[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 498 Introduced in House (IH)]
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119th CONGRESS
1st Session
H. R. 498
To amend title XIX of the Social Security Act to prohibit Federal
Medicaid funding for gender transition procedures for minors.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
January 16, 2025
Mr. Crenshaw (for himself and Ms. Greene of Georgia) introduced the
following bill; which was referred to the Committee on Energy and
Commerce
_______________________________________________________________________
A BILL
To amend title XIX of the Social Security Act to prohibit Federal
Medicaid funding for gender transition procedures for minors.
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 ``Do No Harm in Medicaid Act''.
SEC. 2. PROHIBITING FEDERAL MEDICAID FUNDING FOR GENDER TRANSITION FOR
MINORS.
(a) In General.--Section 1903(i) of the Social Security Act (42
U.S.C. 1396b(i)) is amended--
(1) in paragraph (26), by striking ``; or'' and inserting a
semicolon;
(2) in paragraph (27), by striking the period at the end
and inserting ``; or''; and
(3) by inserting after paragraph (27) the following new
paragraph: ``(28) with respect to any amount expended for
specified gender procedures under section 1905(kk) to an
individual under 18 years of age enrolled in a State plan (or
waiver of such plan), including any amounts expended for the
administration of a State program that furnishes specified
procedures and drugs to individuals under 18 years of age.''.
(4) in the flush left matter at the end, by striking ``and
(18),'' and inserting ``(18), and (28)''.
(b) Prohibiting Federal Medicaid Funding for Gender Transitions for
Minors.--Section 1905 of the Social Security Act (42 U.S.C. 1396d) is
amended by adding at the end the following new subsection:
``(KK) Prohibiting federal medicaid funding for
gender transitions for minors.--
``(A) For purposes of section 1903(i)(28), except
as provided in subparagraph (B), the term `specified
gender transition procedures' means, with respect to an
individual, any of the following when performed for the
purpose of intentionally changing the body of such
individual (including by disrupting the body's
development, inhibiting its natural functions, or
modifying its appearance) to no longer correspond to
the individual's sex:
``(i) Performing any surgery, including--
``(I) castration;
``(II) sterilization;
``(III) orchiectomy;
``(IV) scrotoplasty;
``(V) vasectomy;
``(VI) tubal ligation;
``(VII) hysterectomy;
``(VIII) oophorectomy;
``(IX) ovariectomy;
``(X) metoidioplasty;
``(XI) clitoroplasty;
``(XII) reconstruction of the fixed
part of the urethra with or without a
metoidioplasty or a phalloplasty;
``(XIII) penectomy;
``(XIV) phalloplasty;
``(XV) vaginoplasty;
``(XVI) vaginectomy;
``(XVII) vulvoplasty;
``(XVIII) reduction
thyrochondroplasty;
``(XIX) chondrolaryngoplasty;
``(XX) mastectomy; and
``(XXI) any plastic, cosmetic, or
aesthetic surgery that feminizes or
masculinizes the facial or other
physiological features of an
individual.
``(ii) Any placement of chest implants to
create feminine breasts or any placement of
erection or testicular prosetheses.
``(iii) Any placement of fat or artificial
implants in the gluteal region.
``(iv) Administering, supplying,
prescribing, dispensing, distributing, or
otherwise conveying to an individual
medications, including--
``(I) gonadotropin-releasing
hormone (GnRH) analogues or other
puberty-blocking drugs to stop or delay
normal puberty; and
``(II) testosterone, estrogen,
progesterone or other androgens to an
individual at doses that are
supraphysiologic, greater or more
potent than would normally be produced
endogenously in a healthy individual of
the same age and sex.
``(B) Exception.--Subparagraph (A) shall not apply
to the following when furnished to an individual by a
health care provider with the consent of such
individual's parent or legal guardian:
``(i) Puberty suppression or blocking
prescription drugs for the purpose of
normalizing puberty for an individual
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 chromosome
with undervirilization; and
``(cc) both ovarian and
testicular tissue;
``(II) sex chromosome structure,
sexsteroid hormone production, or sex
hormone action, if determined to be
abnormal for a healthy individual of
the same sex and age by a physician
through genetic or biochemical testing;
``(III) infection, disease, injury,
or disorder caused or exacerbated by a
previous procedure described in
subparagraph (A), or 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
procedures performed for the
alleviation of mental distress; or
``(IV) procedures to restore or
reconstruct the body of the individual
in order to correspond to the
individual's sex after one or more
previous procedures described in
subparagraph (A), which may include the
removal of a pseudo phallus or breast
augmentation.
``(C) Sex.--For purposes of subparagraph(A), the
term `sex' means either male or female, as biologically
determined and defined by clause (i) and clause (ii).
``(i) Female.--The term `female' means an
individual who naturally has, had, will have,
or would have, but for a developmental or
genetic anomaly or historical accident, the
reproductive system that at some point
produces, transports, and utilizes eggs for
fertilization.
``(ii) Male.--The term `male' means an
individual who naturally has, had, will have,
or would have, but for a developmental or
genetic anomaly or historical accident, the
reproductive system that at some point
produces, transports, and utilizes sperm for
fertilization.''.
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