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S 1774119th CongressIntroduced

Protecting Minors in Federal Health Plans Act

Introduced: May 15, 2025
Healthcare
Standard Summary
Comprehensive overview in 1-2 paragraphs

The Protecting Minors in Federal Health Plans Act would amend the Federal Employees Health Benefits (FEHB) program (the health insurance program carried out under title 5, chapter 89) to bar coverage of gender-affirming care for anyone under 18. The bill provides a detailed definition of what qualifies as gender-affirming care and then excludes several specific situations from that definition. It also includes a limited grandfathering provision allowing a minor who was already receiving hormone therapy before the act’s effective date to continue under an approved, physician-supervised reduction plan for up to one year after enactment. The measure applies to FEHB contracts entered into or renewed on or after the date of enactment. The bill is introduced in the Senate by Senators Risch, Lummis, Ricketts, and Cramer and is titled the Protecting Minors in Federal Health Plans Act.

Key Points

  • 1Prohibits FEHB coverage for any gender-affirming care or services for individuals under 18 (with a defined set of carve-outs described below).
  • 2Defines gender-affirming care as medical interventions designed to treat gender dysphoria, including hormone therapy, puberty blockers, and surgeries, but lists explicit exceptions.
  • 3Carve-outs (services not considered gender-affirming care for purposes of the coverage prohibition):
  • 4- Care for medically verifiable disorders of sexual development (DSDs) and certain intersex variations.
  • 5- Treatments for disorders diagnosed via genetic/biochemical testing that show atypical sex chromosome structure or hormone production/action.
  • 6- Treatments of infections, injuries, or diseases caused or worsened by a gender-affirming intervention.
  • 7- Emergency procedures addressing imminent risk of death or major impairment that are not intended for gender transition.
  • 8- Puberty suppression or blocking for precocious puberty in individuals under 18.
  • 9- Hormone therapy for delayed puberty if it is consistent with the individual’s biological sex and intended to stimulate a normal puberty.
  • 10- Male circumcision.
  • 11Grandfathering provision: For minors who were under 18 and on hormone therapy as of the effective date, coverage may continue for up to one year after the effective date if the therapy is provided under a physician-supervised reduction schedule.
  • 12Effective date and applicability: The act applies to FEHB contracts entered into or renewed on or after the date of enactment.

Impact Areas

Primary group/area affected- Minors enrolled in FEHB plans (federal employees, retirees, and their family members) who would otherwise be eligible for gender-affirming care under FEHB.Secondary group/area affected- FEHB carriers/insurers and federal agencies administering FEHB contracts, which would need to adjust covered services to comply with the prohibition and manage the grandfathering exception.Additional impacts- Administrative and compliance changes for FEHB plans to implement the age-based coverage prohibition and the listed carve-outs.- Potential changes in access to and standard of care for transgender or gender-diverse youth within federal employee health benefits.- Possible policy and political implications related to transgender health care access in federal programs.
Generated by gpt-5-nano on Oct 3, 2025