,,ii  #aai? ,,congress  #a/ ,session    
,s4 #cjaa  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,octob] #ae1 #bjbe ,mr4
 ,hawley introduc$ ! foll[+ bill2 :i* 0 
read twice & ref]r$ to ! ,committee on  
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to am5d ! ,pati5t           
,protection & ,af=dable ,c>e ,act to    
exclude cov]age ( g5d]-transition       
proc$ures = m9ors & abortion "u heal?   
plans (f]$ ?r\gh ! ,am]ican ,heal?      
,b5efits ,ex*anges1 & = o!r purposes4   
#a4  ,%ort title  ,?is ,act may be cit$ 
z ! ,prohibit+ ,abortion  ,transg5d]    
,proc$ures on ! ,ex*anges ,act4  #b4    
,exclusion ( g5d]-transition proc$ures =
 m9ors & abortion f cov]age "u heal?    
plans (f]$ ?r\gh ! ,am]ican ,heal?      
,b5efits ,ex*anges  7a7  ,9 g5]al       
,section #acjc ( ! ,pati5t ,protection &
 ,af=dable ,c>e ,act 7#db ,u4,s4,c4     
#ahjbc7 is am5d$--  7#a7 9 subsection   
7a7-- 7,a7 by /rik+ p>agraph 7#b72 &    
7,b7 by /rik+ ! subsection designation &
 head+ & all t foll[s ?r\gh ,a ,/ate 9  

p>agraph 7#a7 & ins]t+ ! foll[+3  7a7   
,/ate opt-,out ( abortion cov]age  ,a   
,/ate  2  7#b7 9 subsection 7b71 by     
/rik+ ! subsection designation & head+ &
 all t foll[s ?r\gh ,no qualifi$ 9      
p>agraph 7#d7 & ins]t+ ! foll[+3  7b7   
,no discrim9ation on basis ( provision (
 abortion  ,no qualifi$  2  7#c7 9      
subsection 7c7--  7,a7 9 p>agraph 7#b7--
 7i7 by /rik+ ! p>agraph designation &  
head+ & all t foll[s ?r\gh ,no?+ 9      
subp>agraph 7,a7 & ins]t+ ! foll[+3     
7#b7  ,no effect on ,f$]al laws reg>d+  
abortion  ,no?+  2 &  7ii7 by r$esignat+
 clauses 7i7 ?r\gh 7iii7 z subp>agraphs 
7,a7 ?r\gh 7,c71 respectively1 & adju/+ 
! m>g9s accord+ly2  7,b7 by /rik+ !     
subsection designation & head+ & all t  
foll[s ?r\gh ! end ( p>agraph 7#a7 &    
ins]t+ ! foll[+3  7c7  ,application (   
,f$]al laws  2 &  7,c7 by r$esignat+    
p>agraphs 7#b7 & 7#c7 z p>agraphs 7#a7 &
 7#b71 respectively2  7#d7 by r$esignat+
 subsections 7a7 ?r\gh 7d7 z subsections
 7b7 ?r\gh 7e71 respectively2 &  7#e7 by

 ins]t+ be=e subsection 7b7 7z s        
r$esignat$7 ! foll[+3  7a7  ,prohibition
 on cov]age ( g5d]-,transition proc$ures
 = m9ors & abortion  7#a7  ,9 g5]al  ,an
 ,ex*ange may n make available any heal?
 plan1 includ+ any heal? plan (f]+      
except$ b5efits 7z def9$ 9 section      
#bgia7;c7 ( ! ,public ,heal? ,s]vice    
,act71 t provides cov]age =--  7,a7     
abortion1 except 9 ! case :]e a woman   
suff]s f a physical disord]1 physical   
injury1 or physical illness t w\ld1 z   
c]tifi$ by a physician1 place ! woman 9 
dang] ( dea? unless an abortion is      
p]=m$1 includ+ a life-endang]+ physical 
condition caus$ by or aris+ f !         
pregnancy itself1 or unless ! pregnancy 
is ! result ( an act ( rape or ince/2 or
  7,b7 g5d]-transition proc$ures =      
m9ors4  7#b7 ,def9itions ,9 ?is         
subsection3  7,a7  ,g5d]-transition     
proc$ure  7i7  ,9 g5]al  ,except z      
provid$ 9 clause 7ii71 ! t]m            
g5d]-transition proc$ure means--  7,i7 !
 prescription or adm9i/ration (         

gonadotrop9-releas+ hormone agoni/s or  
any o!r pub]ty-block+ drugs = ! purpose 
( *ang+ ! body ( an individual s t x    
con=ms to ! subjective s5se ( id5tity ( 
! individual1 9 ! case su* id5tity is at
 odds ) ! individual's biological sex ( 
male or female2  7,,ii7 ! prescription  
or adm9i/ration ( te/o/]one 7:5         
prescrib$ to a female7 or e/rog5 7:5    
prescrib$ to a male7 = ! purpose ( *ang+
 ! body ( an individual s t x con=ms to 
! subjective s5se ( id5tity ( !         
individual1 9 ! case su* id5tity is at  
odds ) ! individual's biological sex (  
male or female2 or  7,,iii7 a surg]y to 
*ange ! body ( an individual s t x      
con=ms to ! subjective s5se ( id5tity ( 
! individual1 9 ! case su* id5tity is at
 odds ) ! individual's biological sex ( 
male or female4  7ii7  ,exception  ,!   
t]m g5d]-transition proc$ure does n     
include--  7,i7 an int]v5tion describ$ 9
 clause 7i7 t is p]=m$ on--  7aa7 an    
individual ) biological sex *>act]i/ics 
t are inh]5tly ambigu\s1 su* z ^? born )

 #df ,,xx *romosomes ) virilization1 #df
 ,,xy *romosomes ) und]virilization1 or 
hav+ bo? ov>ian & te/icul> tissue2 or   
7bb7 an individual ) respect to :om a   
physician has det]m9$ ?r\gh g5etic or   
bio*emical te/+ t ! individual does n h 
normal sex *romosome /ructure1 sex /]oid
 hormone production1 or sex /]oid       
hormone action1 = a biological male or  
biological female2  7,,ii7 ! treatm5t ( 
any infection1 injury1 disease1 or      
disord] t has be5 caus$ or exac]bat$ by 
! p]=mance ( an int]v5tion describ$ 9   
clause 7i7 )\t reg>d to :e!r !          
int]v5tion 0 p]=m$ 9 accordance ) ,/ate 
or ,f$]al law2 or  7,,iii7 any proc$ure 
und]tak5 because ! individual suff]s f a
 physical disord]1 physical injury1 or  
physical illness t w\ld1 z c]tifi$ by a 
physician1 place ! individual 9 imm95t  
dang] ( dea? or impairm5t ( major bodily
 function unless ! proc$ure is p]=m$4   
7,b7  ,m9or  ,! t]m m9or means an       
individual :o has n yet rea*$ #ah ye>s (
 age4  4  7b7  ,con=m+ am5dm5t  ,section

 #accd7;a7 7#db ,u4,s4,c4 #ahjed7;a77 is
 am5d$-- 7#a7 by /rik+ p>agraph 7#f72 & 
7#b7 by r$esignat+ p>agraph 7#g7 z      
p>agraph 7#f74  7c7 ,effective date ,!  
am5dm5ts made by ?is section %all apply 
) respect to plan ye>s beg9n+ on or aft]
 ,janu>y #a1 #bjbf4