119-hr2107

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2107 Introduced in House

    (IH) ]

<DOC>

119th CONGRESS
 1st Session
 H. R. 2107

To amend title III of the Public Health Service Act to reauthorize the 
 program of payments to children's hospitals that operate graduate 
 medical education programs, and for other purposes.

_______________________________________________________________________

 IN THE HOUSE OF REPRESENTATIVES

 March 14, 2025

Mr. Crenshaw (for himself, Mrs. Miller of Illinois, Mrs. Miller-Meeks, 
 Mr. Pfluger, Mr. Ellzey, Mr. Van Drew, Mr. Green of Tennessee, Mr. 
 Rouzer, Mrs. Harshbarger, Mr. Grothman, Mr. Jackson of Texas, and Mr. 
 Scott Franklin of Florida) introduced the following bill; which was 
 referred to the Committee on Energy and Commerce

_______________________________________________________________________

 A BILL

To amend title III of the Public Health Service Act to reauthorize the 
 program of payments to children's hospitals that operate graduate 
 medical education programs, and for other purposes.

 Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

 This Act may be cited as the ``Children's Hospital GME Support 
Reauthorization Act of 2025''.

SEC. 2. PROGRAM OF PAYMENTS TO CHILDREN'S HOSPITALS THAT OPERATE 
 GRADUATE MEDICAL EDUCATION PROGRAMS.

 

Section 340E of the Public Health Service Act (42 U.S.C. 256e) is 
amended--

    (1) in subsection

    (a) , by striking ``2023'' and inserting 
 ``2030'';

    (2) in subsection

    (b)

    (3)
            (D) , by inserting ``and the end of 
 fiscal year 2030,'' after ``fiscal year 2022,'';

    (3) in subsection

    (e) , by adding at the end the following 
 new paragraph:
 ``

    (4) Prohibition on payments to hospitals furnishing 
 specified procedures and drugs to minors.--
 ``
        (A) In general.--Notwithstanding any other 
 provision of this section, no payment may be made under 
 this section to a children's hospital for a fiscal year 
 (beginning with fiscal year 2026) if, at any point 
 during the preceding fiscal year, such hospital 
 furnished specified procedures and drugs (as defined in 
 subsection

    (g) ) to an individual under 18 years of age.
 ``
        (B) Special rule for fiscal year 2026.--In 
 applying subparagraph
        (A) with respect to payments 
 described in such subparagraph for fiscal year 2026--
 ``
            (i) the reference to `for a fiscal year' 
 shall be treated as a reference to `for any 
 portion of fiscal year 2026 occurring after 
 December 31, 2025'; and
 ``
            (ii) the reference to `the preceding 
 fiscal year' shall be treated as a reference to 
 `the period beginning on September 1, 2025, and 
 ending on December 31, 2025'.
 ``
            (C) Rule of construction.--Nothing in this 
 paragraph shall be construed as prohibiting payments 
 for a fiscal year (or, in the case of payments for 
 fiscal year 2026, during the portion of such fiscal 
 year described in subparagraph
        (B)
            (i) ) to a hospital 
 that, during the preceding fiscal year (or, in the case 
 of payments for fiscal year 2026, during the period 
 described in subparagraph
        (B)
            (ii) ), furnished mental or 
 behavioral health services to individuals under 18 
 years of age for the treatment of gender dysphoria not 
 consisting of specified procedures and drugs.'';

    (4) in subsection

    (f) --
        (A) in paragraph

    (1)
        (A) --
            (i) in clause
            (v) , by striking ``and'' at 
 the end;
            (ii) in clause
            (vi) , by striking the period 
 at the end and inserting ``; and''; and
            (iii) by adding at the end the following:
 ``
            (vii) for each of fiscal years 2026 
 through 2030, $124,000,000.''; and
        (B) in paragraph

    (2) --
            (i) in subparagraph
        (E) , by striking 
 ``and'' at the end;
            (ii) in subparagraph
        (F) , by striking the 
 period at the end and inserting ``; and''; and
            (iii) by adding at the end the following:
 ``
        (G) for each of fiscal years 2026 through 2030, 
 $261,000,000''; and

    (5) in subsection

    (g) , by adding at the end the following 
 new paragraph:
 ``

    (4) Specified procedures and drugs.--
 ``
        (A) In general.--Except as provided in 
 subparagraph
        (B) , the term `specified procedures and 
 drugs' means, with respect to an individual, any of the 
 following:
 ``
            (i) Performing any surgery for the 
 purpose of changing the body of such individual 
 to no longer correspond to the individual's 
 sex, including--
 ``
            (I) castration;
 ``
            (II) orchiectomy;
 ``
            (III) scrotoplasty;
 ``
            (IV) vasectomy;
 ``
            (V) hysterectomy;
 ``
            (VI) oophorectomy;
 ``
            (VII) ovariectomy;
 ``
            (VIII) metoidioplasty;
 ``
            (IX) penectomy;
 ``
            (X) phalloplasty;
 ``
            (XI) vaginoplasty;
 ``
            (XII) vaginectomy;
 ``
            (XIII) vulvoplasty;
 ``
            (XIV) reduction 
 thyrochondroplasty;
 ``
            (XV) chondrolaryngoplasty, or any 
 plastic surgery that feminizes or 
 masculinizes the facial features;
 ``
            (XVI) mastectomy, or any 
 placement of chest implants to create 
 feminine breasts; and
 ``
            (XVII) Any placement of fat or 
 artificial implants in the gluteal 
 region.
 ``
            (ii) Administering, supplying, 
 prescribing, dispensing, distributing, or 
 otherwise conveying to an individual 
 medications for the purposes described in 
 clause
            (i) , including gonadotrophin releasing 
 hormone

    (GnRH) analogues or other puberty-
 blocking drugs to stop or delay normal puberty, 
 and estrogen, testosterone, progesterone, or 
 other androgens to an individual in an amount 
 greater than would normally be produced 
 endogenously in a healthy individual of that 
 individual's age and sex.
 ``
        (B) Exception.--Subparagraph
        (A) shall not apply 
 to the provision by a physician or health care 
 provider, with the consent of the child's parent or 
 legal guardian, of--
 ``
            (i) puberty suppression or blocking 
 prescription drugs for the purpose of 
 normalizing puberty for a minor experiencing 
 precocious puberty;
 ``
            (ii) appropriate and medically necessary 
 procedures or treatments to correct for--
 ``
            (I) a medically verifiable 
 genetic disorder of sex development, 
 including--
 ``

    (aa) 46,XX chromosomes 
 with virilization;
 ``

    (bb) 46,XY chromosomes 
 with undervirilization; and
 ``
            (cc) both ovarian and 
 testicular tissue; or
 ``
            (II) sex chromosome structure, 
 sex steroid hormone production, or sex 
 hormone action, if determined to be 
 abnormal by a physician through genetic 
 or biochemical testing;
 ``
            (iii) infection, disease, injury, or 
 disorder caused or exacerbated by previous 
 medical procedures as defined in subsection

    (g)

    (4)
        (A) ; or
 ``
            (iv) a physical disorder, physical 
 injury, or physical 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 
 performed, not including if the procedure or 
 drug is for the purpose described in subsection

    (g)

    (4)
        (A)
            (i) .
 ``
            (C) Sex.--For purposes of subparagraph
        (A) , the 
 term `sex' means the indication of male or female sex 
 by reproductive potential or capacity, sex chromosomes, 
 naturally occurring sex hormones, gonads, or internal 
 or external genitalia present at birth.''.
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