PRIA Logo™
HR9743119th CongressWALLET

TRUTH in Coverage Act of 2026

Sponsored By: Representative Harshbarger, Diana [R-TN-1]

Introduced

Summary

Requires coverage for restorative care to address harms from sex-rejecting procedures. This bill would require health plans and insurers that cover any sex-rejecting procedure to also cover lifetime treatments to monitor, mitigate, or reverse harms from those procedures.

Show full summary
  • People who received sex-rejecting procedures would gain lifetime access to restorative care. Covered services include reconstructive and prosthetic surgeries, fertility services, hormone monitoring, mental health care, rehabilitation, diagnostics, and long-term surveillance.
  • Health plans, issuers, and employers sponsoring plans would have to apply no more restrictive financial limits or treatment limits to restorative care than they apply to predominant medical and surgical benefits. Plans may not impose separate cost-sharing or treatment limits and the rule would apply to group and individual coverage including fully insured, self-funded, and ERISA-covered plans.
  • The bill defines an extensive list of sex-rejecting procedures from puberty blockers and cross-sex hormones to genital, chest, facial, and voice surgeries. It also lists specific exceptions such as treatments for disorders of sex development, life‑threatening conditions, infection or injury care, and puberty suppression for precocious puberty.

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

3 provisions identified: 2 benefits, 0 costs, 1 mixed.

More restorative care coverage for enrollees

This bill would require group and individual health plans or issuers that cover any listed sex-rejecting procedure to also cover restorative care for anyone who ever had such a procedure. Restorative care would include medical, surgical, fertility, mental-health, diagnostic, and surveillance services to treat harms and complications. Financial requirements (including lifetime or annual limits) and treatment limits for restorative care would not be more restrictive than the predominant rules for substantially all medical and surgical benefits. Plans could not impose separate cost-sharing or separate treatment limits only for restorative care. These rules would apply to plan years beginning on or after January 1, 2027.

Which procedures trigger coverage rules

This bill would define 'sex-rejecting procedure' broadly and list many drugs, hormones, surgeries, implants, and cosmetic procedures that fit that term. It would also define 'restorative care' to include services to address, monitor, treat, or reverse harms from those procedures at any point in a person's life. The bill would set statutory meanings for 'male' and 'female' by reproductive-system traits at maturity and cross-reference standard definitions for financial requirements and treatment limitations. Those definitions would determine who can get the parity protections and restorative-care coverage described in the bill.

Exceptions to procedure coverage rules

This bill would exclude some services from the 'sex-rejecting procedure' list. Exceptions include care for people born with medically verifiable disorders of sex development, services tied to a diagnosed disorder of sex development, treatment of infections or injuries caused or worsened by prior procedures, procedures a physician certifies are needed to avoid imminent death or major harm, puberty-suppression for precocious puberty, and male circumcision. Each exception applies when a clinician provides care with the patient's or parent's consent and, where required, a physician's certification.

Sponsors & CoSponsors

Sponsor

Harshbarger, Diana [R-TN-1]

TN • R

Cosponsors

  • Rep. Carter, Earl L. "Buddy" [R-GA-1]

    GA • R

    Sponsored 7/16/2026

  • Rep. McGuire, John J. [R-VA-5]

    VA • R

    Sponsored 7/16/2026

  • Rep. Kennedy, Mike [R-UT-3]

    UT • R

    Sponsored 7/16/2026

  • Rep. Carter, John R. [R-TX-31]

    TX • R

    Sponsored 7/16/2026

  • Rep. Fuller, Clay [R-GA-14]

    GA • R

    Sponsored 7/16/2026

  • Rep. Van Epps, Matt [R-TN-7]

    TN • R

    Sponsored 7/16/2026

  • Rep. Biggs, Sheri [R-SC-3]

    SC • R

    Sponsored 7/16/2026

  • Rep. Babin, Brian [R-TX-36]

    TX • R

    Sponsored 7/16/2026

  • Rep. Miller, Mary E. [R-IL-15]

    IL • R

    Sponsored 7/16/2026

  • Rep. Stutzman, Marlin A. [R-IN-3]

    IN • R

    Sponsored 7/16/2026

  • Rep. Hamadeh, Abraham J. [R-AZ-8]

    AZ • R

    Sponsored 7/16/2026

  • Rep. Ciscomani, Juan [R-AZ-6]

    AZ • R

    Sponsored 7/16/2026

  • Rep. Harris, Andy [R-MD-1]

    MD • R

    Sponsored 7/27/2026

  • Rep. Guest, Michael [R-MS-3]

    MS • R

    Sponsored 9/16/2026

Roll Call Votes

No roll call votes available for this bill.

View on Congress.gov
Back to Legislation