beginning on or after January 1, 
2027 (or, in the case of an individual 
reenrolled in a qualified health plan 
by an Exchange established pursuant 
to section 1321(c), January 1, 2027) 
if, prior to the first day of such 
month, such individual has failed to 
confirm or update such information as 
is necessary to redetermine the eligi-
bility of such individual for such plan 
year pursuant to section 1411(f). 
‘‘(II) SPECIFIED
REENROLLED 
INDIVIDUAL.—The term ‘specified re-
enrolled individual’ means an indi-
vidual who is reenrolled in a qualified 
health plan and with respect to whom 
the advance payment made under sub-
paragraph (A) would, without applica-
tion of any reduction under this sub-
paragraph, reduce the premium pay-
able for a qualified health plan that 
provides coverage to such an indi-
vidual to $0.’’. 
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(h) PROHIBITING COVERAGE OF GENDER TRANSI-
TION PROCEDURES AS AN ESSENTIAL HEALTH BENEFIT 
UNDER PLANS OFFERED BY EXCHANGES.— 
(1) IN GENERAL.—Section 1302(b)(2) of the 
Patient Protection and Affordable Care Act (42 
U.S.C. 18022(b)(2)) is amended by adding at the 
end the following new subparagraph: 
‘‘(C) 
GENDER
TRANSITION
PROCE-
DURES.—For plan years beginning on or after 
January 1, 2027, the essential health benefits 
defined pursuant to paragraph (1) may not in-
clude items and services furnished for a gender 
transition procedure.’’. 
(2) GENDER
TRANSITION
PROCEDURE
DE-
FINED.—Section 1304 of the Patient Protection and 
Affordable Care Act (42 U.S.C. 18024) is amended 
by adding at the end the following new subsection: 
‘‘(f) GENDER TRANSITION PROCEDURE.— 
‘‘(1) IN GENERAL.—In this title, except as pro-
vided in paragraph (2), the term ‘gender transition 
procedure’ means, with respect to an individual, any 
of the following when performed for this purpose of 
intentionally changing the body of such individual 
(including by disrupting the body’s development, in-
hibiting its natural functions, or modifying its ap-
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pearance) to no longer correspond to the individuals 
sex: 
‘‘(A) Performing any surgery, including— 
‘‘(i) castration; 
‘‘(ii) sterilization; 
‘‘(iii) orchiectomy; 
‘‘(iv) scrotoplasty; 
‘‘(v) vasectomy; 
‘‘(vi) tubal ligation; 
‘‘(vii) hysterectomy; 
‘‘(viii) oophorectomy; 
‘‘(ix) ovariectomy; 
‘‘(x) metoidioplasty; 
‘‘(xi) clitoroplasty; 
‘‘(xii) reconstruction of the fixed part 
of 
the 
urethra 
with 
or 
without 
a 
metoidioplasty or a phalloplasty; 
‘‘(xiii) penectomy; 
‘‘(xiv) phalloplasty; 
‘‘(xv) vaginoplasty; 
‘‘(xvi) vaginectomy; 
‘‘(xvii) vulvoplasty; 
‘‘(xviii) reduction thyrochondroplasty; 
‘‘(xix) chrondrolaryngoplasty; 
‘‘(xx) mastectomy; and 
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‘‘(xxi) any plastic, cosmetic, or aes-
thetic 
surgery 
that 
feminizes 
or 
masculinizes the facial or other body fea-
tures of an individual. 
‘‘(B) Any placement of chest implants to 
create feminine breasts or any placement of 
erection or testicular prostheses. 
‘‘(C) Any placement of fat or artificial im-
plants in the gluteal region. 
‘‘(D) Administering, prescribing, or dis-
pensing to an individual medications, includ-
ing— 
‘‘(i) gonadotropin-releasing hormone 
(GnRH) analogues or other puberty-block-
ing drugs to stop or delay normal puberty; 
and 
‘‘(ii) testosterone, estrogen, or other 
androgens to an individual at doses that 
are superphysiologic than would normally 
be produced endogenously in a health indi-
vidual of the same age and sex. 
‘‘(2) EXCEPTION.—Paragraph (1) shall not 
apply to the following: 
‘‘(A) Puberty suppression or blocking pre-
scription drugs for the purpose of normalizing 
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puberty for an individual experiencing pre-
cocious puberty. 
‘‘(B) Medically necessary procedures or 
treatments to correct for— 
‘‘(i) a medically verifiable disorder of 
sex development, including— 
‘‘(I) 46, XX chromosomes with 
virilization; 
‘‘(II) 46, XY chromosomes with 
undervirilization; and 
‘‘(III) both ovarian and testicular 
tissue; 
‘‘(ii) sex chromosome structure, sex 
steroid hormone production, or sex hor-
mone action, if determined to be abnormal 
by a physician through genetic or bio-
chemical testing; 
‘‘(iii) infection, disease, injury, or dis-
order caused or exacerbated by a previous 
procedure described in paragraph (1), or a 
physical disorder, physical injury, or phys-
ical illness that would, as certified by a 
physician, place the individual in imminent 
danger of death or impairment of a major 
bodily function unless the procedure is per-
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formed, not including procedures per-
formed for the alleviation of mental dis-
tress; or 
‘‘(iv) procedures to restore or recon-
struct the body of the individual in order 
to correspond to the individual’s sex after 
one or more previous procedures described 
in paragraph (1), which may include the 
removal of a pseudo phallus or breast aug-
mentation. 
‘‘(3) SEX.—For purposes of this subsection, the 
term ‘sex’ means either male or female, as bio-
logically determined and defined by subparagraph 
(A) and subparagraph (B). 
‘‘(A) FEMALE.—The term ‘female’ means 
an individual who naturally has, had, will have, 
or would have, but for a developmental or ge-
netic anomaly or historical accident, the repro-
ductive systems that at some point produces, 
transports, and utilizes eggs for fertilization. 
‘‘(B) MALE.—The term ‘male’ means an 
individual who naturally has, had, will have, or 
would have, but for a developmental or genetic 
anomaly or historical accident, the reproductive 
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system that at some point produces, transports, 
and utilizes sperm for fertilization.’’. 
(i) ENSURING APPROPRIATE APPLICATION OF GUAR-
ANTEED ISSUE REQUIREMENTS IN CASE OF NON-PAY-
MENT OF PAST PREMIUMS.— 
(1) IN GENERAL.—Section 2702 of the Public 
Health Service Act (42 U.S.C. 300gg–1) is amended 
by adding at the end the following new subsection: 
‘‘(e) NONPAYMENT OF PAST PREMIUMS.— 
‘‘(1) IN GENERAL.—A health insurance issuer 
offering individual health coverage may, to the ex-
tent allowed under State law, deny such coverage in 
the case of an individual who owes any amount for 
premiums for individual health insurance coverage 
offered by such issuer (or by a health insurance 
issuer in the same controlled group (as defined in 
paragraph (3)) as such issuer) in which such indi-
vidual was previously enrolled. 
‘‘(2) ATTRIBUTION OF INITIAL PREMIUM PAY-
MENT OWED AMOUNT.—A health insurance issued 
offering individual health insurance coverage may, in 
the case of an individual described in paragraph (1) 
and to the extent allowed under State law, attribute 
the initial premium payment for such coverage appli-
cable to such individual to the amount owed by such 
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individual for premiums for individual health insur-
ance coverage offered by such issuer (or by a health 
insurance issuer in the same controlled group as the 
issuer) in which such individual was previously en-
rolled. 
‘‘(3) CONTROLLED GROUP DEFINED.—For pur-
poses of this subsection, the term ‘controlled group’ 
means a group of two or more persons that is treat-
ed as a single employed under section 52(a), 52(b), 
414(m), or 414(o) of the Internal Revenue Code of 
1986.’’. 
(2) EFFECTIVE DATE.—The amendment made 
by paragraph (1) shall apply with respect to plan 
years beginning on or after January 1, 2027. 
SEC. 2073. FUNDING COST-SHARING REDUCTION PAY-
MENTS. 
Section 1402 of the Patient Protection and Afford-
able Care Act (42 U.S.C. 18071) is amended by adding 
at the end the following new subsection: 
‘‘(h) FUNDING.— 
‘‘(1) IN GENERAL.—There are appropriated out 
of any monies in the Treasury not otherwise appro-
priated such sums as may be necessary for purposes 
of making payments under this section for plan 
years beginning on or after January 1, 2027. 
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‘‘(2) LIMITATION.— 
‘‘(A) IN GENERAL.—The amounts appro-
priated under paragraph (1) may not be used 
for purposes of making payments under this 
section for a qualified health plan that provides 
health benefit coverage that includes coverage 
of abortion. 
‘‘(B) 
EXCEPTION.—Subparagraph 
(A) 
shall not apply to payments for a qualified 
health plan that provides coverage of abortion 
only if necessary to save the life of the mother 
or if the pregnancy is a result of an act of rape 
or incest.’’. 
TITLE 
III—ENDING 
TAXPAYER 
FUNDING 
FOR 
ABORTION 
AND 
GENDER 
TRANSITION 
PROCEDURES 
Subtitle A—No Taxpayer Funding 
for Abortion and Abortion In-
surance Full Disclosure Act of 
2025 
SEC. 3000. APPLICABILITY TO ENTIRE ACT. 
(a) Notwithstanding any other provision of law, the 
prohibitions and limitations set forth in this title, includ-
ing the amendments made by this title, shall apply to all 
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funds authorized or appropriated under this Act, including 
under title I, title II, and every subtitle thereof, and to 
any trust fund to which such funds are contributed. 
(b) EFFECTIVE DATE.—This section shall take effect 
on the date of the enactment of this Act. 
SEC. 3001. SHORT TITLE. 
This Act may be cited as the ‘‘No Taxpayer Funding 
for Abortion and Abortion Insurance Full Disclosure Act 
of 2025’’. 
SEC. 3002. PROHIBITING TAXPAYER FUNDED ABORTIONS. 
Title 1, United States Code, is amended by adding 
at the end the following new chapter: 
‘‘CHAPTER 4—PROHIBITING TAXPAYER 
FUNDED ABORTIONS 
‘‘§ 301. Prohibition on funding for abortions 
‘‘No funds authorized or appropriated by Federal 
law, and none of the funds in any trust fund to which 
funds are authorized or appropriated by Federal law, shall 
be expended for any abortion. 
‘‘§ 302. Prohibition on funding for health benefits 
plans that cover abortion 
‘‘None of the funds authorized or appropriated by 
Federal law, and none of the funds in any trust fund to 
which funds are authorized or appropriated by Federal 
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100 
law, shall be expended for health benefits coverage that 
includes coverage of abortion. 
‘‘§ 303. Limitation on federal facilities and employees 
‘‘No health care service furnished— 
‘‘(1) by or in a health care facility owned or op-
erated by the Federal Government; or 
‘‘(2) by any physician or other individual em-
ployed by the Federal Government to provide health 
care services within the scope of the physician’s or 
individual’s employment, may include abortion. 
‘‘§ 304. Construction relating to separate coverage 
‘‘Nothing in this chapter shall be construed as pro-
hibiting any individual, entity, or State or locality from 
purchasing separate abortion coverage or health benefits 
coverage that includes abortion so long as such coverage 
is paid for entirely using only funds not authorized or ap-
propriated by Federal law and such coverage shall not be 
purchased using matching funds required for a federally 
subsidized program, including a State’s or locality’s con-
tribution of Medicaid matching funds. 
‘‘§ 305. Construction relating to the use of non-federal 
funds for health coverage 
‘‘Nothing in this chapter shall be construed as re-
stricting the ability of any non-Federal health benefits cov-
erage provider from offering abortion coverage, or the abil-
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101 
ity of a State or locality to contract separately with such 
a provider for such coverage, so long as only funds not 
authorized or appropriated by Federal law are used and 
such coverage shall not be purchased using matching 
funds required for a federally subsidized program, includ-
ing a State’s or locality’s contribution of Medicaid match-
ing funds. 
‘‘§ 306. Non-preemption of other federal laws 
‘‘Nothing in this chapter shall repeal, amend, or have 
any effect on any other Federal law to the extent such 
law imposes any limitation on the use of funds for abortion 
or for health benefits coverage that includes coverage of 
abortion, beyond the limitations set forth in this chapter. 
‘‘§ 307. Construction relating to complications arising 
from abortion 
‘‘Nothing in this chapter shall be construed to apply 
to the treatment of any infection, injury, disease, or dis-
order that has been caused by or exacerbated by the per-
formance of an abortion. This rule of construction shall 
be applicable without regard to whether the abortion was 
performed in accord with Federal or State law, and with-
out regard to whether funding for the abortion is permis-
sible under section 308. 
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102 
‘‘§ 308. Treatment of abortions related to rape, incest, 
or preserving the life of the mother 
‘‘The limitations established in sections 301, 302, 
and 303 shall not apply to an abortion— 
‘‘(1) if the pregnancy is the result of an act of 
rape or incest; or 
‘‘(2) in the case where a woman suffers from a 
physical disorder, physical injury, or physical illness 
that would, as certified by a physician, place the 
woman in danger of death unless an abortion is per-
formed, including a life-endangering physical condi-
tion caused by or arising from the pregnancy itself. 
‘‘§ 309. Application to district of columbia 
‘‘In this chapter: 
‘‘(1) Any reference to funds appropriated by 
Federal law shall be treated as including any 
amounts within the budget of the District of Colum-
bia that have been approved by an Act of Congress 
pursuant to section 446 of the District of Columbia 
Home Rule Act (or any applicable successor Federal 
law). 
‘‘(2) The term ‘Federal Government’ includes 
the Government of the District of Columbia.’’. 
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103 
SEC. 3003. AMENDMENT TO TABLE OF CHAPTERS. 
The table of chapters for title 1, United States Code, 
is amended by adding at the end the following new item: 
‘‘4 Prohibiting taxpayer funded abortions ...............................................
301’’. 
SEC. 3004. CLARIFYING APPLICATION OF PROHIBITION TO 
PREMIUM CREDITS AND COST-SHARING RE-
DUCTIONS UNDER ACA. 
(a) IN GENERAL.— 
(1) DISALLOWANCE OF REFUNDABLE CREDIT 
AND
COST-SHARING
REDUCTIONS
FOR
COVERAGE 
UNDER QUALIFIED HEALTH PLAN WHICH PROVIDES 
COVERAGE FOR ABORTION.— 
(A) IN
GENERAL.—Subparagraph (A) of 
section 36B(c)(3) of the Internal Revenue Code 
of 1986 is amended by inserting before the pe-
riod at the end the following: ‘‘or any health 
plan that includes coverage for abortions (other 
than any abortion or treatment described in 
section 307 or 308 of title 1, United States 
Code)’’. 
(B) OPTION TO PURCHASE OR OFFER SEP-
ARATE COVERAGE OR PLAN.—Paragraph (3) of 
section 36B(c) of such Code is amended by 
adding at the end the following new subpara-
graph: 
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104 
‘‘(C) SEPARATE ABORTION COVERAGE OR 
PLAN ALLOWED.— 
‘‘(i) OPTION TO PURCHASE SEPARATE 
COVERAGE OR PLAN.—Nothing in subpara-
graph (A) shall be construed as prohibiting 
any individual from purchasing separate 
coverage for abortions described in such 
subparagraph, or a health plan that in-
cludes such abortions, so long as no credit 
is allowed under this section with respect 
to the premiums for such coverage or plan. 
‘‘(ii) OPTION TO OFFER COVERAGE OR 
PLAN.—Nothing in subparagraph (A) shall 
restrict any non-Federal health insurance 
issuer offering a health plan from offering 
separate coverage for abortions described 
in such subparagraph, or a plan that in-
cludes such abortions, so long as premiums 
for such separate coverage or plan are not 
paid for with any amount attributable to 
the credit allowed under this section (or 
the amount of any advance payment of the 
credit under section 1412 of the Patient 
Protection and Affordable Care Act).’’. 
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105 
(2) DISALLOWANCE
OF
SMALL
EMPLOYER 
HEALTH
INSURANCE
EXPENSE
CREDIT
FOR
PLAN 
WHICH INCLUDES COVERAGE FOR ABORTION.—Sub-
section (h) of section 45R of the Internal Revenue 
Code of 1986 is amended— 
(A) by striking ‘‘Any term’’ and inserting 
the following: 
‘‘(1) IN GENERAL.—Any term’’; and 
(B) by adding at the end the following new 
paragraph: 
‘‘(2) EXCLUSION OF HEALTH PLANS INCLUDING 
COVERAGE FOR ABORTION.— 
‘‘(A) IN
GENERAL.—The term ‘qualified 
health plan’ does not include any health plan 
that includes coverage for abortions (other than 
any abortion or treatment described in section 
307 or 308 of title 1, United States Code). 
‘‘(B) SEPARATE ABORTION COVERAGE OR 
PLAN ALLOWED.— 
‘‘(i) OPTION TO PURCHASE SEPARATE 
COVERAGE OR PLAN.—Nothing in subpara-
graph (A) shall be construed as prohibiting 
any employer from purchasing for its em-
ployees separate coverage for abortions de-
scribed in such subparagraph, or a health 
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106 
plan that includes such abortions, so long 
as no credit is allowed under this section 
with respect to the employer contributions 
for such coverage or plan. 
‘‘(ii) OPTION TO OFFER COVERAGE OR 
PLAN.—Nothing in subparagraph (A) shall 
restrict any non-Federal health insurance 
issuer offering a health plan from offering 
separate coverage for abortions described 
in such subparagraph, or a plan that in-
cludes such abortions, so long as such sep-
arate coverage or plan is not paid for with 
any employer contribution eligible for the 
credit allowed under this section.’’. 
(3) CONFORMING ACA AMENDMENTS.—Section 
1303(b) of Public Law 111–148 (42 U.S.C. 
18023(b)) is amended— 
(A) by striking paragraph (2); 
(B) by striking paragraph (3), as amended 
by section 202(a); and 
(C) by redesignating paragraph (4) as 
paragraph (2). 
(b) APPLICATION TO MULTI-STATE PLANS.—Para-
graph (6) of section 1334(a) of Public Law 111–148 (42 
U.S.C. 18054(a)) is amended to read as follows: 
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107 
‘‘(6) COVERAGE
CONSISTENT
WITH
FEDERAL 
ABORTION
POLICY.—In entering into contracts 
under this subsection, the Director shall ensure that 
no multi-State qualified health plan offered in an 
Exchange provides health benefits coverage for 
which the expenditure of Federal funds is prohibited 
under chapter 4 of title 1, United States Code.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall apply to taxable years ending after 
December 31, 2025, but only with respect to plan years 
beginning after such date, and the amendment made by 
subsection (b) shall apply to plan years beginning after 
such date. 
SEC. 3005. REVISION TO NOTICE REQUIREMENTS REGARD-
ING DISCLOSURE OF EXTENT OF HEALTH 
PLAN COVERAGE OF ABORTION AND ABOR-
TION PREMIUM SURCHARGES. 
(a) IN GENERAL.—Paragraph (3) of section 1303(b) 
of Public Law 111–148 (42 U.S.C. 18023(b)) is amended 
to read as follows: 
‘‘(3) RULES RELATING TO NOTICE.— 
‘‘(A) IN
GENERAL.—The extent of cov-
erage (if any) of services described in para-
graph (1)(B)(i) or (1)(B)(ii) by a qualified 
health plan shall be disclosed to enrollees at the 
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108 
time of enrollment in the plan and shall be 
prominently displayed in any marketing or ad-
vertising materials, comparison tools, or sum-
mary of benefits and coverage explanation made 
available with respect to such plan by the issuer 
of the plan, by an Exchange, or by the Sec-
retary, including information made available 
through an internet portal or Exchange under 
sections 1311(c)(5) and 1311(d)(4)(C). 
‘‘(B) SEPARATE
DISCLOSURE
OF
ABOR-
TION SURCHARGES.—In the case of a qualified 
health plan that includes the services described 
in paragraph (1)(B)(i) and where the premium 
for the plan is disclosed, including in any mar-
keting or advertising materials or any other in-
formation referred to in subparagraph (A), the 
surcharge described in paragraph (2)(B)(i)(II) 
that is attributable to such services shall also be 
disclosed and identified separately.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply to materials, tools, or other in-
formation made available more than 30 days after the date 
of the enactment of this Act. 
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109 
Subtitle 
B—Prohibiting 
Federal 
Funding for Gender Transition 
Procedures 
SEC. 3006. SHORT TITLE. 
This Act may be cited as the ‘‘End Taxpayer Fund-
ing of Gender Experimentation Act of 2025’’ 
SEC. 3007. PROHIBITING FEDERAL FUNDING FOR GENDER 
TRANSITION PROCEDURES. 
(a) DEFINITION.—In this section, the term ‘‘Speci-
fied sex-trait modification procedure’’ means any pharma-
ceutical or surgical intervention that is provided for the 
purpose of attempting to align an individual’s physical ap-
pearance or body with an asserted identity that differs 
from the individual’s sex either by: 
(1) Intentionally disrupting or suppressing the 
normal development of natural biological functions, 
including primary or secondary sex-based traits; or 
(2) Intentionally altering an individual’s phys-
ical appearance or body, including amputating, mini-
mizing or destroying primary or secondary sex-based 
traits such as the sexual and reproductive organs. 
(3) This term does not include procedures un-
dertaken: 
(A) To treat a person with a medically 
verifiable disorder of sexual development; or 
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110 
(B) For purposes other than attempting to 
align an individual’s physical appearance or 
body with an asserted identity that differs from 
the individual’s sex. 
(b) GENERAL PROHIBITION.—Notwithstanding any 
other provision of law, no Federal funds (including funds 
provided through grants, contracts, insurance, or any 
other means) may be used to pay for, reimburse, or other-
wise support any specified sex-trait modification proce-
dure. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall take effect on the date of the enactment 
of this Act and shall apply to payments, reimbursements, 
and services provided on or after such date. 
Æ 
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