H.R. 2107 — Children’s Hospital GME Support Reauthorization Act of 2025

This section extends authorization of the Program of Payments to Children's Hospitals that Operate Graduate Medical Education Programs (CHGME)—which provides payments to freestanding children's hospitals for direct and indirect expenses of operating approved pediatric residency training programs (i.e., hospitals ineligible for Medicare GME payments)—through FY2030 (from FY2023), specifies annual funding of $124 million for direct expenses and $261 million for indirect expenses for FY2026 through FY2030, extends related reporting requirements through FY2030, and prohibits such payments beginning FY2026 (with a special rule for the period after December 31, 2025, based on hospital activities from September 1 through December 31, 2025) to any children's hospital that furnished "specified procedures and drugs" to individuals under 18 years of age during the preceding fiscal year. Specified procedures and drugs include surgeries to alter an individual's body to not correspond to the individual's sex (e.g., castration, hysterectomy, vaginoplasty, mastectomy) and administration of puberty blockers or cross-sex hormones, subject to exceptions for precocious puberty, genetic disorders of sex development, reversal of prior such procedures, or treatments averting imminent death or major bodily impairment (as certified by a physician); sex is defined by birth indicators including reproductive capacity, chromosomes, hormones, gonads, and genitalia. (Thus, hospitals risk losing CHGME payments if they provide gender-affirming surgeries or medications to minors, absent an exception.)