,,ii #aaith ,,congress #ast ,session ,s4 #cjaa ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,october #ae1 #bjbe ,mr4 ,hawley introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,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 ,exchanges1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,prohibiting ,abortion ,transgender ,procedures on the ,exchanges ,act4 #b4 ,exclusion of gender-transition procedures for minors and abortion from coverage under health plans offered through the ,american ,health ,benefits ,exchanges 7a7 ,in general ,section #acjc of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjbc7 is amended-- 7#a7 in subsection 7a7-- 7,a7 by striking paragraph 7#b72 and 7,b7 by striking the subsection designation and heading and all that follows through ,a ,state in paragraph 7#a7 and inserting the following3 7a7 ,state opt-,out of abortion coverage ,a ,state 2 7#b7 in subsection 7b71 by striking the subsection designation and heading and all that follows through ,no qualified in paragraph 7#d7 and inserting the following3 7b7 ,no discrimination on basis of provision of abortion ,no qualified 2 7#c7 in subsection 7c7-- 7,a7 in paragraph 7#b7-- 7i7 by striking the paragraph designation and heading and all that follows through ,nothing in subparagraph 7,a7 and inserting the following3 7#b7 ,no effect on ,federal laws regarding abortion ,nothing 2 and 7ii7 by redesignating clauses 7i7 through 7iii7 as subparagraphs 7,a7 through 7,c71 respectively1 and adjusting the margins accordingly2 7,b7 by striking the subsection designation and heading and all that follows through the end of paragraph 7#a7 and inserting the following3 7c7 ,application of ,federal laws 2 and 7,c7 by redesignating paragraphs 7#b7 and 7#c7 as paragraphs 7#a7 and 7#b71 respectively2 7#d7 by redesignating subsections 7a7 through 7d7 as subsections 7b7 through 7e71 respectively2 and 7#e7 by inserting before subsection 7b7 7as so redesignated7 the following3 7a7 ,prohibition on coverage of gender-,transition procedures for minors and abortion 7#a7 ,in general ,an ,exchange may not make available any health plan1 including any health plan offering excepted benefits 7as defined in section #bgia7;c7 of the ,public ,health ,service ,act71 that provides coverage for-- 7,a7 abortion1 except in the case where a woman suffers from a physical disorder1 physical injury1 or physical illness that would1 as certified by a physician1 place the woman in danger of death unless an abortion is performed1 including a life-endangering physical condition caused by or arising from the pregnancy itself1 or unless the pregnancy is the result of an act of rape or incest2 or 7,b7 gender-transition procedures for minors4 7#b7 ,definitions ,in this subsection3 7,a7 ,gender-transition procedure 7i7 ,in general ,except as provided in clause 7ii71 the term gender-transition procedure means-- 7,i7 the prescription or administration of gonadotropin-releasing hormone agonists or any other puberty-blocking drugs for the purpose of changing the body of an individual so that it conforms to the subjective sense of identity of the individual1 in the case such identity is at odds with the individual's biological sex of male or female2 7,,ii7 the prescription or administration of testosterone 7when prescribed to a female7 or estrogen 7when prescribed to a male7 for the purpose of changing the body of an individual so that it conforms to the subjective sense of identity of the individual1 in the case such identity is at odds with the individual's biological sex of male or female2 or 7,,iii7 a surgery to change the body of an individual so that it conforms to the subjective sense of identity of the individual1 in the case such identity is at odds with the individual's biological sex of male or female4 7ii7 ,exception ,the term gender-transition procedure does not include-- 7,i7 an intervention described in clause 7i7 that is performed on-- 7aa7 an individual with biological sex characteristics that are inherently ambiguous1 such as those born with #df ,,xx chromosomes with virilization1 #df ,,xy chromosomes with undervirilization1 or having both ovarian and testicular tissue2 or 7bb7 an individual with respect to whom a physician has determined through genetic or biochemical testing that the individual does not have normal sex chromosome structure1 sex steroid hormone production1 or sex steroid hormone action1 for a biological male or biological female2 7,,ii7 the treatment of any infection1 injury1 disease1 or disorder that has been caused or exacerbated by the performance of an intervention described in clause 7i7 without regard to whether the intervention was performed in accordance with ,state or ,federal law2 or 7,,iii7 any procedure undertaken because the individual suffers from a physical disorder1 physical injury1 or physical illness that would1 as certified by a physician1 place the individual in imminent danger of death or impairment of major bodily function unless the procedure is performed4 7,b7 ,minor ,the term minor means an individual who has not yet reached #ah years of age4 4 7b7 ,conforming amendment ,section #accd7;a7 7#db ,u4,s4,c4 #ahjed7;a77 is amended-- 7#a7 by striking paragraph 7#f72 and 7#b7 by redesignating paragraph 7#g7 as paragraph 7#f74 7c7 ,effective date ,the amendments made by this section shall apply with respect to plan years beginning on or after ,january #a1 #bjbf4