mean, when you see the debris field and what happened with this plane, it's terrifying. I mean, how much destruction and damage are we talking about here?"

"Well, it's a huge amount of of damage in about a city block, about a mile," Beshear replied. "Think about the plane loaded with 38,000 gallons of air fuel hitting a petroleum, not refinery, but recycler, which also added to the to the challenges, and then an auto parts lot, and so what we saw is not just the direct impact and explosion of the plane, but everything that then occurred on the ground. Thankfully, there wasn't any significant hazardous material inside the plane. The air quality conditions are improving significantly. We now have a shelter-in-place [order] only around a very small area. We're monitoring water, because of the air, the jet fuel. But the area that we're concerned about is smaller than originally anticipated, and then we've just got so many incredible first responders on on the scene from dozens of different agencies that do such a great job."

"So we are very quickly getting a hold of the environmental search and rescue and other challenges we face," the governor added, "and we'll probably have some pretty close to to final information mid-afternoon."

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