Sponsors (15)
The bill reduces federal spending on gender‑transition procedures and preserves employer flexibility to offer unsubsidized coverage, but it restricts access to gender‑affirming care for people reliant on federal programs and shifts costs and administrative burdens onto individuals, states, insurers, and some employers.
Taxpayers: Federal dollars and premium tax credits would not subsidize gender‑transition procedures, reducing federal health spending on those services.
Employers: Businesses would retain the ability to offer separate, unsubsidized coverage for gender‑transition procedures, preserving employer flexibility in benefit design.
Government/administration: OPM and plan managers will align Multi‑State Plan and Exchange offerings with the federal funding restriction, producing consistent application of the new policy across federally related plans.
Transgender people who rely on federal programs (Medicaid, VA, Exchange premium tax credits, federal employee plans) would lose access to covered gender‑affirming care or face new barriers to receiving medically recommended treatments.
Transgender people: The policy creates unequal treatment in federally subsidized health programs, raising civil‑rights and equity concerns about restricting benefits for a specific group.
Low‑ and moderate‑income individuals who rely on Exchange premium tax credits may face reduced plan choices or higher net premiums and out‑of‑pocket costs if plans covering transition care are unavailable or must be purchased without subsidy.
Based on analysis of 4 sections of legislative text.
Bars premium tax credits and the small employer health credit for health plans that cover defined gender transition procedures while allowing separately paid plans if no disallowed credits are used.
Prohibits federal payment support for gender transition procedures by adding a new chapter to Title 1 of the U.S. Code (the text of that new chapter is not included). It also changes the tax code to deny premium tax credits and the small employer health insurance tax credit for health plans that cover defined “gender transition procedures,” while allowing separate, non-credit-eligible plans or coverage for those procedures if no disallowed credits or advance payments are used. The Office of Personnel Management must ensure Multi-State Plans sold on Exchanges do not provide coverage that would require prohibited federal funding. The tax- and Exchange-related parts take effect for plan years and taxable years beginning more than one year after enactment.
Introduced March 12, 2025 by Roger Wayne Marshall · Last progress March 12, 2025