Children’s Hospital GME Support Reauthorization Act of 2025
H.R. 2107, the Children’s Hospital GME Support Reauthorization Act of 2025, would extend and reauthorize federal payments to children’s hospitals that operate graduate medical education (GME) programs through fiscal year 2030. It largely preserves the existing program but adds a new condition: starting in fiscal year 2026, a hospital would be ineligible to receive payments for that year if, during the preceding year, it provided certain procedures or drugs to anyone under 18 (i.e., gender-affirming surgeries and related medications). The bill also defines what counts as “specified procedures and drugs,” provides exceptions, clarifies some funding amounts for 2026–2030, and retains provisions related to funding levels and the treatment of other child-specific health services (notably, mental/behavioral health services for gender dysphoria not involving the restricted procedures). In short, the bill would continue federal support for pediatric GME but conditions those payments on whether hospitals perform a defined set of gender-transition-related procedures and puberty-blocking/drug therapies on minors, with several important exceptions and transitional rules for 2026.
Key Points
- 1Extension and funding certainty
- 2- Reauthorizes the program of payments to children’s hospitals with GME programs through fiscal year 2030 (replacing the prior end date).
- 3- Establishes specific annual funding levels for 2026–2030: $124,000,000 (a new line item) and $261,000,000 (a separate line item) for each year, potentially creating two distinct funding streams for the program.
- 4Prohibition on payments for certain procedures/drugs (starting FY 2026)
- 5- Beginning in fiscal year 2026, no payment under this program may be made to a children’s hospital if, during the preceding fiscal year, it furnished specified procedures and drugs to an individual under 18.
- 6- There are special rules for fiscal year 2026 to align the timing with portions of the year and the preceding period.
- 7Definition of “specified procedures and drugs”
- 8- Includes a broad list of gender-affirming surgeries (e.g., mastectomy, vaginoplasty, phalloplasty, orchiectomy, hysterectomy, etc.) and procedures altering physical characteristics.
- 9- Includes giving, prescribing, or distributing medications for gender-affirming purposes (e.g., puberty blockers such as GnRH analogues, and cross-sex hormones).
- 10- The definition is subject to a narrow exception.
- 11Exceptions and rule of construction
- 12- Exceptions allow certain treatments to proceed even if they could fall under the list, including:
- 13- Puberty suppression or blocking for precocious puberty.
- 14- Medically necessary treatments to address certain disorders of sex development, genetic conditions, or chromosomal/hormonal abnormalities identified via testing.
- 15- Treatments for infections, injuries, or illnesses resulting from prior procedures.
- 16- Emergencies or conditions where not performing the procedure could place the patient in imminent danger, so long as the treatment isn’t for the purpose of gender transition.
- 17- A physician’s consent from a parent or guardian is required for the non-excluded exceptions.
- 18Definition of “sex”
- 19- For purposes of the specified procedures and drugs, “sex” is defined by reproductive potential or capacity, sex chromosomes, sex hormones, gonads, or birth-era genitalia.
- 20Impact on non-specified mental/behavioral health care
- 21- The bill clarifies that payments are not barred if a hospital provides mental or behavioral health services related to gender dysphoria that do not involve the specified procedures or drugs.