S. 3011: To amend the Patient Protection and Affordable Care Act to exclude coverage of gender-transition procedures for minors and abortion under health plans offered through the American Health Benefits Exchanges, and for other purposes.

This bill seeks to amend the Patient Protection and Affordable Care Act by excluding specific medical procedures from being covered by health plans offered through the American Health Benefits Exchanges. The key provisions of the bill are as follows:

Prohibitions on Coverage

The bill specifically prohibits health plans available through the exchanges from covering:

• Gender-transition procedures for minors, which include a range of treatments aimed at changing an individual's physical gender characteristics to align with their gender identity. This includes hormone therapies and surgeries.
• Abortion procedures, with limited exceptions. Abortion would only be covered if a woman faces a serious health risk or if the pregnancy results from rape or incest.

Definitions

To clarify what is meant by gender-transition procedures, the bill provides specific definitions:

• The term gender-transition procedure encompasses the use of hormone treatments and surgeries aimed at altering an individual's physical traits to match their gender identity.
• Exceptions are noted for individuals with certain medical conditions or intersex traits that might require different consideration.
• The term minor refers to anyone under the age of 18.

State Provisions

The bill allows states to opt out of covering abortion, giving states the authority to decide their own policies regarding this issue, while ensuring that no discrimination occurs against health plans based on whether they provide abortion coverage.

Effective Date

The changes proposed in the bill would take effect for plan years beginning on or after January 1, 2026.

Summary of Legislative Process

The bill was introduced in the Senate on October 15, 2025, and has been referred to the Senate Committee on Health, Education, Labor, and Pensions for further consideration.

Relevant Companies

• None found