Sponsors (15)
The bill reduces federal spending on gender‑affirming care and aligns Exchange offerings with that restriction, saving some federal dollars and preserving employer flexibility to offer unsubsidized benefits, but it substantially reduces subsidized access to transition-related care, raises costs for affected individuals and insurers, shifts costs to states and private payers, and creates equity and administrative burdens.
Taxpayers: Federal spending and premium tax credit subsidies would not cover gender-transition procedures, modestly reducing federal outlays tied to those services.
Employers: Employers retain the ability to offer separate, unsubsidized coverage for gender-transition procedures, preserving employer flexibility to provide benefits without federal subsidy.
Federal program alignment: OPM and Exchange plan rules will be adjusted to ensure Multi-State Plan and Exchange offerings comply with federal funding restrictions, clarifying which plans are eligible for federal subsidies.
Transgender people who rely on federal programs: Would lose coverage or subsidies for medically recommended gender-affirming procedures, increasing out-of-pocket costs and creating gaps in access to necessary care.
Low- and moderate-income Exchange enrollees: Those who use premium tax credits may face reduced plan choices or higher net premiums if plans covering transition care are not subsidy-eligible, making coverage less affordable.
Patients served by federal programs (Medicaid, VA, federal employees): Could lose covered transition-related services under federal programs, shifting costs onto states, insurers, or the individuals themselves.
Based on analysis of 4 sections of legislative text.
Bars premium tax credits and the small-employer health credit for plans that cover gender transition procedures and requires multi-State Plans not to offer such federally prohibited coverage; separate coverage allowed only if paid entirely outside credit-eligible premiums.
Official title: Prohibit taxpayer-funded gender transition procedures, and for other purposes.
Introduced March 12, 2025 by Roger Wayne Marshall · Last progress March 12, 2025
Prohibits use of federal funds and certain federal tax credits for health insurance that covers gender transition procedures, while allowing separate standalone coverage for those procedures if paid for entirely outside credit-eligible premiums or advance payments. It also directs the Office of Personnel Management to ensure multi-State Plan offerings on Exchanges comply with this federal funding restriction. The tax-related changes apply to plan years and taxable years starting after one year from enactment.