I
119THCONGRESS
1
STSESSION H. R. 2107
To amend title III of the Public Health Service Act to reauthorize the
program of payments to children’s hospitals that operate graduate med-
ical education programs, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
MARCH14, 2025
Mr. C
RENSHAW(for himself, Mrs. MILLERof Illinois, Mrs. MILLER-MEEKS,
Mr. P
FLUGER, Mr. ELLZEY, Mr. VANDREW, Mr. GREENof Tennessee,
Mr. R
OUZER, Mrs. HARSHBARGER, Mr. GROTHMAN, Mr. JACKSONof
Texas, and Mr. S
COTTFRANKLINof Florida) introduced the following
bill; which was referred to the Committee on Energy and Commerce
A BILL
To amend title III of the Public Health Service Act to
reauthorize the program of payments to children’s hos-
pitals that operate graduate medical education programs,
and for other purposes.
Be it enacted by the Senate and House of Representa-1
tives of the United States of America in Congress assembled, 2
SECTION 1. SHORT TITLE. 3
This Act may be cited as the ‘‘Children’s Hospital 4
GME Support Reauthorization Act of 2025’’. 5
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SEC. 2. PROGRAM OF PAYMENTS TO CHILDREN’S HOS-1
PITALS THAT OPERATE GRADUATE MEDICAL 2
EDUCATION PROGRAMS. 3
Section 340E of the Public Health Service Act (42 4
U.S.C. 256e) is amended— 5
(1) in subsection (a), by striking ‘‘2023’’ and 6
inserting ‘‘2030’’; 7
(2) in subsection (b)(3)(D), by inserting ‘‘and 8
the end of fiscal year 2030,’’ after ‘‘fiscal year 9
2022,’’; 10
(3) in subsection (e), by adding at the end the 11
following new paragraph: 12
‘‘(4) P
ROHIBITION ON PAYMENTS TO HOS -13
PITALS FURNISHING SPECIFIED PROCEDURES AND 14
DRUGS TO MINORS.— 15
‘‘(A) I
N GENERAL.—Notwithstanding any 16
other provision of this section, no payment may 17
be made under this section to a children’s hos-18
pital for a fiscal year (beginning with fiscal year 19
2026) if, at any point during the preceding fis-20
cal year, such hospital furnished specified pro-21
cedures and drugs (as defined in subsection (g)) 22
to an individual under 18 years of age. 23
‘‘(B) S
PECIAL RULE FOR FISCAL YEAR 24
2026.—In applying subparagraph (A) with re-25
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spect to payments described in such subpara-1
graph for fiscal year 2026— 2
‘‘(i) the reference to ‘for a fiscal year’ 3
shall be treated as a reference to ‘for any 4
portion of fiscal year 2026 occurring after 5
December 31, 2025’; and 6
‘‘(ii) the reference to ‘the preceding 7
fiscal year’ shall be treated as a reference 8
to ‘the period beginning on September 1, 9
2025, and ending on December 31, 2025’. 10
‘‘(C) R
ULE OF CONSTRUCTION .—Nothing 11
in this paragraph shall be construed as prohib-12
iting payments for a fiscal year (or, in the case 13
of payments for fiscal year 2026, during the 14
portion of such fiscal year described in subpara-15
graph (B)(i)) to a hospital that, during the pre-16
ceding fiscal year (or, in the case of payments 17
for fiscal year 2026, during the period de-18
scribed in subparagraph (B)(ii)), furnished 19
mental or behavioral health services to individ-20
uals under 18 years of age for the treatment of 21
gender dysphoria not consisting of specified 22
procedures and drugs.’’; 23
(4) in subsection (f)— 24
(A) in paragraph (1)(A)— 25
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(i) in clause (v), by striking ‘‘and’’ at 1
the end; 2
(ii) in clause (vi), by striking the pe-3
riod at the end and inserting ‘‘; and’’; and 4
(iii) by adding at the end the fol-5
lowing: 6
‘‘(vii) for each of fiscal years 2026 7
through 2030, $124,000,000.’’; and 8
(B) in paragraph (2)— 9
(i) in subparagraph (E), by striking 10
‘‘and’’ at the end; 11
(ii) in subparagraph (F), by striking 12
the period at the end and inserting ‘‘; 13
and’’; and 14
(iii) by adding at the end the fol-15
lowing: 16
‘‘(G) for each of fiscal years 2026 through 17
2030, $261,000,000’’; and 18
(5) in subsection (g), by adding at the end the 19
following new paragraph: 20
‘‘(4) S
PECIFIED PROCEDURES AND DRUGS .— 21
‘‘(A) I
N GENERAL.—Except as provided in 22
subparagraph (B), the term ‘specified proce-23
dures and drugs’ means, with respect to an in-24
dividual, any of the following: 25
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‘‘(i) Performing any surgery for the 1
purpose of changing the body of such indi-2
vidual to no longer correspond to the indi-3
vidual’s sex, including— 4
‘‘(I) castration; 5
‘‘(II) orchiectomy; 6
‘‘(III) scrotoplasty; 7
‘‘(IV) vasectomy; 8
‘‘(V) hysterectomy; 9
‘‘(VI) oophorectomy; 10
‘‘(VII) ovariectomy; 11
‘‘(VIII) metoidioplasty; 12
‘‘(IX) penectomy; 13
‘‘(X) phalloplasty; 14
‘‘(XI) vaginoplasty; 15
‘‘(XII) vaginectomy; 16
‘‘(XIII) vulvoplasty; 17
‘‘(XIV) reduction 18
thyrochondroplasty; 19
‘‘(XV) chondrolaryngoplasty, or 20
any plastic surgery that feminizes or 21
masculinizes the facial features; 22
‘‘(XVI) mastectomy, or any 23
placement of chest implants to create 24
feminine breasts; and 25
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‘‘(XVII) Any placement of fat or 1
artificial implants in the gluteal re-2
gion. 3
‘‘(ii) Administering, supplying, pre-4
scribing, dispensing, distributing, or other-5
wise conveying to an individual medications 6
for the purposes described in clause (i), in-7
cluding gonadotrophin releasing hormone 8
(GnRH) analogues or other puberty-block-9
ing drugs to stop or delay normal puberty, 10
and estrogen, testosterone, progesterone, 11
or other androgens to an individual in an 12
amount greater than would normally be 13
produced endogenously in a healthy indi-14
vidual of that individual’s age and sex. 15
‘‘(B) E
XCEPTION.—Subparagraph (A) 16
shall not apply to the provision by a physician 17
or health care provider, with the consent of the 18
child’s parent or legal guardian, of— 19
‘‘(i) puberty suppression or blocking 20
prescription drugs for the purpose of nor-21
malizing puberty for a minor experiencing 22
precocious puberty; 23
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‘‘(ii) appropriate and medically nec-1
essary procedures or treatments to correct 2
for— 3
‘‘(I) a medically verifiable genetic 4
disorder of sex development, includ-5
ing— 6
‘‘(aa) 46,XX chromosomes 7
with virilization; 8
‘‘(bb) 46,XY chromosomes 9
with undervirilization; and 10
‘‘(cc) both ovarian and tes-11
ticular tissue; or 12
‘‘(II) sex chromosome structure, 13
sex steroid hormone production, or 14
sex hormone action, if determined to 15
be abnormal by a physician through 16
genetic or biochemical testing; 17
‘‘(iii) infection, disease, injury, or dis-18
order caused or exacerbated by previous 19
medical procedures as defined in sub-20
section (g)(4)(A); or 21
‘‘(iv) a physical disorder, physical in-22
jury, or physical illness that would, as cer-23
tified by a physician, place the individual 24
in imminent danger of death or impair-25
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ment of a major bodily function unless the 1
procedure is performed, not including if 2
the procedure or drug is for the purpose 3
described in subsection (g)(4)(A)(i). 4
‘‘(C) S
EX.—For purposes of subparagraph 5
(A), the term ‘sex’ means the indication of male 6
or female sex by reproductive potential or ca-7
pacity, sex chromosomes, naturally occurring 8
sex hormones, gonads, or internal or external 9
genitalia present at birth.’’. 10
Æ
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