FEHB Health Plans Banned From Covering Gender-Affirming Care for Minors Under 18

The “Protecting Minors in Federal Health Plans Act” is a direct and specific piece of legislation that targets the Federal Employees Health Benefits (FEHB) program. If you or someone in your family is covered by an FEHB plan—which covers millions of federal workers, retirees, and their dependents—this bill mandates a major change in coverage. Simply put: FEHB plans cannot cover any medical service defined as “gender-affirming care” for anyone under the age of 18.

The Ban on Coverage: What’s Out

This legislation is clear about what it defines as “gender-affirming care or service”: any medical intervention intended to treat gender dysphoria. This includes hormone therapy, puberty blockers, and any surgery intended for gender transition (SEC. 2). For federal employees whose kids rely on these plans, this means that if your minor child needs or is seeking this type of care, your FEHB insurance will no longer pay for it once this law takes effect. This is a complete prohibition for minors enrolled in the plan.

The Narrow Exceptions: What’s Still Covered

The bill does carve out a few very specific exceptions, meaning coverage is still allowed for these medical situations, even if the patient is under 18. These exceptions are highly technical and relate mostly to congenital conditions. For instance, treatment for a medically verifiable disorder of sexual development (DSD), like ambiguous external characteristics or certain genetic/biochemical issues, is still covered. Similarly, treatment for precocious puberty (puberty starting too early) or delayed puberty (consistent with biological sex) remains covered. The bill also makes sure that treatment for complications from a previous gender-affirming procedure, or life-saving procedures for immediate risk of death, are still covered, but only if they are not being performed for the purpose of gender transition.

The One-Year Taper: The Grandfather Clause

One of the most immediate and concerning impacts of this bill involves minors already receiving care. If a minor under 18 is currently receiving hormone therapy that is covered by an FEHB plan, that coverage doesn’t just stop immediately. The bill includes a grandfathering exception, but it comes with a hard deadline: the therapy can continue only if it follows a reduction schedule supervised by a physician, and it must end completely within one year of the law’s effective date (SEC. 2). For families relying on this coverage, this means finding alternative funding or discontinuing care within 12 months, regardless of the physician’s recommendation for continued treatment. This forced, rapid cessation of ongoing medical care could create significant medical and financial stress for affected families.

Real-World Impact for Federal Families

This law directly affects the healthcare choices and costs for federal employees and their families. If you are a federal worker with a child under 18 receiving gender-affirming care, you will need to find a new way to pay for these services out-of-pocket, as your insurance will drop coverage. For a family in a high-cost area, paying for continuous hormone therapy or other necessary medical services without insurance could quickly become financially unsustainable. Since these new rules apply to any FEHB contract signed or renewed after the Act becomes law, the changes will roll out quickly across the entire program, forcing many families to make difficult decisions about their child’s medical treatment within a short timeframe.