Sponsors (14)
The bill expands and standardizes coverage (including mental‑health and parity in cost‑sharing) for restorative and complication care tied to listed 'sex‑rejecting' procedures, improving access and reducing out‑of‑pocket costs for affected patients, while raising insurance/employer costs and creating potential legal and coverage disputes—particularly for transgender, intersex, and fertility‑seeking individuals.
People who undergo the bill's listed 'sex‑rejecting' procedures would have guaranteed coverage for restorative care and treatment of complications regardless of whether their original plan covered the initial procedure, improving access to necessary follow‑up medical care.
Insurers would be barred from imposing higher cost‑sharing or special treatment limits for this restorative care compared with predominant medical/surgical benefits, lowering out‑of‑pocket costs for affected patients and reducing financial barriers to care.
The bill explicitly includes mental health and rehabilitation services in the restorative care definition, increasing coverage and access to psychiatric, therapy, and rehab services related to these procedures.
Employers, insurers, and taxpayers could face higher insurance costs from the required expanded coverage, which may translate into higher premiums, increased plan expenses, or greater public spending.
The bill's statutory definitions of 'sex' (described as genetically determined at fertilization and framed as binary) could trigger coverage disputes, denials, and legal challenges that disproportionately affect transgender and intersex people and raise rights and equity concerns.
By broadly enumerating many procedures as 'sex‑rejecting' while excluding assisted embryo/egg handling by default for fertility restoration, the bill may limit access to some fertility‑preservation or assisted‑reproduction services for people needing those services.
Based on analysis of 2 sections of legislative text.
Requires plans that cover any sex-rejecting procedure to also cover restorative services for individuals who received such procedures, with parity in cost-sharing and limits.
Official title: To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require group health plans and health insurance issuers offering group or individual health insurance coverage that provide benefits for sex-rejecting procedures to provide benefits for items and services to address the harms caused by sex-rejecting procedures and to restore healthy human form and functioning, to the greatest extent practicable.
Introduced July 16, 2026 by Diana Harshbarger · Last progress July 16, 2026
Requires group and individual health plans that cover any “sex-rejecting procedure” to also cover restorative and reparative items and services for people who have had those procedures, even if the plan did not pay for the original procedure. Plans must apply cost-sharing and treatment limits to those post-procedure services no more restrictively than they apply to the plan’s predominant medical and surgical benefits. Adds statutory definitions of “female” and “male,” adopts federal definitions for financial requirements and treatment limitations (explicitly including annual and lifetime limits), and defines “restorative care” as a broad category of services furnished to anyone who has ever received a sex-rejecting procedure.