Sponsors (4)
The bill trades reduced federal spending and narrower federal mandates on coverage for gender transition procedures and clearer statutory exclusions for substantially reduced coverage and higher costs for transgender people, minors, low-income beneficiaries, and others who rely on Medicaid, Medicare, employer plans, or the medical expense deduction.
Taxpayers and the federal budget: the bill reduces federal spending and taxpayer exposure by excluding specified gender transition procedures from the medical expense tax deduction, Medicaid federal matching, Medicare Parts A/B coverage, and the EHB mandate.
States, insurers, and employers: the bill preserves state and plan decisionmaking and design flexibility by removing federal matching requirements and by narrowing the federal EHB mandate, allowing states and plans to choose whether to cover these services.
CMS, Medicare administrators, and plan administrators: creating an explicit statutory exclusion clarifies coverage rules for Parts A and B and for certain plan requirements, reducing some administrative uncertainty about paying for these procedures.
Medicaid, Medicare, private insurance enrollees (including many transgender people) and minors: will lose coverage for specified gender‑affirming hormonal and surgical care, increasing out-of-pocket costs, reducing access, and likely worsening health outcomes for those who need this care.
Low-income individuals, families, parents, and Medicaid/CHIP enrollees: will face higher financial burdens as coverage shifts away from federal funding or is eliminated, increasing out-of-pocket spending, travel costs, or unmet care needs.
Transgender individuals and patients: the bill's narrow biological definitions of 'sex' and enumerated exclusions create legal and coverage uncertainty that could produce inconsistent eligibility decisions and discriminatory outcomes.
Based on analysis of 6 sections of legislative text.
Blocks federal tax deductions and federal payments under Medicare, Medicaid, and CHIP for defined "gender transition procedures" and bars them from essential health benefits.
Introduced May 5, 2025 by Claudia Tenney · Last progress May 5, 2025
Prohibits federal support for gender transition procedures by: denying a federal tax deduction for those procedures, preventing Medicare and federal Medicaid matching payments for specified hormonal and surgical gender‑transition interventions, stopping CHIP federal payments for such procedures for minors, and forbidding HHS from including them in required essential health benefits. The bill defines “specified gender transition procedures,” lists examples and several narrow medical exclusions, and sets effective dates for tax years or services furnished after enactment.