[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3887 Introduced in House (IH)]
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118th CONGRESS
1st Session
H. R. 3887
To amend title III of the Public Health Service Act to reauthorize the
program of payments to children's hospitals that operate graduate
medical education programs, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 7, 2023
Mr. Crenshaw introduced the following bill; which was referred to the
Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To amend title III of the Public Health Service Act to reauthorize the
program of payments to children's hospitals that operate graduate
medical education programs, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Children's Hospital GME Support
Reauthorization Act of 2023''.
SEC. 2. PROGRAM OF PAYMENTS TO CHILDREN'S HOSPITALS THAT OPERATE
GRADUATE MEDICAL EDUCATION PROGRAMS.
Section 340E of the Public Health Service Act (42 U.S.C. 256e) is
amended--
(1) in subsection (a), by striking ``2023'' and inserting
``2028'';
(2) in subsection (b)(3)(D), by inserting ``and the end of
fiscal year 2028,'' after ``fiscal year 2022,'';
(3) in subsection (e), by adding at the end the following
new paragraph:
``(4) Prohibition on payments to hospitals furnishing
gender-affirming care to minors.--
``(A) In general.--Notwithstanding any other
provision of this section, no payment may be made under
this section to a children's hospital for a fiscal year
(beginning with fiscal year 2024) if, at any point
during the preceding fiscal year, such hospital
furnished gender-affirming care (as defined in
subsection (g)) to an individual under 18 years of age.
``(B) Special rule for fiscal year 2024.--In
applying subparagraph (A) with respect to payments
described in such subparagraph for fiscal year 2024,
the reference to `the preceding fiscal year' shall be
treated as a reference to `the period beginning on July
1, 2023, and ending on September 30, 2023'.
``(C) Rule of construction.--Nothing in this
paragraph shall be construed as prohibiting payments
for a fiscal year to a hospital that, during the
preceding fiscal year (or, in the case of payments for
fiscal year 2024, during the period described in
subparagraph (B)), furnished mental or behavioral
health services to individuals under 18 years of age
for the treatment of gender dysphoria not consisting of
gender-affirming care.'';
(4) in subsection (f)--
(A) in paragraph (1)(A)(vi), by striking ``2023''
and inserting ``2028''; and
(B) in paragraph (2)(F), by striking ``2023'' and
inserting ``2028''; and
(5) in subsection (g), by adding at the end the following
new paragraph:
``(4) Gender-affirming care.--
``(A) In general.--Except as provided in
subparagraph (B), the term `gender-affirming care'
means, with respect to an individual, any of the
following:
``(i) Performing any surgery for the
purpose of changing the body of such individual
to correspond to a sex that differs from their
biological sex, including--
``(I) castration;
``(II) orchiectomy;
``(III) scrotoplasty;
``(IV) vasectomy;
``(V) hysterectomy;
``(VI) oophorectomy;
``(VII) ovariectomy;
``(VIII) metoidioplasty;
``(IX) penectomy;
``(X) phalloplasty;
``(XI) vaginoplasty;
``(XII) vaginectomy;
``(XIII) vulvoplasty;
``(XIV) reduction
thyrochondroplasty;
``(XV) chondrolaryngoplasty; and
``(XVI) mastectomy.
``(ii) Any plastic surgery that feminizes
or masculinizes the facial features for the
purposes described in clause (i).
``(iii) Any placement of chest implants to
create feminine breasts for the purposes
described in clause (i).
``(iv) Any placement of fat or artificial
implants in the gluteal region for the purposes
described in clause (i).
``(v) Administering, supplying,
prescribing, dispensing, distributing, or
otherwise conveying to an individual
medications for the purposes described in
clause (i), including--
``(I) gonadotropin-releasing
hormone (GnRH) analogues or other
puberty-blocking drugs to stop or delay
normal puberty;
``(II) testosterone or other
androgens to biological females at
doses that are supraphysiologic to the
female sex; and
``(III) estrogen to biological
males at doses that are
supraphysiologic to the male sex.
``(B) Exception.--Subparagraph (A) shall not apply
to the following individuals:
``(i) An individual with both ovarian and
testicular tissue.
``(ii) An individual with respect to whom a
physician has determined through genetic or
biochemical testing that the individual does
not have normal sex chromosome structure, sex
steroid hormone production, or sex steroid
hormone action.
``(iii) An individual experiencing
infection, disease, injury, or disorder caused
or exacerbated by previous gender transition
procedures.
``(iv) An individual suffering from a
physical disorder, physical injury, or physical
illness that would, as certified by a
physician, place the individual in imminent
danger of death or impairment of a major bodily
function unless the procedure is performed.
``(C) Biological sex.--For purposes of subparagraph
(A), the term `biological sex' means the indication of
male or female sex by reproductive potential or
capacity, sex chromosomes, naturally occurring sex
hormones, gonads, or internal or external genitalia
present at birth.''.
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