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They are. Namely for poor people, veterans, government employees. Basically people who the government provides healthcare for. My bottom surgery was partially subsidized through the ACA as I was unemployed at the time and because it’s a medically necessary procedure (according to the AMA and APA) that I’d been pursuing for years.
As a complete aside, many, many years ago, before the internet was really a thing, and trans people were not nearly as visible, a friend once told me about a friend of theirs who was getting "bottom surgery" and, because that was literally the first time I'd ever heard that term, I had concocted an image in my head of like, a butthole widening or something, you know, to help him become a better bottom. It's been 30+ years and they still make fun of me for that.
This is the best interpretation ive ever heard and I will now introduce it to my trans masc friend.