Prohibits federal funding for gender transition procedures, restricts coverage under the Affordable Care Act, and defines key terms related to biological sex and gender transition.
Roger Marshall
Senator
KS
The "End Taxpayer Funding of Gender Experimentation Act of 2025" prohibits the use of federal funds for gender transition procedures and health benefits coverage that includes such procedures, while allowing individuals and entities to purchase separate coverage with non-federal funds. It clarifies that premium tax credits and cost-sharing reductions under the Affordable Care Act cannot be used for health plans covering gender transition procedures. The bill defines key terms like "gender transition procedure" and provides specific exclusions, such as treatments for verifiable disorders of sex development or procedures necessary to prevent imminent death. This act aims to ensure that federal taxpayer dollars are not used to fund gender transition interventions, while not restricting access to these procedures when paid for with non-federal funds.
Bill Proposes Ban on Federal Funds for Gender Transition Procedures, Cuts ACA Subsidies for Covering Plans
This bill, the 'End Taxpayer Funding of Gender Experimentation Act of 2025,' aims to block federal money from paying for gender transition procedures or for health insurance plans that cover them. It lays out specific definitions for sex based on biology and details a wide range of medical interventions included under 'gender transition procedure.' The core purpose is to prevent any federal tax dollars, including those used in programs like Medicaid or through ACA subsidies, from funding these specific medical services.
The Nitty-Gritty: Where the Money Stops
The legislation casts a wide net. Section 101 explicitly prohibits using federal funds for procedures like puberty blockers, hormone therapy (estrogen, testosterone), and various surgeries intended to align physical characteristics with gender identity. This ban extends to federal healthcare facilities and federal employees providing care. The bill defines 'sex' as strictly biological male or female based on reproductive systems. However, it carves out exceptions for treating specific conditions like medically verifiable disorders of sex development (DSDs), complications arising from prior transition procedures, or interventions necessary to prevent imminent death. It also clarifies that people can still buy separate insurance for these procedures using their own, non-federal money.
ACA Marketplace Impact: Subsidy Shutdown
Title II takes aim directly at the Affordable Care Act (ACA). Section 201 states that if a health plan sold on the ACA marketplace covers gender transition procedures, individuals buying that plan cannot receive premium tax credits (the subsidies that lower monthly payments) or cost-sharing reductions (which lower deductibles and co-pays). This also applies to the tax credits available to small businesses offering health plans. Essentially, choosing a plan that covers these specific procedures means forfeiting federal financial assistance available through the ACA. These changes would kick in for health plan years starting more than one year after the bill might become law.
Real Talk: What This Means Day-to-Day
So, what's the practical effect? For individuals relying on federal programs (like Medicaid, Medicare, or VA healthcare) or ACA subsidies, access to medical care related to gender transition could be significantly curtailed or become much more expensive. Someone currently receiving hormone therapy covered by their ACA plan might face a choice: find a new plan without that coverage to keep their subsidy, or pay the full, unsubsidized premium for their current plan. Small businesses wanting to offer comprehensive benefits that include transition-related care would lose eligibility for federal tax credits if they do so. While exceptions exist for DSDs and complications, the bill's definitions and the overall funding ban create new hurdles and potential financial barriers for transgender individuals seeking care, and could raise questions for those needing treatment for DSDs.