119-hr498

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 498 Introduced in House

    (IH) ]

<DOC>

119th CONGRESS
 1st Session
 H. R. 498

 To amend title XIX of the Social Security Act to prohibit Federal 
 Medicaid funding for gender transition procedures for minors.

_______________________________________________________________________

 IN THE HOUSE OF REPRESENTATIVES

 January 16, 2025

 Mr. Crenshaw (for himself and Ms. Greene of Georgia) introduced the 
 following bill; which was referred to the Committee on Energy and 
 Commerce

_______________________________________________________________________

 A BILL

 To amend title XIX of the Social Security Act to prohibit Federal 
 Medicaid funding for gender transition procedures for minors.

 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 ``Do No Harm in Medicaid Act''.

SEC. 2. PROHIBITING FEDERAL MEDICAID FUNDING FOR GENDER TRANSITION FOR 
 MINORS.

    (a) In General.--

Section 1903
            (i) of the Social Security Act (42 
U.S.C. 1396b
            (i) ) is amended--

    (1) in paragraph

    (26) , by striking ``; or'' and inserting a 
 semicolon;

    (2) in paragraph

    (27) , by striking the period at the end 
 and inserting ``; or''; and

    (3) by inserting after paragraph

    (27) the following new 
 paragraph: ``

    (28) with respect to any amount expended for 
 specified gender procedures under 

section 1905

    (kk) to an 
 individual under 18 years of age enrolled in a State plan (or 
 waiver of such plan), including any amounts expended for the 
 administration of a State program that furnishes specified 
 procedures and drugs to individuals under 18 years of age.''.

    (4) in the flush left matter at the end, by striking ``and

    (18) ,'' and inserting ``

    (18) , and

    (28) ''.

    (b) Prohibiting Federal Medicaid Funding for Gender Transitions for 
Minors.--

Section 1905 of the Social Security Act (42 U.S.C. 1396d) is 
amended by adding at the end the following new subsection:
 ``

    (KK) Prohibiting federal medicaid funding for 
 gender transitions for minors.--
 ``
        (A) For purposes of 

section 1903
            (i) (28) , except 
 as provided in subparagraph
        (B) , the term `specified 
 gender transition procedures' means, with respect to an 
 individual, any of the following when performed for the 
 purpose of intentionally changing the body of such 
 individual (including by disrupting the body's 
 development, inhibiting its natural functions, or 
 modifying its appearance) to no longer correspond to 
 the individual's sex:
 ``
            (i) 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) chondrolaryngoplasty;
 ``
            (XX) mastectomy; and
 ``
            (XXI) any plastic, cosmetic, or 
 aesthetic surgery that feminizes or 
 masculinizes the facial or other 
 physiological features of an 
 individual.
 ``
            (ii) Any placement of chest implants to 
 create feminine breasts or any placement of 
 erection or testicular prosetheses.
 ``
            (iii) Any placement of fat or artificial 
 implants in the gluteal region.
 ``
            (iv) Administering, supplying, 
 prescribing, dispensing, distributing, or 
 otherwise conveying to an individual 
 medications, including--
 ``
            (I) gonadotropin-releasing 
 hormone

    (GnRH) analogues or other 
 puberty-blocking drugs to stop or delay 
 normal puberty; and
 ``
            (II) testosterone, estrogen, 
 progesterone or other androgens to an 
 individual at doses that are 
 supraphysiologic, greater or more 
 potent than would normally be produced 
 endogenously in a healthy individual of 
 the same age and sex.
 ``
        (B) Exception.--Subparagraph
        (A) shall not apply 
 to the following when furnished to an individual by a 
 health care provider with the consent of such 
 individual's parent or legal guardian:
 ``
            (i) Puberty suppression or blocking 
 prescription drugs for the purpose of 
 normalizing puberty for an individual 
 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 chromosome 
 with undervirilization; and
 ``
            (cc) both ovarian and 
 testicular tissue;
 ``
            (II) sex chromosome structure, 
 sexsteroid hormone production, or sex 
 hormone action, if determined to be 
 abnormal for a healthy individual of 
 the same sex and age by a physician 
 through genetic or biochemical testing;
 ``
            (III) infection, disease, injury, 
 or disorder caused or exacerbated by a 
 previous procedure described in 
 subparagraph
        (A) , or 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 
 procedures performed for the 
 alleviation of mental distress; or
 ``
            (IV) procedures to restore or 
 reconstruct the body of the individual 
 in order to correspond to the 
 individual's sex after one or more 
 previous procedures described in 
 subparagraph
        (A) , which may include the 
 removal of a pseudo phallus or breast 
 augmentation.
 ``
            (C) Sex.--For purposes of subparagraph
        (A) , the 
 term `sex' means either male or female, as biologically 
 determined and defined by clause
            (i) and clause
            (ii) .
 ``
            (i) Female.--The term `female' means an 
 individual who naturally has, had, will have, 
 or would have, but for a developmental or 
 genetic anomaly or historical accident, the 
 reproductive system that at some point 
 produces, transports, and utilizes eggs for 
 fertilization.
 ``
            (ii) 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 system that at some point 
 produces, transports, and utilizes sperm for 
 fertilization.''.
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