Sponsors (4)
Prevents FEHB plans from covering gender-affirming care for people under 18, with listed medical exceptions and a one-year continuation for existing hormone therapy coverage.
The bill reduces FEHB spending and clarifies emergency exceptions by excluding gender‑affirming care for minors, but it does so at the cost of restricting medically recommended care for gender‑diverse youth, imposing financial burdens on families, and adding administrative complexity.
Children and other FEHB enrollees retain coverage for emergency, life‑saving, and non‑transition pediatric care (e.g., emergency procedures, treatment for DSD, precocious puberty) because the bill clarifies exclusions and emergency exceptions.
Federal employees and their families likely face lower FEHB plan costs or slower premium growth because plans will no longer pay for gender‑affirming care for minors, reducing insurer payouts.
Minors covered by FEHB lose access to puberty blockers, cross‑sex hormones, and gender‑affirming surgeries even when recommended by clinicians, reducing necessary healthcare access for gender‑diverse youth.
A short one‑year phasedown forces minors already receiving hormone therapy to cease or dramatically alter treatment within 12 months, risking clinical disruption and harm from abrupt or supervised cessation.
Parents and families of federal employees may face increased out‑of‑pocket costs for gender‑affirming care for minors that FEHB no longer covers, creating new financial burdens for affected households.
Based on analysis of 2 sections of legislative text.
Official title: Amend title 5, United States Code, to provide that certain treatments may not be covered under the health insurance program carried out under chapter 89 of that title, and for other purposes.
Introduced May 15, 2025 by James Risch · Last progress May 15, 2025
Prohibits Federal Employees Health Benefits (FEHB) plans from covering gender-affirming care or services for people under age 18. It defines “gender-affirming care or service” to include treatments for gender dysphoria such as puberty blockers, hormone therapy, and surgical transition procedures, while listing several medical exceptions (e.g., treatment for disorders of sexual development, emergency care, treatment for precocious or delayed puberty, and treatment of complications). A one-year supervised reduction exception allows continuation of hormone therapy for minors already covered immediately before the law takes effect. The rule applies to FEHB contracts entered into or renewed for any contract year on or after enactment.