Text of GA SB 39 (2026)

25 LC 52 0647 Senate Bill 39 By: Senators Tillery of the 19th, Summers of the 13th, Robertson of the 29th, Watson of the 1st, Walker III of the 20th and others A BILL TO BE ENTITLED AN ACT To amend Chapter 18 of Title 45, Chapter 4 of Title 49, and Chapter 1 of Title 50 of the 1 Official Code of Georgia Annotated, relating to the employees' insurance and benefits plans, 2 public assistance, and general provisions relative to state government, respectively, so as to 3 prohibit coverage of expenses for gender-affirming care under the state health benefit plan 4 or with any state funds; to provide for definitions; to provide for limited exceptions; to 5 prohibit state healthcare facilities and healthcare providers employed by the state from 6 providing gender-affirming care; to provide for related matters; to provide for legislative 7 findings; to provide for an effective date; to repeal conflicting laws; and for other purposes. 8 BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA: 9 SECTION 1. 10 The General Assembly finds that: 11 (1) The State of Georgia has taken measures to protect individuals from a radical gender 12 ideology that has, among other things, resulted in a massive unexplained rise in diagnoses 13 of gender dysphoria; 14 (2) Senate Bill 140 enacted by the General Assembly in the 2023 regular session broadly 15 banned physicians from performing sex reassignment surgeries, hormone replacement 16 S. B. 39 - 1 - 25 LC 52 0647 therapies, and other gender transition procedures on minors, and similar bills from other 17 states have been upheld by a federal appeals court; 18 (3) In October, 2023, under the guidance of the Georgia Attorney General, a lawsuit 19 brought by or on behalf of a number of state employees and a child seeking access to 20 transgender related healthcare coverage under the state health plan was settled; 21 (4) Prior to the settlement, coverage under the state health benefit plan excluded 22 operations to change one's sex and related services; 23 (5) Under the settlement, the state health benefit plan was required to implement 24 provisions defining transgender related health coverage and to make it available to all 25 employees. In addition, the state reportedly paid a sum of $365,000.00 that was split 26 among four individuals, including a child, and an organization called the Campaign for 27 Southern Equality, which has been described in news reports as "a nonprofit organization 28 dedicated to advancing LGBTQ+ civil rights in the South." According to the plaintiffs' 29 attorneys, the settlement also covered a portion of the plaintiffs' legal expenses; 30 (6) This settlement was entered into by the state health benefit plan and the Attorney 31 General without prior notice to or approval by the General Assembly; and 32 (7) It is the policy of the State of Georgia that these procedures shall neither be covered 33 by the state health benefit plan nor otherwise paid for through the use of state funds. 34 SECTION 2. 35 Chapter 18 of Title 45 of the Official Code of Georgia Annotated, relating to employees' 36 insurance and benefits plans, is amended by revising Code Section 45-18-4, relating to 37 expenses not to be covered by the state employees' health insurance plan, as follows: 38 "45-18-4. 39 (a) As used in this Code section, the term: 40 (1) 'Abortion' shall have the same meaning as provided in Code Section 31-9A-2. 41 S. B. 39 - 2 - 25 LC 52 0647 (2) 'Gender' means the psychological, behavioral, social, and cultural aspects of being 42 male or female. 43 (3) 'Gender-affirming care' means healthcare, such as hormone therapy or sex 44 reassignment surgery, to attempt to affirm an individual's perception of such individual's 45 sex that is inconsistent with such individual's sex. 46 (4) 'Hormone therapy' means treatment that adds, blocks, or removes hormones for the 47 purpose of assisting an individual in attempting to alter such individual's sex or to alter 48 the appearance of such individual's sex that is inconsistent with such individual's sex. 49 (5) 'Sex' means the biological state of being male or female, in the context of 50 reproductive potential or capacity, based on the individual's sex organs, chromosomes, 51 naturally occurring sex hormones, gonads, and internal and external genitalia present at 52 birth, including secondary sex characteristics, without regard to an individual's 53 psychological, chosen, or subjective identification of gender. 54 (6) 'Sex reassignment surgery' means any surgical procedure that seeks to surgically alter 55 or remove healthy or nondiseased physical or anatomical characteristics or features that 56 are typical for an individual's sex in order to instill or create physiological or anatomical 57 characteristics that resemble a sex different from such individual's sex. Such term means 58 genital or nongenital surgery performed for the purpose of assisting an individual with 59 attempting to alter such individual's sex or to alter the appearance of or affirm such 60 individual's perception of his or her gender or sex if such appearance or perception is 61 inconsistent with such individual's sex. Such term includes but is not limited to 62 castration, clitorectomy, clitoroplasty, facial gender-affirming surgery, hysterectomy, 63 mammoplasty, mastectomy, metoidioplasty, oophorectomy, orchiectomy, ovariectomy, 64 penectomy, phalloplasty, scrotoplasty, vaginectomy, vaginoplasty, vasectomy, voice 65 feminization or masculinization surgery, and vulvoplasty, and any healthcare services 66 before or after such surgery. 67 S. B. 39 - 3 - 25 LC 52 0647 (b) The health insurance plan shall not include expenses incurred by or on account of an 68 individual prior to the effective date of the plan; expenses for services received for injury 69 or sickness due to war or any act of war, whether declared or undeclared, which war or act 70 of war shall have occurred after the effective date of this plan; expenses for which the 71 individual is not required to make payment; expenses to the extent of benefits provided 72 under any employer group plan other than this plan in which the state participates in the 73 cost thereof; expenses for abortion services except to the extent permitted under the state 74 health benefit plan approved by the board as such plan existed on January 1, 2014; 75 expenses for gender-affirming care except as provided in subsection (c) of this Code 76 section; and such other expenses as may be excluded by regulations of the board. For 77 purposes of this Code section, the term 'abortion' shall have the same meaning as provided 78 in Code Section 31-9A-2. 79 (c) The board shall adopt rules and regulations regarding the exclusion of expenses for 80 gender-affirming care provided in subsection (b) of this Code section, which shall contain 81 limited exceptions for: 82 (1) Treatments for medical conditions other than gender dysphoria or for the purpose of 83 sex reassignment where such treatments are deemed medically necessary; 84 (2) Treatments for individuals born with a medically verifiable disorder of sex 85 development, including individuals born with ambiguous genitalia or chromosomal 86 abnormalities resulting in ambiguity regarding the individual's biological sex; 87 (3) Treatments for individuals with partial androgen insensitivity syndrome; and 88 (4) Any other treatments for similar conditions to the extent permitted under the state 89 health benefit plan approved by the board as such plan existed on January 1, 2025." 90 SECTION 3. 91 Chapter 4 of Title 49 of the Official Code of Georgia Annotated, relating to public assistance, 92 is amended by adding a new Code section to read as follows: 93 S. B. 39 - 4 - 25 LC 52 0647 "49-4-159.5. 94 The department shall prohibit the coverage of gender-affirming care as provided for in 95 Code Section 45-18-4 for recipients of medical assistance." 96 SECTION 4. 97 Chapter 1 of Title 50 of the Official Code of Georgia Annotated, relating to general 98 provisions relative to state government, is amended by adding a new Code section to read as 99 follows: 100 "50-1-14. 101 (a) No state funds shall be expended for health benefits coverage that includes coverage 102 for gender-affirming care as provided for in Code Section 45-18-4. 103 (b) No healthcare facility owned or operated by the state and no physician or other 104 healthcare provider employed by an agency or entity of this state shall provide 105 gender-affirming care as provided for in Code Section 45-18-4. 106 (c) Nothing in this Code section shall be construed as: 107 (1) Prohibiting any individual, entity, or local government from purchasing separate 108 coverage for gender-affirming care or health benefits coverage that includes 109 gender-affirming care, provided that such coverage is paid for entirely using only funds 110 not authorized or appropriated by the state; or 111 (2) Restricting the ability of any nonstate health benefits coverage provider from offering 112 coverage for gender-affirming care, or the ability of a local government to contract 113 separately with such a provider for such coverage, provided that such coverage is paid 114 for entirely using only funds not authorized or appropriated by the state." 115 SECTION 5. 116 This Act shall become effective upon its approval by the Governor or upon its becoming law 117 without such approval. 118 S. B. 39 - 5 - 25 LC 52 0647 SECTION 6. 119 All laws and parts of laws in conflict with this Act are repealed. 120 S. B. 39 - 6 -