# What This Bill Actually Does

This bill would prohibit the federal government from spending any money on gender transition procedures and related medical care. It applies to all federal funding sources—Medicare, Medicaid, Veterans Affairs, military health insurance, federal employee health plans, and any other program that uses federal dollars. The bill also prevents federal facilities and federal employees from providing these procedures as part of their work.

The bill defines "gender transition procedures" broadly to include hormone treatments (like puberty blockers or cross-sex hormones), surgeries, and other medical services intended to help someone transition. However, it specifically carves out treatment for people born with disorders of sex development (conditions where reproductive anatomy is ambiguous or atypical) and treatment for any complications that arise from transition procedures, regardless of how they were originally funded.

**Who this affects:** People relying on federal health programs would lose coverage for gender transition care. This includes Medicare beneficiaries, Medicaid recipients, military service members, veterans, federal employees, and people receiving care at VA hospitals or military medical facilities. The bill would take effect one year after passage for most programs. Private insurance and state-funded programs using only state money could still cover these procedures, but the bill prevents states from using their share of Medicaid matching funds to pay for them.

The bill also addresses the Affordable Care Act's insurance marketplaces, saying that plans offering gender transition coverage wouldn't qualify for federal tax credits that help people afford premiums. However, people could still buy separate coverage for these procedures with their own money—they just wouldn't get the federal subsidy. Insurance companies could offer such coverage separately, as long as no federal money goes toward it.