Text of US HB 3887 (2024)

I 118TH CONGRESS 1ST SESSION H. R. 3887 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 JUNE 7, 2023 Mr. CRENSHAW 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 2023’’. 5 VerDate Sep 11 2014 03:53 Jul 04, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H3887.IH H3887 pbinns on DSKJLVW7X2PROD with $$_JOB 2 •HR 3887 IH SEC. 2. PROGRAM OF PAYMENTS TO CHILDREN’S HOS- 1 PITALS THAT OPERATE GRADUATE MEDICAL 2 EDUCATION PROGRAMS. 3 Section 340E of the Public Health Service Act (42 4 U.S.C. 256e) is amended— 5 (1) in subsection (a), by striking ‘‘2023’’ and 6 inserting ‘‘2028’’; 7 (2) in subsection (b)(3)(D), by inserting ‘‘and 8 the end of fiscal year 2028,’’ after ‘‘fiscal year 9 2022,’’; 10 (3) in subsection (e), by adding at the end the 11 following new paragraph: 12 ‘‘(4) PROHIBITION ON PAYMENTS TO HOS- 13 PITALS FURNISHING GENDER-AFFIRMING CARE TO 14 MINORS.— 15 ‘‘(A) IN GENERAL.—Notwithstanding any 16 other provision of this section, no payment may 17 be made under this section to a children’s hos- 18 pital for a fiscal year (beginning with fiscal year 19 2024) if, at any point during the preceding fis- 20 cal year, such hospital furnished gender-affirm- 21 ing care (as defined in subsection (g)) to an in- 22 dividual under 18 years of age. 23 ‘‘(B) SPECIAL RULE FOR FISCAL YEAR 24 2024.—In applying subparagraph (A) with re- 25 spect to payments described in such subpara- 26 VerDate Sep 11 2014 03:53 Jul 04, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3887.IH H3887 pbinns on DSKJLVW7X2PROD with $$_JOB 3 •HR 3887 IH graph for fiscal year 2024, the reference to ‘the 1 preceding fiscal year’ shall be treated as a ref- 2 erence to ‘the period beginning on July 1, 2023, 3 and ending on September 30, 2023’. 4 ‘‘(C) RULE OF CONSTRUCTION.—Nothing 5 in this paragraph shall be construed as prohib- 6 iting payments for a fiscal year to a hospital 7 that, during the preceding fiscal year (or, in the 8 case of payments for fiscal year 2024, during 9 the period described in subparagraph (B)), fur- 10 nished mental or behavioral health services to 11 individuals under 18 years of age for the treat- 12 ment of gender dysphoria not consisting of gen- 13 der-affirming care.’’; 14 (4) in subsection (f)— 15 (A) in paragraph (1)(A)(vi), by striking 16 ‘‘2023’’ and inserting ‘‘2028’’; and 17 (B) in paragraph (2)(F), by striking 18 ‘‘2023’’ and inserting ‘‘2028’’; and 19 (5) in subsection (g), by adding at the end the 20 following new paragraph: 21 ‘‘(4) GENDER-AFFIRMING CARE.— 22 ‘‘(A) IN GENERAL.—Except as provided in 23 subparagraph (B), the term ‘gender-affirming 24 VerDate Sep 11 2014 03:53 Jul 04, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H3887.IH H3887 pbinns on DSKJLVW7X2PROD with $$_JOB 4 •HR 3887 IH care’ means, with respect to an individual, any 1 of the following: 2 ‘‘(i) Performing any surgery for the 3 purpose of changing the body of such indi- 4 vidual to correspond to a sex that differs 5 from their biological sex, including— 6 ‘‘(I) castration; 7 ‘‘(II) orchiectomy; 8 ‘‘(III) scrotoplasty; 9 ‘‘(IV) vasectomy; 10 ‘‘(V) hysterectomy; 11 ‘‘(VI) oophorectomy; 12 ‘‘(VII) ovariectomy; 13 ‘‘(VIII) metoidioplasty; 14 ‘‘(IX) penectomy; 15 ‘‘(X) phalloplasty; 16 ‘‘(XI) vaginoplasty; 17 ‘‘(XII) vaginectomy; 18 ‘‘(XIII) vulvoplasty; 19 ‘‘(XIV) reduction 20 thyrochondroplasty; 21 ‘‘(XV) chondrolaryngoplasty; and 22 ‘‘(XVI) mastectomy. 23 VerDate Sep 11 2014 03:53 Jul 04, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H3887.IH H3887 pbinns on DSKJLVW7X2PROD with $$_JOB 5 •HR 3887 IH ‘‘(ii) Any plastic surgery that femi- 1 nizes or masculinizes the facial features for 2 the purposes described in clause (i). 3 ‘‘(iii) Any placement of chest implants 4 to create feminine breasts for the purposes 5 described in clause (i). 6 ‘‘(iv) Any placement of fat or artificial 7 implants in the gluteal region for the pur- 8 poses described in clause (i). 9 ‘‘(v) Administering, supplying, pre- 10 scribing, dispensing, distributing, or other- 11 wise conveying to an individual medications 12 for the purposes described in clause (i), in- 13 cluding— 14 ‘‘(I) gonadotropin-releasing hor- 15 mone (GnRH) analogues or other pu- 16 berty-blocking drugs to stop or delay 17 normal puberty; 18 ‘‘(II) testosterone or other 19 androgens to biological females at 20 doses that are supraphysiologic to the 21 female sex; and 22 ‘‘(III) estrogen to biological 23 males at doses that are 24 supraphysiologic to the male sex. 25 VerDate Sep 11 2014 03:53 Jul 04, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H3887.IH H3887 pbinns on DSKJLVW7X2PROD with $$_JOB 6 •HR 3887 IH ‘‘(B) EXCEPTION.—Subparagraph (A) 1 shall not apply to the following individuals: 2 ‘‘(i) An individual with both ovarian 3 and testicular tissue. 4 ‘‘(ii) An individual with respect to 5 whom a physician has determined through 6 genetic or biochemical testing that the in- 7 dividual does not have normal sex chro- 8 mosome structure, sex steroid hormone 9 production, or sex steroid hormone action. 10 ‘‘(iii) An individual experiencing infec- 11 tion, disease, injury, or disorder caused or 12 exacerbated by previous gender transition 13 procedures. 14 ‘‘(iv) An individual suffering from a 15 physical disorder, physical injury, or phys- 16 ical illness that would, as certified by a 17 physician, place the individual in imminent 18 danger of death or impairment of a major 19 bodily function unless the procedure is per- 20 formed. 21 ‘‘(C) BIOLOGICAL SEX.—For purposes of 22 subparagraph (A), the term ‘biological sex’ 23 means the indication of male or female sex by 24 reproductive potential or capacity, sex chro- 25 VerDate Sep 11 2014 03:53 Jul 04, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H3887.IH H3887 pbinns on DSKJLVW7X2PROD with $$_JOB 7 •HR 3887 IH mosomes, naturally occurring sex hormones, go- 1 nads, or internal or external genitalia present at 2 birth.’’. 3 Æ VerDate Sep 11 2014 03:53 Jul 04, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6301 E:\BILLS\H3887.IH H3887 pbinns on DSKJLVW7X2PROD with $$_JOB