WASHINGTON — The House voted 281-140 on Wednesday to pass a bicameral compromise version of the fiscal 2025 National Defense Authorization Act, with a majority of Democrats voting against the bill.

The House action on the $883.7 billion legislation paves the way for a Senate vote in the coming days to clear the measure for its likely enactment into law for the 64th consecutive fiscal year.

The NDAA typically has more bipartisan support in the House than it did Wednesday. But the usual group of Democratic “no” votes each year was supplemented this time around by the opposition to the bill from Democratic hawks and doves alike, while Republicans mostly backed the measure. Democrats voted 81-124 on passage.

The Democratic objections were due mainly to the bill’s restriction on the Pentagon’s TRICARE health care insurance plans covering the costs of gender dysphoria treatments for people under the age of 18.

The controversy surrounds a one-sentence provision: “Medical interventions for the treatment of gender dysphoria that could result in sterilization may not be provided to a child under the age of 18.’’

Rep. Adam Smith of Washington state, the top Democrat on the Armed Services Committee, said in floor remarks ahead of the vote that the provision “taints an otherwise excellent” bill.

“We have an outright ban on care that undoubtedly is saving lives of minors experiencing gender dysphoria and the anxiety and depression and suicidal thoughts that come with that,” Smith said. “We are doing it because of ignorant, bigoted reasons against the trans community.”

Transgender issue

The gender dysphoria provision was not part of the package that Armed Services leaders from both chambers had agreed on.

Rather, it was added in recent days by Speaker Mike Johnson, R-La., as a sop to ultraconservative members, lawmakers from both parties have said.

Rep. Mike D. Rogers, R-Ala., the chairman of the Armed Services Committee, told reporters this week he was not consulted on adding the provision to the bill. And he said he considers the health care policy directive unnecessary, because he believes President-elect Donald Trump will institute the ban administratively anyway.

With the provision likely to become law in the days ahead, the debate may soon turn to the question of how many service members the military could lose because they cannot afford puberty-pausing medications for their transgender children.

Trump issued during his first term a ban on transgender people serving in the military, which President Joe Biden overturned. But Trump may reprise the order in his next term. If that happens, it could also have an effect on recruiting and retention.

Supporters of gender dysphoria treatments for teenagers say the word sterilization is misleading, as the drugs’ effects are reversible.

Currently, TRICARE covers hormone therapy and psychological counseling for gender dysphoria, including for beneficiaries. Smith said perhaps 4,000 children of service members are getting such treatments today.

TRICARE does not cover gender transition surgery, though active-duty service members may request a waiver for medically necessary procedures.

Gender transition surgeries are extremely rare for U.S. teenagers, a recent study found.

“By forcing families to choose between their military careers and their children’s health care, this bill would lead to decreased military readiness and retention,” said Rachel Branaman, executive director of the Modern Military Association of America, which advocates for LGBTQ service members, in a statement earlier this week.

Other flashpoints extinguished

Despite the outsized focus on this one part of the compromise NDAA, most other controversial culture war provisions that had been adopted mostly as House floor amendments were dropped weeks ago from the compromise version.

These included a broader ban on TRICARE covering gender-transition procedures, a prohibition on the Pentagon reimbursing service members for expenses incurred if they must travel to obtain abortions, and a mandate that all personnel decisions in the Defense Department must be merit-based.

Another provision that fell by the wayside was a requirement for TRICARE to cover in vitro fertilization, even though both chambers’ NDAAs had called for it and even though federal civilians will get that benefit in 2025.

“Each corner had some wins and some losses, but the totality of the bill deserves the support of all members,” Rogers said on the floor ahead of the vote.

Massive measure

Not to be lost in the fracas over transgender health care is the sweeping set of other provisions in the 1,813-page bill and its accompanying 696-page joint explanatory statement.

In addition to the $883.7 billion in spending the compromise measure would authorize for fiscal 2025, another approximately $11.5 billion for defense is authorized by other bills. So the national defense spending total will fall in line with the $895.2 billion defense budget cap for fiscal 2025 set in last year’s debt-ceiling law.

The Senate Armed Services Committee bill, by contrast, had advocated a total amount of spending that was $28.1 billion higher than the House bill or the compromise legislation. The full Senate never voted on its NDAA.

The total amount of funds themselves — and how they are apportioned — will not be decided until the coming year.

GOP leaders in the next Congress plan to use the so-called reconciliation process to boost defense spending by perhaps $20 billion or more.

Lawmakers will also try next year to write fiscal 2025 appropriations bills for defense and other programs by the time the next continuing resolution expires, probably sometime in March.

Pay and firepower

Notably, the compromise NDAA would authorize the Pentagon to start paying in January a pay raise for all troops of 4.5%, with an additional 10% hike for junior enlisted personnel.

Without additional appropriations enacted to cover these raises, however, Pentagon officials have said they will have to shift money from other parts of their budget.

The compromise NDAA includes a raft of other changes beyond the payroll that are designed to improve quality of life in the military, from enhancing housing to expanding child care services.

The bill would authorize a full slate of weaponry, too, though the funding for each program will be determined by appropriators.

The NDAA would approve, for example, the 68 F-35 fighter jets requested by the Biden administration but allow delivery of just 48 of them pending submission of a host of plans for correcting deficiencies in the jet and its support systems.

The bill would require, too, that 578 Air National Guard personnel who perform space missions move to the Space Force, a provision America’s governors may sue over.

And the measure would mandate the establishment before 2031 of a third strategic antimissile site on America’s East Coast, subject to appropriations to carry it out.

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