This bill, known as the "TRUTH in Coverage Act of 2026," proposes amendments to the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986. Its central objective is to require group health plans and health insurance issuers that offer coverage for certain procedures to also provide benefits for related restorative care. This ensures comprehensive support for individuals experiencing harms or complications from specific medical interventions. Specifically, if a plan or issuer covers any "sex-rejecting procedure," it must also cover items and services designed to address the harms of such procedures and to restore healthy human form and functioning. This obligation applies irrespective of whether the individual's current plan initially covered the sex-rejecting procedure. The bill broadly defines "restorative care" to include services for impaired reproductive capacity, endocrine dysfunction, sexual function, urinary issues, vocal cord damage, and skeletal disorders, among many others. The term "sex-rejecting procedure" is extensively defined as any medical or surgical intervention intended to align an individual's physical appearance or body with an asserted identity that differs from their genetically determined sex. This includes a wide array of interventions such as puberty blockers, cross-sex hormones, various genital and breast surgeries, facial feminization or masculinization procedures, and the removal of otherwise healthy body parts. The intent is to cover a broad spectrum of procedures often associated with gender transition. However, the bill outlines specific exceptions where procedures are not considered "sex-rejecting." These exceptions include services for individuals with medically verifiable disorders of sex development, life-threatening physical disorders, precocious puberty, and male circumcision. Furthermore, the legislation mandates that financial requirements and treatment limitations for restorative care cannot be more restrictive than those applied to substantially all other medical and surgical benefits covered by the plan. The bill also provides explicit definitions for "male" and "female" based on reproductive systems and genetic determination at fertilization. These new coverage requirements are scheduled to become effective for plan years beginning on or after January 1, 2027, allowing time for implementation.