End Taxpayer Funding of Gender Experimentation Act of 2020
This bill modifies provisions relating to federal funding for, and health insurance coverage of, gender reassignment medical interventions, which include surgical remedies and hormone therapy arising from a conflict between an individual's gender identity and the sex the individual has or was identified as having at birth. Specifically, the bill prohibits the use of federal funds for gender reassignment medical interventions or for health coverage that includes such interventions. Additionally, such interventions may not be provided in a federal health care facility or by a federal employee. Under current law, coverage of these interventions through Medicare and Medicaid is generally determined at the state level.
The bill's restrictions regarding the use of federal funds do not apply to treatment of individuals with medically verifiable disorders of sex development, such as individuals born with atypical development of chromosomal, gonadal, or anatomical sex.
The bill also prohibits qualified health plans from including coverage for gender reassignment medical interventions. Further, plans that include coverage for such interventions are not eligible for federal subsidies.
[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8013 Introduced in House (IH)]
<DOC>
116th CONGRESS
2d Session
H. R. 8013
To prohibit taxpayer-funded gender reassignment medical interventions,
and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
August 11, 2020
Mr. LaMalfa (for himself, Mr. Norman, Mr. Aderholt, Mr. Lamborn, Mr.
Allen, Mr. King of Iowa, Mr. Steube, Mr. Babin, Mr. Flores, and Mr.
Hice of Georgia) introduced the following bill; which was referred to
the Committee on Energy and Commerce, and in addition to the Committees
on the Judiciary, and Ways and Means, for a period to be subsequently
determined by the Speaker, in each case for consideration of such
provisions as fall within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To prohibit taxpayer-funded gender reassignment medical interventions,
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; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``End Taxpayer
Funding of Gender Experimentation Act of 2020''.
(b) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; table of contents.
TITLE I--PROHIBITING FEDERALLY FUNDED GENDER REASSIGNMENT MEDICAL
INTERVENTIONS
Sec. 101. Prohibiting taxpayer-funded gender reassignment medical
interventions.
Sec. 102. Amendment to table of chapters.
TITLE II--APPLICATION UNDER THE AFFORDABLE CARE ACT
Sec. 201. Clarifying application of prohibition to premium credits and
cost-sharing reductions under ACA.
TITLE I--PROHIBITING FEDERALLY FUNDED GENDER REASSIGNMENT MEDICAL
INTERVENTIONS
SEC. 101. PROHIBITING TAXPAYER-FUNDED GENDER REASSIGNMENT MEDICAL
INTERVENTIONS.
Title 1, United States Code, is amended by adding at the end the
following new chapter:
``CHAPTER 4--PROHIBITING TAXPAYER-FUNDED GENDER REASSIGNMENT MEDICAL
INTERVENTIONS
``301. Prohibition on funding for gender reassignment medical
interventions.
``302. Prohibition on funding for health benefits plans that cover
gender reassignment medical interventions.
``303. Limitation on Federal facilities and employees.
``304. Construction relating to separate coverage.
``305. Construction relating to the use of non-Federal funds for health
coverage.
``306. Construction relating to complications arising from gender
reassignment medical interventions.
``307. Treatment of individuals born with medically verifiable disorder
of sex development.
``308. Gender reassignment medical intervention defined.
``Sec. 301. Prohibition on funding for gender reassignment medical
interventions
``No funds authorized or appropriated by Federal law, and none of
the funds in any trust fund to which funds are authorized or
appropriated by Federal law, shall be expended for any gender
reassignment medical intervention.
``Sec. 302. Prohibition on funding for health benefits plans that cover
gender reassignment medical interventions
``No funds authorized or appropriated by Federal law, and none of
the funds in any trust fund to which funds are authorized or
appropriated by Federal law, shall be expended for health benefits
coverage that includes coverage of gender reassignment medical
interventions.
``Sec. 303. Limitation on Federal facilities and employees
``No health care service furnished--
``(1) by or in a health care facility owned or operated by
the Federal Government; or
``(2) by any physician or other individual employed by the
Federal Government to provide health care services within the
scope of the physician's or individual's employment,
may include gender reassignment medical interventions.
``Sec. 304. Construction relating to separate coverage
``Nothing in this chapter shall be construed as prohibiting any
individual, entity, or State or locality from purchasing separate
coverage for gender reassignment medical interventions or health
benefits coverage that includes gender reassignment medical
interventions so long as such coverage is paid for entirely using only
funds not authorized or appropriated by Federal law and such coverage
shall not be purchased using matching funds required for a federally
subsidized program, including a State's or locality's contribution of
Medicaid matching funds.
``Sec. 305. Construction relating to the use of non-Federal funds for
health coverage
``Nothing in this chapter shall be construed as restricting the
ability of any non-Federal health benefits coverage provider from
offering coverage for gender reassignment medical interventions, or the
ability of a State or locality to contract separately with such a
provider for such coverage, so long as only funds not authorized or
appropriated by Federal law are used and such coverage shall not be
purchased using matching funds required for a federally subsidized
program, including a State's or locality's contribution of Medicaid
matching funds.
``Sec. 306. Construction relating to complications arising from gender
reassignment medical interventions
``Nothing in this chapter shall be construed to apply to the
treatment of any infection, injury, disease, or disorder that has been
caused by or exacerbated by the performance of a gender reassignment
medical intervention. This rule of construction shall be applicable
without regard to whether the gender reassignment medical intervention
was performed in accord with Federal or State law, and without regard
to whether funding for the gender reassignment medical intervention is
permissible under section 307.
``Sec. 307. Treatment of individuals born with medically verifiable
disorder of sex development
``The limitations established in sections 301, 302, and 303 shall
not apply with respect to the following individuals:
``(1) An individual with external biological sex
characteristics that are irresolvably ambiguous, such as those
born with 46 XX chromosomes with virilization, 46 XY
chromosomes with undervirilization, or having both ovarian and
testicular tissue.
``(2) 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 female.
``Sec. 308. Gender reassignment medical intervention defined
``For purposes of this chapter, the term `gender reassignment
medical intervention' means--
``(1) performing a surgery that sterilizes an individual,
including castration, vasectomy, hysterectomy, oophorectomy,
metoidioplasty, penectomy, phalloplasty, and vaginoplasty, to
change the body of such individual to correspond to a sex that
is discordant with biological sex;
``(2) performing a mastectomy on an individual for the
purpose described in paragraph (1); and
``(3) administering or supplying to an individual
medications for the purpose described in paragraph (1),
including--
``(A) GnRH agonists or other puberty-blocking drugs
to stop or delay normal puberty;
``(B) testosterone or other androgens to biological
females at doses that are supraphysiologic to the
female sex; and
``(C) estrogen to biological males at doses that
are supraphysiologic to the male sex.''.
SEC. 102. AMENDMENT TO TABLE OF CHAPTERS.
The table of chapters for title 1, United States Code, is amended
by adding at the end the following new item:
``4. Prohibiting taxpayer-funded gender reassignment medical 301''.
interventions.
TITLE II--APPLICATION UNDER THE AFFORDABLE CARE ACT
SEC. 201. CLARIFYING APPLICATION OF PROHIBITION TO PREMIUM CREDITS AND
COST-SHARING REDUCTIONS UNDER ACA.
(a) In General.--
(1) Disallowance of refundable credit and cost-sharing
reductions for coverage under qualified health plan which
provides coverage for gender reassignment medical
interventions.--
(A) In general.--Subparagraph (A) of section
36B(c)(3) of the Internal Revenue Code of 1986 is
amended by inserting before the period at the end the
following: ``or any health plan that includes coverage
for gender reassignment medical interventions (other
than any gender reassignment medical intervention or
treatment described in section 306 or 307 of title 1,
United States Code)''.
(B) Option to purchase or offer separate coverage
or plan.--Paragraph (3) of section 36B(c) of such Code
is amended by adding at the end the following new
subparagraph:
``(C) Separate coverage or plan for gender
reassignment medical interventions allowed.--
``(i) Option to purchase separate coverage
or plan.--Nothing in subparagraph (A) shall be
construed as prohibiting any individual from
purchasing separate coverage for gender
reassignment medical interventions described in
such subparagraph, or a health plan that
includes such gender reassignment medical
interventions, so long as no credit is allowed
under this section with respect to the premiums
for such coverage or plan.
``(ii) Option to offer coverage or plan.--
Nothing in subparagraph (A) shall restrict any
non-Federal health insurance issuer offering a
health plan from offering separate coverage for
gender reassignment medical interventions
described in such subparagraph, or a plan that
includes such gender reassignment medical
interventions, so long as premiums for such
separate coverage or plan are not paid for with
any amount attributable to the credit allowed
under this section (or the amount of any
advance payment of the credit under section
1412 of the Patient Protection and Affordable
Care Act).''.
(2) Disallowance of small employer health insurance expense
credit for plan which includes coverage for gender reassignment
medical interventions.--Subsection (h) of section 45R of the
Internal Revenue Code of 1986 is amended--
(A) by striking ``Any term'' and inserting the
following:
``(1) In general.--Any term''; and
(B) by adding at the end the following new
paragraph:
``(2) Exclusion of health plans including coverage for
gender reassignment medical interventions.--
``(A) In general.--The term `qualified health plan'
does not include any health plan that includes coverage
for gender reassignment medical interventions (other
than any gender reassignment medical intervention or
treatment described in section 306 or 307 of title 1,
United States Code).
``(B) Separate coverage or plan for gender
reassignment medical interventions allowed.--
``(i) Option to purchase separate coverage
or plan.--Nothing in subparagraph (A) shall be
construed as prohibiting any employer from
purchasing for its employees separate coverage
for gender reassignment medical interventions
described in such subparagraph, or a health
plan that includes such gender reassignment
medical interventions, so long as no credit is
allowed under this section with respect to the
employer contributions for such coverage or
plan.
``(ii) Option to offer coverage or plan.--
Nothing in subparagraph (A) shall restrict any
non-Federal health insurance issuer offering a
health plan from offering separate coverage for
gender reassignment medical interventions
described in such subparagraph, or a plan that
includes such gender reassignment medical
interventions, so long as such separate
coverage or plan is not paid for with any
employer contribution eligible for the credit
allowed under this section.''.
(b) Application to Multi-State Plans.--Section 1334(a) of Public
Law 111-148 (42 U.S.C. 18054(a)) is amended by adding at the end the
following new paragraph:
``(7) Coverage consistent with federal policy regarding
gender reassignment medical interventions.--In entering into
contracts under this subsection, the Director shall ensure that
no multi-State qualified health plan offered in an Exchange
provides health benefits coverage for which the expenditure of
Federal funds is prohibited under chapter 4 of title 1, United
States Code.''.
(c) Effective Date.--The amendments made by subsection (a) shall
apply to taxable years ending after December 31, 2019, but only with
respect to plan years beginning after such date, and the amendment made
by subsection (b) shall apply to plan years beginning after such date.
<all>
Introduced in House
Introduced in House
Referred to the Committee on Energy and Commerce, and in addition to the Committees on the Judiciary, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on the Judiciary, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on the Judiciary, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
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