[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 3011 Introduced in Senate (IS)]
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119th CONGRESS
1st Session
S. 3011
To amend the Patient Protection and Affordable Care Act to exclude
coverage of gender-transition procedures for minors and abortion under
health plans offered through the American Health Benefits Exchanges,
and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
October 15, 2025
Mr. Hawley introduced the following bill; which was read twice and
referred to the Committee on Health, Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To amend the Patient Protection and Affordable Care Act to exclude
coverage of gender-transition procedures for minors and abortion under
health plans offered through the American Health Benefits Exchanges,
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 ``Prohibiting Abortion & Transgender
Procedures on the Exchanges Act''.
SEC. 2. EXCLUSION OF GENDER-TRANSITION PROCEDURES FOR MINORS AND
ABORTION FROM COVERAGE UNDER HEALTH PLANS OFFERED THROUGH
THE AMERICAN HEALTH BENEFITS EXCHANGES.
(a) In General.--Section 1303 of the Patient Protection and
Affordable Care Act (42 U.S.C. 18023) is amended--
(1) in subsection (a)--
(A) by striking paragraph (2); and
(B) by striking the subsection designation and
heading and all that follows through ``A State'' in
paragraph (1) and inserting the following:
``(a) State Opt-Out of Abortion Coverage.--A State'';
(2) in subsection (b), by striking the subsection
designation and heading and all that follows through ``No
qualified'' in paragraph (4) and inserting the following:
``(b) No Discrimination on Basis of Provision of Abortion.--No
qualified'';
(3) in subsection (c)--
(A) in paragraph (2)--
(i) by striking the paragraph designation
and heading and all that follows through
``Nothing'' in subparagraph (A) and inserting
the following:
``(2) No effect on federal laws regarding abortion.--
Nothing''; and
(ii) by redesignating clauses (i) through
(iii) as subparagraphs (A) through (C),
respectively, and adjusting the margins
accordingly;
(B) by striking the subsection designation and
heading and all that follows through the end of
paragraph (1) and inserting the following:
``(c) Application of Federal Laws.--''; and
(C) by redesignating paragraphs (2) and (3) as
paragraphs (1) and (2), respectively;
(4) by redesignating subsections (a) through (d) as
subsections (b) through (e), respectively; and
(5) by inserting before subsection (b) (as so redesignated)
the following:
``(a) Prohibition on Coverage of Gender-Transition Procedures for
Minors and Abortion.--
``(1) In general.--An Exchange may not make available any
health plan, including any health plan offering excepted
benefits (as defined in section 2791(c) of the Public Health
Service Act), that provides coverage for--
``(A) abortion, except in the case where a woman
suffers from a physical disorder, physical injury, or
physical illness that would, as certified by a
physician, place the woman in danger of death unless an
abortion is performed, including a life-endangering
physical condition caused by or arising from the
pregnancy itself, or unless the pregnancy is the result
of an act of rape or incest; or
``(B) gender-transition procedures for minors.
``(2) Definitions.--In this subsection:
``(A) Gender-transition procedure.--
``(i) In general.--Except as provided in
clause (ii), the term `gender-transition
procedure' means--
``(I) the prescription or
administration of gonadotropin-
releasing hormone agonists or any other
puberty-blocking drugs for the purpose
of changing the body of an individual
so that it conforms to the subjective
sense of identity of the individual, in
the case such identity is at odds with
the individual's biological sex of male
or female;
``(II) the prescription or
administration of testosterone (when
prescribed to a female) or estrogen
(when prescribed to a male) for the
purpose of changing the body of an
individual so that it conforms to the
subjective sense of identity of the
individual, in the case such identity
is at odds with the individual's
biological sex of male or female; or
``(III) a surgery to change the
body of an individual so that it
conforms to the subjective sense of
identity of the individual, in the case
such identity is at odds with the
individual's biological sex of male or
female.
``(ii) Exception.--The term `gender-
transition procedure' does not include--
``(I) an intervention described in
clause (i) that is performed on--
``(aa) an individual with
biological sex characteristics
that are inherently ambiguous,
such as those born with 46 XX
chromosomes with virilization,
46 XY chromosomes with
undervirilization, or having
both ovarian and testicular
tissue; or
``(bb) 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, for
a biological male or biological
female;
``(II) the treatment of any
infection, injury, disease, or disorder
that has been caused or exacerbated by
the performance of an intervention
described in clause (i) without regard
to whether the intervention was
performed in accordance with State or
Federal law; or
``(III) any procedure undertaken
because the individual suffers 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 major bodily function
unless the procedure is performed.
``(B) Minor.--The term `minor' means an individual
who has not yet reached 18 years of age.''.
(b) Conforming Amendment.--Section 1334(a) (42 U.S.C. 18054(a)) is
amended--
(1) by striking paragraph (6); and
(2) by redesignating paragraph (7) as paragraph (6).
(c) Effective Date.--The amendments made by this section shall
apply with respect to plan years beginning on or after January 1, 2026.
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