You can easily drop those from a universal healthcare system - look at the NHS and gender affirming care across the pond. So it can't only be that part - I think it's wanting the undeserving to not have healthcare.

It’s not that easy. You have to make it through the primaries to stand for election. Both parties are increasingly dominated by their outside wings. If you said “I’ll try to get universal healthcare done and I’ll build the coalition needed for it, even if it means accepting painful compromises like not covering gender affirming care” you won’t make it out of the democratic primaries. That’s why there’s so many common sense positions that have majority support yet never a majority in political bodies.