“A bill to deny tax deductions and other Federal funding for the costs of gender transition procedures.”
No CRS summary available for this bill.
This section excludes expenses for gender transition procedures from the definition of medical care under section 213(d) of the Internal Revenue Code, thereby denying their deductibility as itemized medical expenses (which taxpayers may otherwise deduct to the extent they exceed 7.5% of adjusted gross income). Gender transition procedures include hormonal interventions (e.g., puberty blockers, supraphysiologic cross-sex hormones) and surgical procedures (e.g., mastectomy, vaginoplasty, phalloplasty, castration) intended to align physical appearance with an identity differing from biological sex (male or female, determined at conception by reproductive function); exclusions apply to treatments for disorders of sex development, infections or injuries from prior procedures, physical emergencies, or reversals of prior procedures. The amendment applies to taxable years beginning after enactment.
This section prohibits federal Medicaid payments for any specified gender transition procedure provided to an enrollee under a state plan (or waiver), including related administrative costs, by adding a new prohibition in Section 1903(i)(28) of the Social Security Act. Specified gender transition procedures include (1) puberty suppression or blocking drugs for individuals not identifying with their sex; (2) supraphysiologic doses of cross-sex hormones to align physical appearance with a non-biological identity; (3) surgeries to alter physical appearance, sexual organs, or biological functions to match a non-biological identity; and (4) an enumerated list of procedures (e.g., castration, vaginoplasty, phalloplasty, mastectomy, hysterectomy). The prohibition excludes procedures for (A) medically verifiable disorders of sex development; (B) certain physician-diagnosed sexual development disorders confirmed by testing; (C) treatment of infections, injuries, or diseases caused by prior gender transition procedures; (D) life-saving physical treatments; (E) reversal or reconstruction to restore biological sex; (F) precocious puberty treatment; and (G) male circumcision. (Thus, states must fully fund any non-excluded procedures using only state dollars, with no federal matching.)
This section prohibits federal payments to states under the Children's Health Insurance Program (CHIP) for any state plan expenditures to provide specified gender transition procedures (as defined in section 1905(kk) of the Social Security Act) to minors or to assist in purchasing, in whole or in part, health coverage that includes such procedures. The prohibition applies to services furnished on or after the date of enactment and includes a conforming amendment to the list of CHIP amendments in section 2107(e)(1)(N).
This section excludes from Medicare payment under parts A or B any specified gender transition procedures (as defined in section 1905(kk)). The exclusion applies to items and services furnished on or after the date of enactment.
This section excludes gender transition procedures from essential health benefits (EHB) by prohibiting their inclusion in the Secretary's definition of the 10 required categories (e.g., hospitalization, prescription drugs, mental health services) or in subsequent revisions under current law. (EHB set the minimum benefits that must be covered by non-grandfathered health plans in the ACA's individual and small-group markets, with overall scope benchmarked to typical employer-sponsored coverage; thus, ACA Exchange plans will not be required to cover such procedures as EHB.)