H.R. 2202

119th CONGRESS 1st Session

To prohibit taxpayer-funded gender transition procedures, and for other purposes.

IN THE HOUSE OF REPRESENTATIVES · March 18, 2025 · Sponsor: Mr. LaMalfa

Sec. 1. Short title; table of contents.

• (a) Short title
  • This Act may be cited as the End Taxpayer Funding of Gender Experimentation Act of 2025.
  • Short title
• (b) Table of contents
  • The table of contents of this Act is as follows:
  • Sec. 1. Short title; table of contents.
  • TITLE I—Prohibiting federally funded gender transition procedures
  • Sec. 101. Prohibiting taxpayer-funded gender transition procedures.
  • Sec. 102. Amendment to table of chapters.
  • TITLE II—Application under the Affordable Care Act
  • Sec. 201. Clarifying application of prohibition to premium credits and cost-sharing reductions under ACA.

TITLE I—Prohibiting federally funded gender transition procedures

Sec. 101. Prohibiting taxpayer-funded gender transition procedures.

Title 1, United States Code, is amended by adding at the end the following new chapter:

• Sec.
• 301. Prohibition on funding for gender transition procedures.
• 302. Prohibition on funding for health benefits plans that cover gender transition procedures.
• 303. Limitation on Federal facilities and employees.
• 304. Construction relating to separate coverage.
• 305. Construction relating to the use of non-Federal funds for health coverage.
• 306. Construction relating to complications arising from gender transition procedures.
• 307. Definitions.
• No funds authorized or appropriated by Federal law, and none of the funds in any trust fund to which funds are authorized or appropriated by Federal law, shall be expended for any gender transition procedures.
• No funds authorized or appropriated by Federal law, and none of the funds in any trust fund to which funds are authorized or appropriated by Federal law, shall be expended for health benefits coverage that includes coverage of gender transition procedures.
• No health care service furnished—
  • by or in a health care facility owned or operated by the Federal Government; or
  • by any physician or other individual employed by the Federal Government to provide health care services within the scope of the physician’s or individual’s employment,
• may include gender transition procedures.
• Nothing in this chapter shall be construed as prohibiting any individual, entity, or State or locality from purchasing separate coverage for gender transition procedures or health benefits coverage that includes gender transition procedures so long as such coverage is paid for entirely using only funds not authorized or appropriated by Federal law and such coverage shall not be purchased using matching funds required for a federally subsidized program, including a State’s or locality’s contribution of Medicaid matching funds.
• Nothing in this chapter shall be construed as restricting the ability of any non-Federal health benefits coverage provider from offering coverage for gender transition procedures, or the ability of a State or locality to contract separately with such a provider for such coverage, so long as only funds not authorized or appropriated by Federal law are used and such coverage shall not be purchased using matching funds required for a federally subsidized program, including a State’s or locality’s contribution of Medicaid matching funds.
• Nothing in this chapter shall be construed to apply to the treatment of any infection, injury, disease, or disorder that has been caused by or exacerbated by the performance of a gender transition procedure.
• For purposes of this chapter:
  • The term , when used to refer to a natural person, means an individual who naturally has, had, will have, or would have, but for a congenital anomaly, historical accident, or intentional or unintentional disruption, the reproductive system that at some point produces, transports, and utilizes eggs for fertilization. female
  • The term gender transition means the process in which an individual goes from identifying with or presenting as his or her sex to identifying with or presenting a self-proclaimed identity that does not correspond with or is different from his or her sex, and may be accompanied with social, legal, or physical changes.
  • The term , when used to refer to a natural person, means an individual who naturally has, had, will have, or would have, but for a congenital anomaly, historical accident, or intentional or unintentional disruption, the reproductive system that at some point produces, transports, and utilizes sperm for fertilization. male
  • The term , when referring to an individual’s sex, means to refer to either male or female, as biologically determined. sex

Sec. 102. Amendment to table of chapters.

The table of chapters for title 1, United States Code, is amended by adding at the end the following new item:

• Prohibiting taxpayer-funded gender transition procedures

TITLE II—Application under the Affordable Care Act

Sec. 201. Clarifying application of prohibition to premium credits and cost-sharing reductions under ACA.

• (a) In general
  • (1) Disallowance of refundable credit and cost-sharing reductions for coverage under qualified health plan which provides coverage for gender procedures
    • (A) In general
      • Subparagraph (A) of of the Internal Revenue Code of 1986 is amended by inserting before the period at the end the following: . section 36B(c)(3)
    • (B) Option to purchase or offer separate coverage or plan
      • Paragraph (3) of section 36B(c) of such Code is amended by adding at the end the following new subparagraph:
        • (C) Separate coverage or plan for gender transition procedures allowed
          • (i) Nothing in subparagraph (A) shall be construed as prohibiting any individual from purchasing separate coverage for gender transition procedures described in such subparagraph, or a health plan that includes such gender transition procedures, so long as no credit is allowed under this section with respect to the premiums for such coverage or plan.
          • (ii) Nothing in subparagraph (A) shall restrict any non-Federal health insurance issuer offering a health plan from offering separate coverage for gender transition procedures described in such subparagraph, or a plan that includes such gender transition procedures, so long as premiums for such separate coverage or plan are not paid for with any amount attributable to the credit allowed under this section (or the amount of any advance payment of the credit under section 1412 of the Patient Protection and Affordable Care Act).
  • (2) Disallowance of small employer health insurance expense credit for plan which includes coverage for gender transition procedures
    • Subsection (h) of of the Internal Revenue Code of 1986 is amended— section 45R
      • by striking and inserting the following:
        • (1) In general
          • Any term
        • (2) Exclusion of health plans including coverage for gender transition procedures
          • (A) In general
            • In this section, the term does not include any health plan that includes coverage for gender transition procedures, as defined in section 307 of title 1, United States Code (other than any procedure described in section 306 of such title). qualified health plan
          • (B) Separate coverage or plan for gender transition procedures allowed
            • (i) Nothing in subparagraph (A) shall be construed as prohibiting any employer from purchasing for its employees separate coverage for gender transition procedures described in such subparagraph, or a health plan that includes such gender transition procedures, so long as no credit is allowed under this section with respect to the employer contributions for such coverage or plan.
            • (ii) Nothing in subparagraph (A) shall restrict any non-Federal health insurance issuer offering a health plan from offering separate coverage for gender transition procedures described in such subparagraph, or a plan that includes such gender transition procedures, so long as such separate coverage or plan is not paid for with any employer contribution eligible for the credit allowed under this section.
      • by adding at the end the following new paragraph:
• (b) Application to multi-State plans
  • Section 1334(a) of () is amended by adding at the end the following new paragraph: Public Law 111–148; 42 U.S.C. 18054(a)
    • (8) Coverage consistent with Federal policy regarding gender transition procedures
      • In entering into contracts under this subsection, the Director shall ensure that no multi-State qualified health plan offered in an Exchange provides health benefits coverage for which the expenditure of Federal funds is prohibited under of title 1, United States Code. chapter 4
• (c) Effective date
  • The amendments made by subsection (a) shall apply to taxable years ending after the date that is 1 year after the date of enactment of this Act, but only with respect to plan years beginning after such date, and the amendment made by subsection (b) shall apply to plan years beginning after such date.