The Senate on Wednesday passed an $895.2 billion defense policy bill that sparked controversy when House Speaker Mike Johnson amended the legislation to forbid the use of federal funds to cover specialized medical care for the transgender children of U.S. military personnel.

The annual National Defense Authorization Act was approved by a vote of 85-14, with several Democrats opposing. It will now go to the president, who is expected to sign it into law.

It also includes provisions to help protect service members from brain injuries, a provision added to the bill after the Lewiston mass shooting renewed nationwide concerns about the effects of soldiers’ exposure to blasts.

Over the objections of most House Democrats and some Republicans, Johnson, R-La., upended what historically is an overwhelmingly bipartisan vote to approve the NDAA.

The House passed the bill 281-140 last week, with fewer than half of the chamber’s Democrats voting in favor of it. Many — including some who played key roles drafting the sprawling national security package — expressed bitterness that months of good-faith negotiation between members of both political parties from the House and Senate had been tainted.

Rep. Chellie Pingree of Maine, D-1st District, voted against the bill and said in an emailed statement Monday that she was disappointed by the House’s vote last week and Johnson’s decision to try to intervene in a lawsuit filed by a Maine veteran’s daughter against the Department of Defense for refusing to pay for her gender-affirming surgeries.

“It is deeply disappointing that House Republican leaders continue to politicize the rights and dignity of Americans,” Pingree wrote. “The divisive language they added to the National Defense Authorization Act in the eleventh hour, including provisions targeting gender-affirming care for military families, reflects a concerning effort to roll back hard-won rights.”

Rep. Jared Golden of Maine, D-2nd District, voted in favor of the bill and issued a written statement last week citing provisions he supported, such as the pay raise for service members and construction of a new DDG-51 destroyer at Bath Iron Works, something he worked to include in the bill as a member of the House Armed Services Committee.

For decades, federal law has barred TRICARE from covering any surgery that improves a person’s physical appearance “but is not expected to significantly restore functions.” It specifically names “sex gender changes,” among other procedures, as uncovered — yet the DOD acknowledged that TRICARE has paid for such surgeries for active-duty members.

The woman at the heart of the Maine lawsuit, who is the daughter of a veteran, said she needed several gender-affirming surgeries but was denied coverage through TRICARE, even though her doctors agreed the procedures were medically necessary to treat gender dysphoria, a condition in which a person’s gender identity does not match their assigned sex at birth.

The case was headed toward a settlement when the House moved to intervene in the case and defend the coverage rules, which a federal judge has tentatively ruled unconstitutional.

The anger over the Republican changes to the bill spilled over into the Senate this week, as Sen. Tammy Baldwin, D-Wis., led 20 other senators in a largely symbolic effort to strike Johnson’s provision from the legislation. On Tuesday, she said she was so appalled by its inclusion that she would vote against the NDAA for the first time in her Senate career — “a position I do not take lightly,” she added.

“It’s flat-out wrong,” Baldwin said on the Senate floor, blasting a policy that “guts our service members’ rights” simply “to score cheap political points.” If not for that provision, Baldwin said, “I would have been proud to support it.”

The NDAA sets Pentagon and U.S. national security policy for the year ahead. Republicans and Democrats alike have lauded the bill’s 14.5% pay increase for junior enlisted troops, along with its authorization for spending increases on military “quality of life” issues. The bill also strengthens U.S. defenses against China while expanding investment in new military technologies and replenishing U.S. weapons stockpiles, they said.

Several senior Democratic senators said that while they shared their colleagues’ frustration with the transgender care provision, the NDAA was too important to fail.

“The NDAA is not perfect, but it still makes several important advances Democrats fought for,” Senate Majority Leader Chuck Schumer, D-N.Y., said Wednesday on the Senate floor, praising the bill’s “strong stand” against China and its authorized investment in artificial intelligence.

Sen. Jack Reed, D-R.I., who chairs the Senate Armed Services Committee, said Wednesday ahead of the vote that he shares his “colleagues’ frustration” and that he voted against Johnson’s “frankly misguided provision” during the negotiation process.

Reed earlier this week told reporters that Democrats had also been “successful in stripping out the vast majority of very far-right provisions that had passed in the House bill” and stressed the bill’s larger mission to provide the resources the military needs to successfully defend America.

“We have a duty to support our servicemen and women … and we believe this bill, by and large, accomplishes that,” he said.

Sen. Mark Warner, D-Va., who chairs the Senate Intelligence Committee, said he worried Johnson’s provision could set a dangerous precedent for the inclusion of other “social policy riders” in future NDAAs, which in turn could threaten the annual policy bill’s decadeslong record of consistent passage.

“But at the end of the day, I’m not going to sink the whole defense and intel bill,” he said in an interview.

Johnson’s provision states that “medical interventions for the treatment of gender dysphoria” — a medical diagnosis for those whose gender identity is different from their biological sex at birth — “that could result in sterilization may not be provided to a child under the age of 18,” something medical professionals say does not happen in most cases.

Republican supporters of the move — many of whom, like Johnson, have sought to limit transgender rights and treatments more broadly — portrayed the provision as protecting children from the potentially permanent consequences of medical treatments administered to them as minors.

On the other side of the aisle, Democrats framed it as an act born of bigotry and ignorance that would deny potentially lifesaving treatments to adolescents struggling with gender dysphoria — a population that has a high prevalence of suicide.

It is unclear how many children would be affected by the provision. The House Armed Services Committee’s Democratic staff said the Pentagon told them it would impact thousands of families.

In 2017, there were 2,500 minors receiving such health care through the military’s TRICARE health system, according to a report circulated by the American Civil Liberties Union. The Williams Institute, a UCLA-based think tank that researches gender identity and sexual orientation laws, says that nationwide, there are about 300,000 youth, aged 13 to 18, who identify as transgender, and that 0.6% of the total U.S. population identifies as transgender.

House Armed Services Committee Chairman Mike Rogers, R-Ala., told reporters last week that Johnson’s provision was unnecessary because President-elect Donald Trump is likely to enact the same policy — with or without Congress — once he takes office next month.

Senior lawmakers from both parties have sought to highlight what the NDAA does accomplish. For instance, the bill authorizes a significant pay increase for junior enlisted U.S. service members, whose lagging salaries have forced many military families to resort to food stamps and other forms of public assistance — circumstances that have shocked members of both parties in hearings held over the past two years.

It also authorizes roughly $3 billion to improve military housing, including the replacement of dilapidated and crumbling barracks. And it will expand child care and other benefits to a military that lawmakers say has failed to offer competitive career options amid a worsening recruitment crisis.

Maine independent Sen. Angus King praised the bill’s passage in an emailed statement Wednesday, calling attention to the added provisions to protect service members from blast exposure.

King cited the funding for shipbuilding at Bath Iron Works and Portsmouth Naval Shipyard as supporting jobs and manufacturing in Maine. And, he said, “There are many more important provisions in this legislation – including a long-overdue brain injury monitoring program, fighting the opioid epidemic, and deterring Chinese and Russian aggression.”

The bill authorizes the expansion of U.S. military resources to assist with migrant interdiction on the border with Mexico and expands U.S. assistance to Israel — core Republican priorities.

It does not authorize additional military assistance for Ukraine, an issue where most Republicans now echo Trump’s skepticism about continuing to aid Kyiv’s efforts to repel Russia’s full-scale invasion. Instead, it requires the administration to provide Congress with an assessment of the “likely course of war in Ukraine,” including whether its military will be able to “to defend against Russian aggression” if the United States stops providing support.

The bill also does not include an additional $25 billion to its top line. That additional funding for missile defense, shipbuilding and counter-drone technology was approved over the summer by the Senate Armed Services Committee — at the urging of its top Republican, Sen. Roger Wicker of Mississippi — but was abandoned in the final bill negotiated between the House and Senate.

Wicker on Wednesday called the NDAA “a good bill” but scolded Congress for having “missed the opportunity to strengthen” Trump’s hand as he takes office next month and confronts what Wicker described as “the most dangerous national security moment since World War II.”

Senate Minority Leader Mitch McConnell, R-Ky., this week also derided the NDAA as a “compromised product” for its failure to include those additional funds.

“The absence of the Senate-backed increase to top-line investments will go down as a tremendous, tremendous missed opportunity,” McConnell said on the Senate floor Monday. “Artificial budget restraints mean that major bill provisions, like a pay raise for enlisted service members, will come at the expense of investments in the critical weapon systems and munitions that deter conflict and keeps them safe.”

Washington Post writer Mariana Alfaro contributed to this report. Material from the Portland Press Herald was added to this report.