H.R. 2202 — End Taxpayer Funding of Gender Experimentation Act of 2025

This section establishes a new chapter 4 in Title 1, United States Code, prohibiting the use of federal funds—including those in trust funds—for gender transition procedures (defined as hormonal or surgical interventions to change an individual's sex characteristics, including puberty blockers, supraphysiologic hormones, over 30 specified surgeries such as castration, hysterectomy, phalloplasty, vaginoplasty, and mastectomy, and other procedures like voice surgery or hair reconstruction, excluding treatments for medically verifiable disorders of sex development). The prohibitions apply to (1) direct funding of such procedures; (2) health benefits coverage including such procedures; and (3) services furnished by or in federal facilities or by federal employees. The section clarifies that it permits separate non-federal coverage (not using federal matching funds, including Medicaid), non-federal providers offering such coverage with non-federal funds, and treatment of complications from gender transition procedures.

This section prohibits the premium tax credit under IRC §36B(c)(3)—which subsidizes individual ACA Exchange coverage—for qualified health plans providing coverage for gender transition procedures, as defined in 1 U.S.C. §307 (other than procedures described in §306); prohibits the small employer health insurance expense credit under IRC §45R—which reimburses up to 50% of employer premiums for eligible small businesses providing health coverage—for such plans; and directs the Office of Personnel Management, in contracting for multi-state qualified health plans under ACA §1334(a) (i.e., standardized plans available nationwide through Exchanges, modeled on the Federal Employees Health Benefits Program), to ensure no such plan provides coverage for which federal funds are prohibited under 1 U.S.C. chapter 4. Separate coverage or plans for gender transition procedures are permitted if no federal credits or funds apply. The changes apply to plan years beginning after one year post-enactment.