| 1 | 1 | | II |
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| 2 | 2 | | 119THCONGRESS |
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| 3 | 3 | | 1 |
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| 4 | 4 | | STSESSION S. 977 |
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| 5 | 5 | | To prohibit taxpayer-funded gender transition procedures, and for other |
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| 6 | 6 | | purposes. |
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| 7 | 7 | | IN THE SENATE OF THE UNITED STATES |
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| 8 | 8 | | MARCH12, 2025 |
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| 9 | 9 | | Mr. M |
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| 10 | 10 | | ARSHALL(for himself, Mrs. HYDE-SMITH, Mr. CRAMER, Mr. HAWLEY, |
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| 11 | 11 | | Mr. B |
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| 12 | 12 | | UDD, Mr. GRAHAM, Mr. SHEEHY, Mrs. BLACKBURN, Mr. BANKS, |
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| 13 | 13 | | Mr. W |
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| 14 | 14 | | ICKER, Mr. LEE, Ms. LUMMIS, and Mr. RISCH) introduced the fol- |
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| 15 | 15 | | lowing bill; which was read twice and referred to the Committee on Fi- |
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| 16 | 16 | | nance |
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| 17 | 17 | | A BILL |
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| 18 | 18 | | To prohibit taxpayer-funded gender transition procedures, |
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| 19 | 19 | | and for other purposes. |
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| 20 | 20 | | Be it enacted by the Senate and House of Representa-1 |
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| 21 | 21 | | tives of the United States of America in Congress assembled, 2 |
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| 22 | 22 | | SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 3 |
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| 23 | 23 | | (a) S |
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| 24 | 24 | | HORTTITLE.—This Act may be cited as the 4 |
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| 25 | 25 | | ‘‘End Taxpayer Funding of Gender Experimentation Act 5 |
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| 26 | 26 | | of 2025’’. 6 |
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| 27 | 27 | | (b) T |
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| 28 | 28 | | ABLE OFCONTENTS.—The table of contents of 7 |
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| 29 | 29 | | this Act is as follows: 8 |
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| 30 | 30 | | Sec. 1. Short title; table of contents. |
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| 32 | 32 | | kjohnson on DSK7ZCZBW3PROD with $$_JOB 2 |
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| 33 | 33 | | •S 977 IS |
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| 34 | 34 | | TITLE I—PROHIBITING FEDERALLY FUNDED GENDER |
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| 35 | 35 | | TRANSITION PROCEDURES |
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| 36 | 36 | | Sec. 101. Prohibiting taxpayer-funded gender transition procedures. |
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| 37 | 37 | | Sec. 102. Amendment to table of chapters. |
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| 38 | 38 | | TITLE II—APPLICATION UNDER THE AFFORDABLE CARE ACT |
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| 39 | 39 | | Sec. 201. Clarifying application of prohibition to premium credits and cost- |
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| 40 | 40 | | sharing reductions under ACA. |
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| 41 | 41 | | TITLE I—PROHIBITING FEDER-1 |
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| 42 | 42 | | ALLY FUNDED GENDER TRAN-2 |
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| 43 | 43 | | SITION PROCEDURES 3 |
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| 44 | 44 | | SEC. 101. PROHIBITING TAXPAYER-FUNDED GENDER TRAN-4 |
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| 45 | 45 | | SITION PROCEDURES. 5 |
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| 46 | 46 | | Title 1, United States Code, is amended by adding 6 |
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| 47 | 47 | | at the end the following new chapter: 7 |
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| 48 | 48 | | ‘‘CHAPTER 4—PROHIBITING TAXPAYER- 8 |
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| 49 | 49 | | FUNDED GENDER TRANSITION PROCE-9 |
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| 50 | 50 | | DURES 10 |
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| 51 | 51 | | ‘‘Sec. |
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| 52 | 52 | | ‘‘301. Prohibition on funding for gender transition procedures. |
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| 53 | 53 | | ‘‘302. Prohibition on funding for health benefits plans that cover gender transi- |
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| 54 | 54 | | tion procedures. |
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| 55 | 55 | | ‘‘303. Limitation on Federal facilities and employees. |
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| 56 | 56 | | ‘‘304. Construction relating to separate coverage. |
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| 57 | 57 | | ‘‘305. Construction relating to the use of non-Federal funds for health coverage. |
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| 58 | 58 | | ‘‘306. Construction relating to complications arising from gender transition pro- |
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| 59 | 59 | | cedures. |
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| 60 | 60 | | ‘‘307. Definitions. |
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| 61 | 61 | | ‘‘§ 301. Prohibition on funding for gender transition 11 |
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| 62 | 62 | | procedures 12 |
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| 63 | 63 | | ‘‘No funds authorized or appropriated by Federal 13 |
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| 64 | 64 | | law, and none of the funds in any trust fund to which 14 |
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| 65 | 65 | | funds are authorized or appropriated by Federal law, shall 15 |
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| 66 | 66 | | be expended for any gender transition procedures. 16 |
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| 69 | 69 | | •S 977 IS |
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| 70 | 70 | | ‘‘§ 302. Prohibition on funding for health benefits 1 |
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| 71 | 71 | | plans that cover gender transition proce-2 |
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| 72 | 72 | | dures 3 |
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| 73 | 73 | | ‘‘No funds authorized or appropriated by Federal 4 |
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| 74 | 74 | | law, and none of the funds in any trust fund to which 5 |
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| 75 | 75 | | funds are authorized or appropriated by Federal law, shall 6 |
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| 76 | 76 | | be expended for health benefits coverage that includes cov-7 |
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| 77 | 77 | | erage of gender transition procedures. 8 |
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| 78 | 78 | | ‘‘§ 303. Limitation on Federal facilities and employees 9 |
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| 79 | 79 | | ‘‘No health care service furnished— 10 |
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| 80 | 80 | | ‘‘(1) by or in a health care facility owned or op-11 |
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| 81 | 81 | | erated by the Federal Government; or 12 |
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| 82 | 82 | | ‘‘(2) by any physician or other individual em-13 |
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| 83 | 83 | | ployed by the Federal Government to provide health 14 |
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| 84 | 84 | | care services within the scope of the physician’s or 15 |
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| 85 | 85 | | individual’s employment, 16 |
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| 86 | 86 | | may include gender transition procedures. 17 |
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| 87 | 87 | | ‘‘§ 304. Construction relating to separate coverage 18 |
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| 88 | 88 | | ‘‘Nothing in this chapter shall be construed as pro-19 |
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| 89 | 89 | | hibiting any individual, entity, or State or locality from 20 |
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| 90 | 90 | | purchasing separate coverage for gender transition proce-21 |
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| 91 | 91 | | dures or health benefits coverage that includes gender 22 |
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| 92 | 92 | | transition procedures so long as such coverage is paid for 23 |
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| 93 | 93 | | entirely using only funds not authorized or appropriated 24 |
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| 94 | 94 | | by Federal law and such coverage shall not be purchased 25 |
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| 95 | 95 | | using matching funds required for a federally subsidized 26 |
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| 97 | 97 | | kjohnson on DSK7ZCZBW3PROD with $$_JOB 4 |
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| 98 | 98 | | •S 977 IS |
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| 99 | 99 | | program, including a State’s or locality’s contribution of 1 |
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| 100 | 100 | | Medicaid matching funds. 2 |
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| 101 | 101 | | ‘‘§ 305. Construction relating to the use of non-Fed-3 |
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| 102 | 102 | | eral funds for health coverage 4 |
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| 103 | 103 | | ‘‘Nothing in this chapter shall be construed as re-5 |
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| 104 | 104 | | stricting the ability of any non-Federal health benefits cov-6 |
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| 105 | 105 | | erage provider from offering coverage for gender transi-7 |
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| 106 | 106 | | tion procedures, or the ability of a State or locality to con-8 |
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| 107 | 107 | | tract separately with such a provider for such coverage, 9 |
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| 108 | 108 | | so long as only funds not authorized or appropriated by 10 |
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| 109 | 109 | | Federal law are used and such coverage shall not be pur-11 |
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| 110 | 110 | | chased using matching funds required for a federally sub-12 |
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| 111 | 111 | | sidized program, including a State’s or locality’s contribu-13 |
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| 112 | 112 | | tion of Medicaid matching funds. 14 |
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| 113 | 113 | | ‘‘§ 306. Construction relating to complications arising 15 |
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| 114 | 114 | | from gender transition procedures 16 |
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| 115 | 115 | | ‘‘Nothing in this chapter shall be construed to apply 17 |
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| 116 | 116 | | to the treatment of any infection, injury, disease, or dis-18 |
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| 117 | 117 | | order that has been caused by or exacerbated by the per-19 |
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| 118 | 118 | | formance of a gender transition procedure. 20 |
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| 119 | 119 | | ‘‘§ 307. Definitions 21 |
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| 120 | 120 | | ‘‘For purposes of this chapter: 22 |
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| 121 | 121 | | ‘‘(1) F |
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| 122 | 122 | | EMALE.—The term ‘female’, when used 23 |
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| 123 | 123 | | to refer to a natural person, means an individual 24 |
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| 124 | 124 | | who naturally has, had, will have, or would have, but 25 |
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| 126 | 126 | | kjohnson on DSK7ZCZBW3PROD with $$_JOB 5 |
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| 127 | 127 | | •S 977 IS |
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| 128 | 128 | | for a congenital anomaly, historical accident, or in-1 |
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| 129 | 129 | | tentional or unintentional disruption, the reproduc-2 |
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| 130 | 130 | | tive system that at some point produces, transports, 3 |
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| 131 | 131 | | and utilizes eggs for fertilization. 4 |
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| 132 | 132 | | ‘‘(2) G |
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| 133 | 133 | | ENDER TRANSITION.—The term ‘gender 5 |
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| 134 | 134 | | transition’ means the process in which an individual 6 |
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| 135 | 135 | | goes from identifying with or presenting as his or 7 |
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| 136 | 136 | | her sex to identifying with or presenting a self-pro-8 |
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| 137 | 137 | | claimed identity that does not correspond with or is 9 |
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| 138 | 138 | | different from his or her sex, and may be accom-10 |
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| 139 | 139 | | panied with social, legal, or physical changes. 11 |
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| 140 | 140 | | ‘‘(3) G |
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| 141 | 141 | | ENDER TRANSITION PROCEDURE .— 12 |
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| 142 | 142 | | ‘‘(A) I |
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| 143 | 143 | | N GENERAL.—The term ‘gender 13 |
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| 144 | 144 | | transition procedure’ means any hormonal or 14 |
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| 145 | 145 | | surgical intervention for the purpose of gender 15 |
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| 146 | 146 | | transition, including— 16 |
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| 147 | 147 | | ‘‘(i) gonadotropin-releasing hormone 17 |
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| 148 | 148 | | (GnRH) agonists or other puberty-blocking 18 |
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| 149 | 149 | | or suppressing drugs to stop or delay nor-19 |
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| 150 | 150 | | mal puberty; 20 |
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| 151 | 151 | | ‘‘(ii) testosterone, estrogen, progester-21 |
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| 152 | 152 | | one, or other androgens to an individual at 22 |
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| 153 | 153 | | doses that are supraphysiologic to what 23 |
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| 154 | 154 | | would normally be produced endogenously 24 |
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| 157 | 157 | | •S 977 IS |
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| 158 | 158 | | in a healthy individual of the same age and 1 |
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| 159 | 159 | | sex; 2 |
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| 160 | 160 | | ‘‘(iii) castration; 3 |
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| 161 | 161 | | ‘‘(iv) orchiectomy; 4 |
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| 162 | 162 | | ‘‘(v) scrotoplasty; 5 |
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| 163 | 163 | | ‘‘(vi) implantation of erection or tes-6 |
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| 164 | 164 | | ticular prostheses; 7 |
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| 165 | 165 | | ‘‘(vii) vasectomy; 8 |
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| 166 | 166 | | ‘‘(viii) hysterectomy; 9 |
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| 167 | 167 | | ‘‘(ix) oophorectomy; 10 |
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| 168 | 168 | | ‘‘(x) ovariectomy; 11 |
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| 169 | 169 | | ‘‘(xi) reconstruction of the fixed part 12 |
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| 170 | 170 | | of the urethra with or without a 13 |
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| 171 | 171 | | metoidioplasty or a phalloplasty; 14 |
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| 172 | 172 | | ‘‘(xii) metoidioplasty; 15 |
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| 173 | 173 | | ‘‘(xiii) penectomy; 16 |
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| 174 | 174 | | ‘‘(xiv) phalloplasty; 17 |
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| 175 | 175 | | ‘‘(xv) vaginoplasty; 18 |
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| 176 | 176 | | ‘‘(xvi) clitoroplasty 19 |
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| 177 | 177 | | ‘‘(xvii) vaginectomy; 20 |
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| 178 | 178 | | ‘‘(xviii) vulvoplasty; 21 |
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| 179 | 179 | | ‘‘(xix) reduction thyrochondroplasty; 22 |
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| 180 | 180 | | ‘‘(xx) chondrolaryngoplasty; 23 |
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| 181 | 181 | | ‘‘(xxi) mastectomy; 24 |
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| 182 | 182 | | ‘‘(xxii) tubal ligation; 25 |
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| 185 | 185 | | •S 977 IS |
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| 186 | 186 | | ‘‘(xxiii) sterilization; 1 |
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| 187 | 187 | | ‘‘(xxiv) any plastic, cosmetic, or aes-2 |
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| 188 | 188 | | thetic surgery that feminizes or 3 |
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| 189 | 189 | | masculinizes the facial or other physio-4 |
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| 190 | 190 | | logical features of an individual; 5 |
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| 191 | 191 | | ‘‘(xxv) any placement of chest im-6 |
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| 192 | 192 | | plants to create feminine breasts; 7 |
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| 193 | 193 | | ‘‘(xxvi) any placement of fat or artifi-8 |
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| 194 | 194 | | cial implants in the gluteal region; 9 |
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| 195 | 195 | | ‘‘(xxvii) augmentation mammoplasty; 10 |
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| 196 | 196 | | ‘‘(xxviii) liposuction; 11 |
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| 197 | 197 | | ‘‘(xxix) lipofilling; 12 |
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| 198 | 198 | | ‘‘(xxx) voice surgery; 13 |
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| 199 | 199 | | ‘‘(xxxi) hair reconstruction; 14 |
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| 200 | 200 | | ‘‘(xxxii) pectoral implants; and 15 |
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| 201 | 201 | | ‘‘(xxxiii) the removal of any otherwise 16 |
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| 202 | 202 | | healthy or non-diseased body part or tis-17 |
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| 203 | 203 | | sue. 18 |
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| 204 | 204 | | ‘‘(B) E |
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| 205 | 205 | | XCLUSIONS.—The term ‘gender 19 |
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| 206 | 206 | | transition procedure’ does not include the fol-20 |
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| 207 | 207 | | lowing when furnished to an individual by a 21 |
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| 208 | 208 | | health care provider with the consent of such 22 |
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| 209 | 209 | | individual or, if applicable, such individual’s 23 |
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| 210 | 210 | | parents or legal guardian: 24 |
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| 213 | 213 | | •S 977 IS |
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| 214 | 214 | | ‘‘(i) Services to individuals born with 1 |
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| 215 | 215 | | a medically verifiable disorder of sex devel-2 |
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| 216 | 216 | | opment, including an individual with exter-3 |
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| 217 | 217 | | nal sex characteristics that are irresolvably 4 |
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| 218 | 218 | | ambiguous, such as an individual born with 5 |
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| 219 | 219 | | 46 XX chromosomes with virilization, an 6 |
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| 220 | 220 | | individual born with 46 XY chromosomes 7 |
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| 221 | 221 | | with undervirilization, or an individual 8 |
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| 222 | 222 | | born having both ovarian and testicular 9 |
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| 223 | 223 | | tissue. 10 |
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| 224 | 224 | | ‘‘(ii) Services provided when a physi-11 |
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| 225 | 225 | | cian has otherwise diagnosed a disorder of 12 |
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| 226 | 226 | | sexual development in which the physician 13 |
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| 227 | 227 | | has determined through genetic or bio-14 |
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| 228 | 228 | | chemical testing that the individual does 15 |
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| 229 | 229 | | not have normal sex chromosome struc-16 |
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| 230 | 230 | | ture, sex steroid hormone production, or 17 |
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| 231 | 231 | | sex steroid hormone action for a healthy 18 |
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| 232 | 232 | | individual of the same sex and age. 19 |
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| 233 | 233 | | ‘‘(iii) The treatment of any infection, 20 |
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| 234 | 234 | | injury, disease, or disorder that has been 21 |
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| 235 | 235 | | caused by or exacerbated by the perform-22 |
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| 236 | 236 | | ance of gender transition procedures, 23 |
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| 237 | 237 | | whether or not the gender transition proce-24 |
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| 238 | 238 | | dure was performed in accordance with 25 |
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| 240 | 240 | | kjohnson on DSK7ZCZBW3PROD with $$_JOB 9 |
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| 241 | 241 | | •S 977 IS |
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| 242 | 242 | | State and Federal law or whether or not 1 |
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| 243 | 243 | | funding for the gender transition proce-2 |
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| 244 | 244 | | dure is permissible under this section. 3 |
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| 245 | 245 | | ‘‘(iv) Any procedure undertaken be-4 |
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| 246 | 246 | | cause the individual suffers from a physical 5 |
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| 247 | 247 | | disorder, physical injury, or physical illness 6 |
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| 248 | 248 | | (but not mental, behavioral, or emotional 7 |
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| 249 | 249 | | distress or a mental, behavioral, or emo-8 |
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| 250 | 250 | | tional disorder) that would, as certified by 9 |
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| 251 | 251 | | a physician, place the individual in immi-10 |
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| 252 | 252 | | nent danger of death or impairment of 11 |
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| 253 | 253 | | major bodily function, unless the procedure 12 |
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| 254 | 254 | | is performed. 13 |
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| 255 | 255 | | ‘‘(v) Puberty suppression or blocking 14 |
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| 256 | 256 | | prescription drugs for the purpose of nor-15 |
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| 257 | 257 | | malizing puberty for a minor experiencing 16 |
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| 258 | 258 | | precocious puberty. 17 |
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| 259 | 259 | | ‘‘(vi) Male circumcision. 18 |
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| 260 | 260 | | ‘‘(4) M |
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| 261 | 261 | | ALE.—The term ‘male’, when used to 19 |
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| 262 | 262 | | refer to a natural person, means an individual who 20 |
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| 263 | 263 | | naturally has, had, will have, or would have, but for 21 |
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| 264 | 264 | | a congenital anomaly, historical accident, or inten-22 |
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| 265 | 265 | | tional or unintentional disruption, the reproductive 23 |
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| 266 | 266 | | system that at some point produces, transports, and 24 |
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| 267 | 267 | | utilizes sperm for fertilization. 25 |
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| 270 | 270 | | •S 977 IS |
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| 271 | 271 | | ‘‘(5) SEX.—The term ‘sex’, when referring to 1 |
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| 272 | 272 | | an individual’s sex, means to refer to either male or 2 |
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| 273 | 273 | | female, as biologically determined.’’. 3 |
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| 274 | 274 | | SEC. 102. AMENDMENT TO TABLE OF CHAPTERS. 4 |
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| 275 | 275 | | The table of chapters for title 1, United States Code, 5 |
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| 276 | 276 | | is amended by adding at the end the following new item: 6 |
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| 277 | 277 | | ‘‘4. Prohibiting taxpayer-funded gender transition pro- |
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| 278 | 278 | | cedures.......................................................................301’’. |
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| 279 | 279 | | TITLE II—APPLICATION UNDER 7 |
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| 280 | 280 | | THE AFFORDABLE CARE ACT 8 |
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| 281 | 281 | | SEC. 201. CLARIFYING APPLICATION OF PROHIBITION TO 9 |
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| 282 | 282 | | PREMIUM CREDITS AND COST-SHARING RE-10 |
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| 283 | 283 | | DUCTIONS UNDER ACA. 11 |
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| 284 | 284 | | (a) I |
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| 285 | 285 | | NGENERAL.— 12 |
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| 286 | 286 | | (1) D |
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| 287 | 287 | | ISALLOWANCE OF REFUNDABLE CREDIT 13 |
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| 288 | 288 | | AND COST-SHARING REDUCTIONS FOR COVERAGE 14 |
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| 289 | 289 | | UNDER QUALIFIED HEALTH PLAN WHICH PROVIDES 15 |
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| 290 | 290 | | COVERAGE FOR GENDER PROCEDURES .— 16 |
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| 291 | 291 | | (A) I |
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| 292 | 292 | | N GENERAL.—Subparagraph (A) of 17 |
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| 293 | 293 | | section 36B(c)(3) of the Internal Revenue Code 18 |
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| 294 | 294 | | of 1986 is amended by inserting before the pe-19 |
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| 295 | 295 | | riod at the end the following: ‘‘or any health 20 |
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| 296 | 296 | | plan that includes coverage for gender transi-21 |
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| 297 | 297 | | tion procedures, as defined in section 307 of 22 |
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| 298 | 298 | | title 1, United States Code (other than any pro-23 |
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| 299 | 299 | | cedure described in section 306 of such title)’’. 24 |
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| 302 | 302 | | •S 977 IS |
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| 303 | 303 | | (B) OPTION TO PURCHASE OR OFFER SEP -1 |
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| 304 | 304 | | ARATE COVERAGE OR PLAN .—Paragraph (3) of 2 |
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| 305 | 305 | | section 36B(c) of such Code is amended by 3 |
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| 306 | 306 | | adding at the end the following new subpara-4 |
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| 307 | 307 | | graph: 5 |
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| 308 | 308 | | ‘‘(C) S |
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| 309 | 309 | | EPARATE COVERAGE OR PLAN FOR 6 |
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| 310 | 310 | | GENDER TRANSITION PROCEDURES AL -7 |
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| 311 | 311 | | LOWED.— 8 |
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| 312 | 312 | | ‘‘(i) O |
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| 313 | 313 | | PTION TO PURCHASE SEPARATE 9 |
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| 314 | 314 | | COVERAGE OR PLAN.—Nothing in subpara-10 |
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| 315 | 315 | | graph (A) shall be construed as prohibiting 11 |
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| 316 | 316 | | any individual from purchasing separate 12 |
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| 317 | 317 | | coverage for gender transition procedures 13 |
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| 318 | 318 | | described in such subparagraph, or a 14 |
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| 319 | 319 | | health plan that includes such gender tran-15 |
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| 320 | 320 | | sition procedures, so long as no credit is 16 |
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| 321 | 321 | | allowed under this section with respect to 17 |
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| 322 | 322 | | the premiums for such coverage or plan. 18 |
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| 323 | 323 | | ‘‘(ii) O |
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| 324 | 324 | | PTION TO OFFER COVERAGE OR 19 |
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| 325 | 325 | | PLAN.—Nothing in subparagraph (A) shall 20 |
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| 326 | 326 | | restrict any non-Federal health insurance 21 |
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| 327 | 327 | | issuer offering a health plan from offering 22 |
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| 328 | 328 | | separate coverage for gender transition 23 |
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| 329 | 329 | | procedures described in such subpara-24 |
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| 330 | 330 | | graph, or a plan that includes such gender 25 |
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| 333 | 333 | | •S 977 IS |
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| 334 | 334 | | transition procedures, so long as premiums 1 |
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| 335 | 335 | | for such separate coverage or plan are not 2 |
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| 336 | 336 | | paid for with any amount attributable to 3 |
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| 337 | 337 | | the credit allowed under this section (or 4 |
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| 338 | 338 | | the amount of any advance payment of the 5 |
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| 339 | 339 | | credit under section 1412 of the Patient 6 |
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| 340 | 340 | | Protection and Affordable Care Act).’’. 7 |
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| 341 | 341 | | (2) D |
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| 342 | 342 | | ISALLOWANCE OF SMALL EMPLOYER 8 |
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| 343 | 343 | | HEALTH INSURANCE EXPENSE CREDIT FOR PLAN 9 |
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| 344 | 344 | | WHICH INCLUDES COVERAGE FOR GENDER TRANSI -10 |
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| 345 | 345 | | TION PROCEDURES.—Subsection (h) of section 45R 11 |
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| 346 | 346 | | of the Internal Revenue Code of 1986 is amended— 12 |
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| 347 | 347 | | (A) by striking ‘‘Any term’’ and inserting 13 |
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| 348 | 348 | | the following: 14 |
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| 349 | 349 | | ‘‘(1) I |
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| 350 | 350 | | N GENERAL.—Any term’’; and 15 |
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| 351 | 351 | | (B) by adding at the end the following new 16 |
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| 352 | 352 | | paragraph: 17 |
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| 353 | 353 | | ‘‘(2) E |
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| 354 | 354 | | XCLUSION OF HEALTH PLANS INCLUDING 18 |
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| 355 | 355 | | COVERAGE FOR GENDER TRANSITION PROCE -19 |
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| 356 | 356 | | DURES.— 20 |
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| 357 | 357 | | ‘‘(A) I |
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| 358 | 358 | | N GENERAL.—In this section, the 21 |
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| 359 | 359 | | term ‘qualified health plan’ does not include 22 |
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| 360 | 360 | | any health plan that includes coverage for gen-23 |
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| 361 | 361 | | der transition procedures, as defined in section 24 |
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| 362 | 362 | | 307 of title 1, United States Code (other than 25 |
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| 364 | 364 | | kjohnson on DSK7ZCZBW3PROD with $$_JOB 13 |
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| 365 | 365 | | •S 977 IS |
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| 366 | 366 | | any procedure described in section 306 of such 1 |
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| 367 | 367 | | title). 2 |
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| 368 | 368 | | ‘‘(B) S |
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| 369 | 369 | | EPARATE COVERAGE OR PLAN FOR 3 |
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| 370 | 370 | | GENDER TRANSITION PROCEDURES AL -4 |
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| 371 | 371 | | LOWED.— 5 |
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| 372 | 372 | | ‘‘(i) O |
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| 373 | 373 | | PTION TO PURCHASE SEPARATE 6 |
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| 374 | 374 | | COVERAGE OR PLAN.—Nothing in subpara-7 |
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| 375 | 375 | | graph (A) shall be construed as prohibiting 8 |
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| 376 | 376 | | any employer from purchasing for its em-9 |
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| 377 | 377 | | ployees separate coverage for gender tran-10 |
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| 378 | 378 | | sition procedures described in such sub-11 |
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| 379 | 379 | | paragraph, or a health plan that includes 12 |
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| 380 | 380 | | such gender transition procedures, so long 13 |
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| 381 | 381 | | as no credit is allowed under this section 14 |
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| 382 | 382 | | with respect to the employer contributions 15 |
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| 383 | 383 | | for such coverage or plan. 16 |
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| 384 | 384 | | ‘‘(ii) O |
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| 385 | 385 | | PTION TO OFFER COVERAGE OR 17 |
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| 386 | 386 | | PLAN.—Nothing in subparagraph (A) shall 18 |
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| 387 | 387 | | restrict any non-Federal health insurance 19 |
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| 388 | 388 | | issuer offering a health plan from offering 20 |
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| 389 | 389 | | separate coverage for gender transition 21 |
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| 390 | 390 | | procedures described in such subpara-22 |
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| 391 | 391 | | graph, or a plan that includes such gender 23 |
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| 392 | 392 | | transition procedures, so long as such sep-24 |
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| 393 | 393 | | arate coverage or plan is not paid for with 25 |
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| 395 | 395 | | kjohnson on DSK7ZCZBW3PROD with $$_JOB 14 |
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| 396 | 396 | | •S 977 IS |
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| 397 | 397 | | any employer contribution eligible for the 1 |
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| 398 | 398 | | credit allowed under this section.’’. 2 |
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| 399 | 399 | | (b) A |
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| 400 | 400 | | PPLICATION TOMULTI-STATEPLANS.—Section 3 |
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| 401 | 401 | | 1334(a) of Public Law 111–148 (42 U.S.C. 18054(a)) is 4 |
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| 402 | 402 | | amended by adding at the end the following new para-5 |
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| 403 | 403 | | graph: 6 |
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| 404 | 404 | | ‘‘(8) C |
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| 405 | 405 | | OVERAGE CONSISTENT WITH FEDERAL 7 |
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| 406 | 406 | | POLICY REGARDING GENDER TRANSITION PROCE -8 |
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| 407 | 407 | | DURES.—In entering into contracts under this sub-9 |
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| 408 | 408 | | section, the Director shall ensure that no multi-State 10 |
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| 409 | 409 | | qualified health plan offered in an Exchange pro-11 |
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| 410 | 410 | | vides health benefits coverage for which the expendi-12 |
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| 411 | 411 | | ture of Federal funds is prohibited under chapter 4 13 |
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| 412 | 412 | | of title 1, United States Code.’’. 14 |
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| 413 | 413 | | (c) E |
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| 414 | 414 | | FFECTIVEDATE.—The amendments made by 15 |
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| 415 | 415 | | subsection (a) shall apply to taxable years ending after 16 |
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| 416 | 416 | | the date that is 1 year after the date of enactment of this 17 |
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| 417 | 417 | | Act, but only with respect to plan years beginning after 18 |
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| 418 | 418 | | such date, and the amendment made by subsection (b) 19 |
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| 419 | 419 | | shall apply to plan years beginning after such date. 20 |
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| 420 | 420 | | Æ |
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