Text of US HB 2107 (2025)

I 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 med- ical 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 hos- pitals that operate graduate medical education programs, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Children’s Hospital 4 GME Support Reauthorization Act of 2025’’. 5 VerDate Sep 11 2014 05:15 Apr 02, 2025 Jkt 059200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2107.IH H2107 kjohnson on DSK7ZCZBW3PROD with $$_JOB 2 •HR 2107 IH SEC. 2. PROGRAM OF PAYMENTS TO CHILDREN’S HOS- 1 PITALS THAT OPERATE GRADUATE MEDICAL 2 EDUCATION PROGRAMS. 3 Section 340E of the Public Health Service Act (42 4 U.S.C. 256e) is amended— 5 (1) in subsection (a), by striking ‘‘2023’’ and 6 inserting ‘‘2030’’; 7 (2) in subsection (b)(3)(D), by inserting ‘‘and 8 the end of fiscal year 2030,’’ after ‘‘fiscal year 9 2022,’’; 10 (3) in subsection (e), by adding at the end the 11 following new paragraph: 12 ‘‘(4) PROHIBITION ON PAYMENTS TO HOS- 13 PITALS FURNISHING SPECIFIED PROCEDURES AND 14 DRUGS TO MINORS.— 15 ‘‘(A) IN GENERAL.—Notwithstanding any 16 other provision of this section, no payment may 17 be made under this section to a children’s hos- 18 pital for a fiscal year (beginning with fiscal year 19 2026) if, at any point during the preceding fis- 20 cal year, such hospital furnished specified pro- 21 cedures and drugs (as defined in subsection (g)) 22 to an individual under 18 years of age. 23 ‘‘(B) SPECIAL RULE FOR FISCAL YEAR 24 2026.—In applying subparagraph (A) with re- 25 VerDate Sep 11 2014 05:15 Apr 02, 2025 Jkt 059200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2107.IH H2107 kjohnson on DSK7ZCZBW3PROD with $$_JOB 3 •HR 2107 IH spect to payments described in such subpara- 1 graph for fiscal year 2026— 2 ‘‘(i) the reference to ‘for a fiscal year’ 3 shall be treated as a reference to ‘for any 4 portion of fiscal year 2026 occurring after 5 December 31, 2025’; and 6 ‘‘(ii) the reference to ‘the preceding 7 fiscal year’ shall be treated as a reference 8 to ‘the period beginning on September 1, 9 2025, and ending on December 31, 2025’. 10 ‘‘(C) RULE OF CONSTRUCTION.—Nothing 11 in this paragraph shall be construed as prohib- 12 iting payments for a fiscal year (or, in the case 13 of payments for fiscal year 2026, during the 14 portion of such fiscal year described in subpara- 15 graph (B)(i)) to a hospital that, during the pre- 16 ceding fiscal year (or, in the case of payments 17 for fiscal year 2026, during the period de- 18 scribed in subparagraph (B)(ii)), furnished 19 mental or behavioral health services to individ- 20 uals under 18 years of age for the treatment of 21 gender dysphoria not consisting of specified 22 procedures and drugs.’’; 23 (4) in subsection (f)— 24 (A) in paragraph (1)(A)— 25 VerDate Sep 11 2014 05:15 Apr 02, 2025 Jkt 059200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2107.IH H2107 kjohnson on DSK7ZCZBW3PROD with $$_JOB 4 •HR 2107 IH (i) in clause (v), by striking ‘‘and’’ at 1 the end; 2 (ii) in clause (vi), by striking the pe- 3 riod at the end and inserting ‘‘; and’’; and 4 (iii) by adding at the end the fol- 5 lowing: 6 ‘‘(vii) for each of fiscal years 2026 7 through 2030, $124,000,000.’’; and 8 (B) in paragraph (2)— 9 (i) in subparagraph (E), by striking 10 ‘‘and’’ at the end; 11 (ii) in subparagraph (F), by striking 12 the period at the end and inserting ‘‘; 13 and’’; and 14 (iii) by adding at the end the fol- 15 lowing: 16 ‘‘(G) for each of fiscal years 2026 through 17 2030, $261,000,000’’; and 18 (5) in subsection (g), by adding at the end the 19 following new paragraph: 20 ‘‘(4) SPECIFIED PROCEDURES AND DRUGS.— 21 ‘‘(A) IN GENERAL.—Except as provided in 22 subparagraph (B), the term ‘specified proce- 23 dures and drugs’ means, with respect to an in- 24 dividual, any of the following: 25 VerDate Sep 11 2014 05:15 Apr 02, 2025 Jkt 059200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2107.IH H2107 kjohnson on DSK7ZCZBW3PROD with $$_JOB 5 •HR 2107 IH ‘‘(i) Performing any surgery for the 1 purpose of changing the body of such indi- 2 vidual to no longer correspond to the indi- 3 vidual’s sex, including— 4 ‘‘(I) castration; 5 ‘‘(II) orchiectomy; 6 ‘‘(III) scrotoplasty; 7 ‘‘(IV) vasectomy; 8 ‘‘(V) hysterectomy; 9 ‘‘(VI) oophorectomy; 10 ‘‘(VII) ovariectomy; 11 ‘‘(VIII) metoidioplasty; 12 ‘‘(IX) penectomy; 13 ‘‘(X) phalloplasty; 14 ‘‘(XI) vaginoplasty; 15 ‘‘(XII) vaginectomy; 16 ‘‘(XIII) vulvoplasty; 17 ‘‘(XIV) reduction 18 thyrochondroplasty; 19 ‘‘(XV) chondrolaryngoplasty, or 20 any plastic surgery that feminizes or 21 masculinizes the facial features; 22 ‘‘(XVI) mastectomy, or any 23 placement of chest implants to create 24 feminine breasts; and 25 VerDate Sep 11 2014 05:15 Apr 02, 2025 Jkt 059200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H2107.IH H2107 kjohnson on DSK7ZCZBW3PROD with $$_JOB 6 •HR 2107 IH ‘‘(XVII) Any placement of fat or 1 artificial implants in the gluteal re- 2 gion. 3 ‘‘(ii) Administering, supplying, pre- 4 scribing, dispensing, distributing, or other- 5 wise conveying to an individual medications 6 for the purposes described in clause (i), in- 7 cluding gonadotrophin releasing hormone 8 (GnRH) analogues or other puberty-block- 9 ing drugs to stop or delay normal puberty, 10 and estrogen, testosterone, progesterone, 11 or other androgens to an individual in an 12 amount greater than would normally be 13 produced endogenously in a healthy indi- 14 vidual of that individual’s age and sex. 15 ‘‘(B) EXCEPTION.—Subparagraph (A) 16 shall not apply to the provision by a physician 17 or health care provider, with the consent of the 18 child’s parent or legal guardian, of— 19 ‘‘(i) puberty suppression or blocking 20 prescription drugs for the purpose of nor- 21 malizing puberty for a minor experiencing 22 precocious puberty; 23 VerDate Sep 11 2014 05:15 Apr 02, 2025 Jkt 059200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2107.IH H2107 kjohnson on DSK7ZCZBW3PROD with $$_JOB 7 •HR 2107 IH ‘‘(ii) appropriate and medically nec- 1 essary procedures or treatments to correct 2 for— 3 ‘‘(I) a medically verifiable genetic 4 disorder of sex development, includ- 5 ing— 6 ‘‘(aa) 46,XX chromosomes 7 with virilization; 8 ‘‘(bb) 46,XY chromosomes 9 with undervirilization; and 10 ‘‘(cc) both ovarian and tes- 11 ticular tissue; or 12 ‘‘(II) sex chromosome structure, 13 sex steroid hormone production, or 14 sex hormone action, if determined to 15 be abnormal by a physician through 16 genetic or biochemical testing; 17 ‘‘(iii) infection, disease, injury, or dis- 18 order caused or exacerbated by previous 19 medical procedures as defined in sub- 20 section (g)(4)(A); or 21 ‘‘(iv) a physical disorder, physical in- 22 jury, or physical illness that would, as cer- 23 tified by a physician, place the individual 24 in imminent danger of death or impair- 25 VerDate Sep 11 2014 05:15 Apr 02, 2025 Jkt 059200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H2107.IH H2107 kjohnson on DSK7ZCZBW3PROD with $$_JOB 8 •HR 2107 IH ment of a major bodily function unless the 1 procedure is performed, not including if 2 the procedure or drug is for the purpose 3 described in subsection (g)(4)(A)(i). 4 ‘‘(C) SEX.—For purposes of subparagraph 5 (A), the term ‘sex’ means the indication of male 6 or female sex by reproductive potential or ca- 7 pacity, sex chromosomes, naturally occurring 8 sex hormones, gonads, or internal or external 9 genitalia present at birth.’’. 10 Æ VerDate Sep 11 2014 05:15 Apr 02, 2025 Jkt 059200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6301 E:\BILLS\H2107.IH H2107 kjohnson on DSK7ZCZBW3PROD with $$_JOB