No Subsidies for Gender Transition Procedures Act
Sponsored By: Senator Roger Marshall
Introduced
Summary
Blocks federal funding and tax deductions for gender transition procedures. This bill would ban federal payments and tax breaks for a broad set of gender transition services across tax law, Medicaid, the Children’s Health Insurance Program, Medicare, and Essential Health Benefits under the Affordable Care Act.
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- People seeking gender transition care: Would not be able to deduct expenses for defined transition procedures and therapies. The bill defines a wide range of services as transition-related, while listing specific exceptions such as disorders of sexual development and treatment of infections or related complications.
- Federal health programs and providers: Would be prohibited from using federal Medicaid, CHIP, or Medicare funds to pay for the listed transition procedures for services furnished after enactment. Each program would receive new statutory definitions and payment limits to enforce the ban.
- Health insurance coverage rules: Would exclude specified transition procedures from the Essential Health Benefits category, which would allow plans governed by those requirements to omit coverage for those procedures.
The bill would take effect on the date of enactment.
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Bill Overview
Analyzed Economic Effects
3 provisions identified: 0 benefits, 3 costs, 0 mixed.
Medicare, Medicaid, CHIP stop transition payments
If enacted, the bill would prohibit Federal payment under Medicare and Federal matching payments for Medicaid, and would bar CHIP payments, for items the bill defines as specified gender transition procedures. The ban would apply to items and services furnished on or after enactment and would also cover amounts spent on administration of State programs that furnish such services. The bill lists narrow exceptions, such as medically verifiable disorders of sex development, treatment of complications, physician-certified emergencies, restorative surgery after prior transition procedures, puberty suppression for precocious puberty, and male circumcision. If you get these services while on Medicare, Medicaid, or CHIP, federal programs would not pay and States or patients might need to pay instead.
No medical tax deduction for transition
If enacted, the bill would bar the federal medical-expense tax deduction for expenses the bill defines as gender transition procedures. The ban would apply for taxable years beginning after enactment. Certain narrow exceptions remain, like treatment for verified disorders of sex development, emergency care, treatment of complications, restorative surgery after prior transition, puberty suppression for precocious puberty, and male circumcision. If you claim medical deductions and paid for these procedures, you could not deduct those costs under this rule.
Marketplace plans may exclude transition care
If enacted, the bill would tell the Health and Human Services Secretary not to include gender transition procedures when defining essential health benefits. That could let ACA marketplace and small-group plans leave those services out of required coverage. The exact scope follows the bill's definition and the same narrow exceptions used elsewhere in the bill. If you have a marketplace plan, your insurer might no longer be required to cover these services.
Sponsors & CoSponsors
Sponsor
Roger Marshall
KS • R
Cosponsors
Pete Ricketts
NE • R
Sponsored 5/1/2025
Bill Cassidy
LA • R
Sponsored 5/1/2025
Mike Lee
UT • R
Sponsored 5/1/2025
Roll Call Votes
No roll call votes available for this bill.
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