[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2107 Introduced in House (IH)]
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119th CONGRESS
1st Session
H. R. 2107
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
March 14, 2025
Mr. Crenshaw (for himself, Mrs. Miller of Illinois, Mrs. Miller-Meeks,
Mr. Pfluger, Mr. Ellzey, Mr. Van Drew, Mr. Green of Tennessee, Mr.
Rouzer, Mrs. Harshbarger, Mr. Grothman, Mr. Jackson of Texas, and Mr.
Scott Franklin of Florida) 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 2025''.
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
``2030'';
(2) in subsection (b)(3)(D), by inserting ``and the end of
fiscal year 2030,'' after ``fiscal year 2022,'';
(3) in subsection (e), by adding at the end the following
new paragraph:
``(4) Prohibition on payments to hospitals furnishing
specified procedures and drugs 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 2026) if, at any point
during the preceding fiscal year, such hospital
furnished specified procedures and drugs (as defined in
subsection (g)) to an individual under 18 years of age.
``(B) Special rule for fiscal year 2026.--In
applying subparagraph (A) with respect to payments
described in such subparagraph for fiscal year 2026--
``(i) the reference to `for a fiscal year'
shall be treated as a reference to `for any
portion of fiscal year 2026 occurring after
December 31, 2025'; and
``(ii) the reference to `the preceding
fiscal year' shall be treated as a reference to
`the period beginning on September 1, 2025, and
ending on December 31, 2025'.
``(C) Rule of construction.--Nothing in this
paragraph shall be construed as prohibiting payments
for a fiscal year (or, in the case of payments for
fiscal year 2026, during the portion of such fiscal
year described in subparagraph (B)(i)) to a hospital
that, during the preceding fiscal year (or, in the case
of payments for fiscal year 2026, during the period
described in subparagraph (B)(ii)), furnished mental or
behavioral health services to individuals under 18
years of age for the treatment of gender dysphoria not
consisting of specified procedures and drugs.'';
(4) in subsection (f)--
(A) in paragraph (1)(A)--
(i) in clause (v), by striking ``and'' at
the end;
(ii) in clause (vi), by striking the period
at the end and inserting ``; and''; and
(iii) by adding at the end the following:
``(vii) for each of fiscal years 2026
through 2030, $124,000,000.''; and
(B) in paragraph (2)--
(i) in subparagraph (E), by striking
``and'' at the end;
(ii) in subparagraph (F), by striking the
period at the end and inserting ``; and''; and
(iii) by adding at the end the following:
``(G) for each of fiscal years 2026 through 2030,
$261,000,000''; and
(5) in subsection (g), by adding at the end the following
new paragraph:
``(4) Specified procedures and drugs.--
``(A) In general.--Except as provided in
subparagraph (B), the term `specified procedures and
drugs' 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 no longer correspond to the individual's
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, or any
plastic surgery that feminizes or
masculinizes the facial features;
``(XVI) mastectomy, or any
placement of chest implants to create
feminine breasts; and
``(XVII) Any placement of fat or
artificial implants in the gluteal
region.
``(ii) Administering, supplying,
prescribing, dispensing, distributing, or
otherwise conveying to an individual
medications for the purposes described in
clause (i), including gonadotrophin releasing
hormone (GnRH) analogues or other puberty-
blocking drugs to stop or delay normal puberty,
and estrogen, testosterone, progesterone, or
other androgens to an individual in an amount
greater than would normally be produced
endogenously in a healthy individual of that
individual's age and sex.
``(B) Exception.--Subparagraph (A) shall not apply
to the provision by a physician or health care
provider, with the consent of the child's parent or
legal guardian, of--
``(i) puberty suppression or blocking
prescription drugs for the purpose of
normalizing puberty for a minor experiencing
precocious puberty;
``(ii) appropriate and medically necessary
procedures or treatments to correct for--
``(I) a medically verifiable
genetic disorder of sex development,
including--
``(aa) 46,XX chromosomes
with virilization;
``(bb) 46,XY chromosomes
with undervirilization; and
``(cc) both ovarian and
testicular tissue; or
``(II) sex chromosome structure,
sex steroid hormone production, or sex
hormone action, if determined to be
abnormal by a physician through genetic
or biochemical testing;
``(iii) infection, disease, injury, or
disorder caused or exacerbated by previous
medical procedures as defined in subsection
(g)(4)(A); or
``(iv) 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, not including if the procedure or
drug is for the purpose described in subsection
(g)(4)(A)(i).
``(C) Sex.--For purposes of subparagraph (A), the
term `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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