Prohibiting Abortion & Transgender Procedures on the Exchanges Act
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.