Prohibiting Abortion & Transgender Procedures on the Exchanges Act

This bill seeks to modify the Patient Protection and Affordable Care Act (ACA) by restricting the types of services covered by health plans available through American Health Benefits Exchanges. Specifically, it prohibits these exchanges from offering health plans that provide coverage for gender-transition procedures for minors and most abortions . The legislation defines "gender-transition procedure" broadly to include the prescription of puberty blockers, cross-sex hormones, and surgeries intended to align an individual's body with a subjective identity that differs from their biological sex. However, it carves out exceptions for individuals with inherently ambiguous biological sex characteristics, certain genetic conditions, or when such procedures are necessary to treat complications or prevent imminent danger to life or major bodily function. For abortion coverage, the bill permits exceptions only when a physician certifies that the mother's life is in danger due to a physical disorder, injury, or illness, or if the pregnancy resulted from rape or incest. These amendments are slated to take effect for plan years beginning on or after January 1, 2026, significantly altering the scope of covered services within ACA exchange plans.