LegisTrack
Back to all bills
S 3011119th CongressIn Committee

Prohibiting Abortion & Transgender Procedures on the Exchanges Act

Introduced: Oct 15, 2025
Sponsor: Sen. Hawley, Josh [R-MO] (R-Missouri)
Standard Summary
Comprehensive overview in 1-2 paragraphs

This bill would amend the Patient Protection and Affordable Care Act (ACA) to bar health plans sold through the American Health Benefits Exchanges from covering two categories: (1) abortion, except in narrowly defined life-threatening or rape/incest situations, and (2) gender-transition procedures for minors (those under 18). It sets a specific definition of what counts as a gender-transition procedure (puberty-blocking drugs, certain hormone therapies, and surgery) and includes limited exceptions. The changes would apply to plan years beginning on or after January 1, 2026. In short, the bill would significantly reduce or eliminate coverage for abortion (except in rare cases) and all coverage for gender-transition procedures for minors within exchange plans, changing the scope of benefits available to individuals purchasing coverage through these exchanges.

Key Points

  • 1Prohibits coverage for abortion and gender-transition procedures in health plans offered through the American Health Benefits Exchanges, with limited abortion exceptions.
  • 2Abortion could be covered only in very narrow circumstances (to save the woman’s life or in cases of rape or incest, or other life-endangering conditions as certified by a physician).
  • 3Defines gender-transition procedure to include puberty-blocking drugs, certain hormone therapies, and surgeries intended to align the body with an individual’s gender identity, with explicit exceptions for specific medical or genetic conditions.
  • 4Applies specifically to plans offered through the ACA exchanges (including plans offering excepted benefits) and would take effect for plan years beginning on or after January 1, 2026.
  • 5The bill restructures certain ACA provisions related to abortion coverage and state opt-out language, and it clarifies that the restrictions do not create new federal prohibitions on other federal laws governing abortion in other contexts.

Impact Areas

Primary group/area affected- Minors (under 18) who seek gender-transition procedures and their families.- Individuals seeking abortion through exchange plans (with limited allowed circumstances).- Health insurers and health plans offered on the ACA exchanges (they would need to remove these coverages to comply).Secondary group/area affected- States, since the bill interacts with state-level decisions on abortion coverage within exchanges and may influence state flexibility under exchange rules.- Healthcare providers and clinics that perform abortion or gender-transition-related services for minors (changes in coverage could affect demand and access).Additional impacts- Could affect out-of-pocket costs and access to care for affected individuals.- Potential legal and policy debates around minors’ access to gender-transition care and abortion coverage.- Administrative changes for plan offerings and compliance beginning with the 2026 plan year.The bill’s sponsor is Senator Hawley, and it is introduced legislation in the 119th Congress. It requests changes to the ACA’s Section 1303 and related provisions, with an effective date for plan years starting in 2026.The text explicitly limits abortion coverage to specific, narrow circumstances and prohibits coverage of gender-transition procedures for minors in exchange plans. It does not explicitly state a ban on abortion or gender-transition procedures outside of ACA exchange plans.
Generated by gpt-5-nano on Oct 23, 2025