Us Congress 2025-2026 Regular Session

Us Congress House Bill HB498 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	I
2	2	119THCONGRESS
3	3	1
4	4	STSESSION H. R. 498
5	5	To amend title XIX of the Social Security Act to prohibit Federal Medicaid
6	6	funding for gender transition procedures for minors.
7	7	IN THE HOUSE OF REPRESENTATIVES
8	8	JANUARY16, 2025
9	9	Mr. C
10	10	RENSHAW(for himself and Ms. GREENEof Georgia) introduced the
11	11	following bill; which was referred to the Committee on Energy and Commerce
12	12	A BILL
13	13	To amend title XIX of the Social Security Act to prohibit
14	14	Federal Medicaid funding for gender transition proce-
15	15	dures for minors.
16	16	Be it enacted by the Senate and House of Representa-1
17	17	tives of the United States of America in Congress assembled, 2
18	18	SECTION 1. SHORT TITLE. 3
19	19	This Act may be cited as the ‘‘Do No Harm in Med-4
20	20	icaid Act’’. 5
21	21	SEC. 2. PROHIBITING FEDERAL MEDICAID FUNDING FOR 6
22	22	GENDER TRANSITION FOR MINORS. 7
23	23	(a) I
24	24	NGENERAL.—Section 1903(i) of the Social Se-8
25	25	curity Act (42 U.S.C. 1396b(i)) is amended— 9
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28	28	•HR 498 IH
29	29	(1) in paragraph (26), by striking ‘‘; or’’ and 1
30	30	inserting a semicolon; 2
31	31	(2) in paragraph (27), by striking the period at 3
32	32	the end and inserting ‘‘; or’’; and 4
33	33	(3) by inserting after paragraph (27) the fol-5
34	34	lowing new paragraph: ‘‘(28) with respect to any 6
35	35	amount expended for specified gender procedures 7
36	36	under section 1905(kk) to an individual under 18 8
37	37	years of age enrolled in a State plan (or waiver of 9
38	38	such plan), including any amounts expended for the 10
39	39	administration of a State program that furnishes 11
40	40	specified procedures and drugs to individuals under 12
41	41	18 years of age.’’. 13
42	42	(4) in the flush left matter at the end, by strik-14
43	43	ing ‘‘and (18),’’ and inserting ‘‘(18), and (28)’’. 15
44	44	(b) P
45	45	ROHIBITINGFEDERALMEDICAIDFUNDING FOR 16
46	46	G
47	47	ENDERTRANSITIONS FOR MINORS.—Section 1905 of 17
48	48	the Social Security Act (42 U.S.C. 1396d) is amended by 18
49	49	adding at the end the following new subsection: 19
50	50	‘‘(KK) P
51	51	ROHIBITING FEDERAL MEDICAID 20
52	52	FUNDING FOR GENDER TRANSITIONS FOR MI -21
53	53	NORS.— 22
54	54	‘‘(A) For purposes of section 1903(i)(28), 23
55	55	except as provided in subparagraph (B), the 24
56	56	term ‘specified gender transition procedures’ 25
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59	59	•HR 498 IH
60	60	means, with respect to an individual, any of the 1
61	61	following when performed for the purpose of in-2
62	62	tentionally changing the body of such individual 3
63	63	(including by disrupting the body’s develop-4
64	64	ment, inhibiting its natural functions, or modi-5
65	65	fying its appearance) to no longer correspond to 6
66	66	the individual’s sex: 7
67	67	‘‘(i) Performing any surgery, includ-8
68	68	ing— 9
69	69	‘‘(I) castration; 10
70	70	‘‘(II) sterilization; 11
71	71	‘‘(III) orchiectomy; 12
72	72	‘‘(IV) scrotoplasty; 13
73	73	‘‘(V) vasectomy; 14
74	74	‘‘(VI) tubal ligation; 15
75	75	‘‘(VII) hysterectomy; 16
76	76	‘‘(VIII) oophorectomy; 17
77	77	‘‘(IX) ovariectomy; 18
78	78	‘‘(X) metoidioplasty; 19
79	79	‘‘(XI) clitoroplasty; 20
80	80	‘‘(XII) reconstruction of the fixed 21
81	81	part of the urethra with or without a 22
82	82	metoidioplasty or a phalloplasty; 23
83	83	‘‘(XIII) penectomy; 24
84	84	‘‘(XIV) phalloplasty; 25
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87	87	•HR 498 IH
88	88	‘‘(XV) vaginoplasty; 1
89	89	‘‘(XVI) vaginectomy; 2
90	90	‘‘(XVII) vulvoplasty; 3
91	91	‘‘(XVIII) reduction 4
92	92	thyrochondroplasty; 5
93	93	‘‘(XIX) chondrolaryngoplasty; 6
94	94	‘‘(XX) mastectomy; and 7
95	95	‘‘(XXI) any plastic, cosmetic, or 8
96	96	aesthetic surgery that feminizes or 9
97	97	masculinizes the facial or other phys-10
98	98	iological features of an individual. 11
99	99	‘‘(ii) Any placement of chest implants 12
100	100	to create feminine breasts or any place-13
101	101	ment of erection or testicular prosetheses. 14
102	102	‘‘(iii) Any placement of fat or artifi-15
103	103	cial implants in the gluteal region. 16
104	104	‘‘(iv) Administering, supplying, pre-17
105	105	scribing, dispensing, distributing, or other-18
106	106	wise conveying to an individual medica-19
107	107	tions, including— 20
108	108	‘‘(I) gonadotropin-releasing hor-21
109	109	mone (GnRH) analogues or other pu-22
110	110	berty-blocking drugs to stop or delay 23
111	111	normal puberty; and 24
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114	114	•HR 498 IH
115	115	‘‘(II) testosterone, estrogen, pro-1
116	116	gesterone or other androgens to an in-2
117	117	dividual at doses that are 3
118	118	supraphysiologic, greater or more po-4
119	119	tent than would normally be produced 5
120	120	endogenously in a healthy individual 6
121	121	of the same age and sex. 7
122	122	‘‘(B) E
123	123	XCEPTION.—Subparagraph (A) 8
124	124	shall not apply to the following when furnished 9
125	125	to an individual by a health care provider with 10
126	126	the consent of such individual’s parent or legal 11
127	127	guardian: 12
128	128	‘‘(i) Puberty suppression or blocking 13
129	129	prescription drugs for the purpose of nor-14
130	130	malizing puberty for an individual experi-15
131	131	encing precocious puberty. 16
132	132	‘‘(ii) Appropriate and medically nec-17
133	133	essary procedures or treatments to correct 18
134	134	for— 19
135	135	‘‘(I) a medically verifiable genetic 20
136	136	disorder of sex development, includ-21
137	137	ing— 22
138	138	‘‘(aa) 46,XX chromosomes 23
139	139	with virilization; 24
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143	143	‘‘(bb) 46,XY chromosome 1
144	144	with undervirilization; and 2
145	145	‘‘(cc) both ovarian and tes-3
146	146	ticular tissue; 4
147	147	‘‘(II) sex chromosome structure, 5
148	148	sexsteroid hormone production, or sex 6
149	149	hormone action, if determined to be 7
150	150	abnormal for a healthy individual of 8
151	151	the same sex and age by a physician 9
152	152	through genetic or biochemical test-10
153	153	ing; 11
154	154	‘‘(III) infection, disease, injury, 12
155	155	or disorder caused or exacerbated by a 13
156	156	previous procedure described in sub-14
157	157	paragraph (A), or a physical disorder, 15
158	158	physical injury, or physical illness that 16
159	159	would, as certified by a physician, 17
160	160	place the individual in imminent dan-18
161	161	ger of death or impairment of a major 19
162	162	bodily function unless the procedure is 20
163	163	performed, not including procedures 21
164	164	performed for the alleviation of men-22
165	165	tal distress; or 23
166	166	‘‘(IV) procedures to restore or re-24
167	167	construct the body of the individual in 25
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170	170	•HR 498 IH
171	171	order to correspond to the individual’s 1
172	172	sex after one or more previous proce-2
173	173	dures described in subparagraph (A), 3
174	174	which may include the removal of a 4
175	175	pseudo phallus or breast augmenta-5
176	176	tion. 6
177	177	‘‘(C) S
178	178	EX.—For purposes of subpara-7
179	179	graph(A), the term ‘sex’ means either male or 8
180	180	female, as biologically determined and defined 9
181	181	by clause (i) and clause (ii). 10
182	182	‘‘(i) F
183	183	EMALE.—The term ‘female’ 11
184	184	means an individual who naturally has, 12
185	185	had, will have, or would have, but for a de-13
186	186	velopmental or genetic anomaly or histor-14
187	187	ical accident, the reproductive system that 15
188	188	at some point produces, transports, and 16
189	189	utilizes eggs for fertilization. 17
190	190	‘‘(ii) M
191	191	ALE.—The term ‘male’ means 18
192	192	an individual who naturally has, had, will 19
193	193	have, or would have, but for a develop-20
194	194	mental or genetic anomaly or historical ac-21
195	195	cident, the reproductive system that at 22
196	196	some point produces, transports, and uti-23
197	197	lizes sperm for fertilization.’’. 24
198	198	Æ
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