PRIA Logo™
119-s-3011119th CongressWALLET

Prohibiting Abortion & Transgender Procedures on the Exchanges Act

Sponsored By: Senator Hawley, Josh [R-MO]

Introduced

Summary

Prohibits coverage of gender‑transition procedures for minors and sharply limits abortion coverage in ACA Exchange health plans. This bill would amend the Affordable Care Act so Exchange plans cannot cover those services starting in plan years on or after January 1, 2026.

Show full summary
  • Minors and families: Would ban Exchange coverage of puberty‑blocking drugs, cross‑sex hormones (testosterone for females or estrogen for males) and surgeries for anyone under 18. Exceptions are made for people with inherently ambiguous biological sex or certain genetic or hormonal conditions and for emergency life‑saving care or treatment of injury or disease caused by a prior intervention.
  • Pregnant people: Would allow abortion coverage only in two narrow cases. First, when a physician certifies a physical disorder, injury, or illness places the woman in danger of death unless an abortion is performed, including life‑threatening conditions caused by the pregnancy or resulting from rape or incest. Second, when the pregnancy results from an act of rape or incest.
  • Health plans and Exchanges: Would bar Exchanges from offering any plan that provides abortion (except as described above) or gender‑transition procedures for minors. The prohibition applies to all Exchange plans, including plans that offer excepted benefits, and the bill also restructures related ACA text and makes conforming edits.

Personalized for You

How does this bill affect your finances?

Personalize government policy and PRIA will tell you what this bill means for your household, plus every other piece of legislation we track. PRIA reads each provision against your financial profile to show you exactly what matters to your wallet.

Free to download

Bill Overview

Analyzed Economic Effects

1 provisions identified: 0 benefits, 1 costs, 0 mixed.

Marketplace ban on abortion and minor care

If enacted, this bill would bar Exchange (marketplace) health plans from covering most abortions and from covering gender‑transition procedures for people under 18. Abortion coverage would be allowed only if a physician certifies the pregnancy threatens the woman's life, or if the pregnancy resulted from rape or incest. Gender‑transition procedures covered by the ban include puberty blockers, cross‑sex hormones, and surgery; the bill exempts certain intersex conditions, treatment of complications, and procedures needed to prevent imminent death or major bodily harm. The rule would apply to plan years beginning on or after January 1, 2026, and it covers plans that offer excepted benefits. Households buying Exchange plans could see higher out‑of‑pocket costs or loss of coverage for these services.

Sponsors & CoSponsors

Sponsor

Hawley, Josh [R-MO]

MO • R

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

No roll call votes available for this bill.

View on Congress.gov
Back to Legislation