Overview
Title
To amend title III of the Public Health Service Act to reauthorize the program of payments to children’s hospitals that operate graduate medical education programs, and for other purposes.
ELI5 AI
H.R. 2107 is a plan that gives money to children's hospitals to help teach new doctors. But it won't give money to hospitals that help kids change their gender unless it’s for specific health reasons, which might make it tricky for some hospitals to keep getting money and help all the kids who need care.
Summary AI
H.R. 2107 aims to renew the program that provides funding to children's hospitals for operating graduate medical education programs until 2030. It introduces a prohibition on these payments to hospitals if they provide specific gender-related surgical procedures or medications to individuals under 18, starting from the fiscal year 2026. However, the bill allows exceptions for certain medical conditions or emergencies, including treatments related to developmental disorders, infections, or life-threatening conditions. Additionally, it specifies the funding amounts allocated for the fiscal years 2026 through 2030.
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AnalysisAI
General Summary of the Bill
H.R. 2107, titled the "Children's Hospital GME Support Reauthorization Act of 2025," aims to amend the Public Health Service Act to continue funding children's hospitals that operate graduate medical education programs until 2030. However, it includes a significant condition: hospitals that provide specific gender-transition procedures or administer certain drugs to minors would be denied payments. The legislation outlines detailed definitions and exemptions regarding which procedures and drugs are affected.
Summary of Significant Issues
Several issues emerge from the proposed amendments, primarily revolving around the restrictions placed on hospitals regarding gender-transition procedures and drugs. The extensive definition of these procedures could complicate enforcement and lead to possible legal challenges. Moreover, the criteria used to determine "sex" based on chromosomes and genitalia may conflict with modern medical understanding and provoke political and ethical debates. Finally, the legislation extends funding without a clear evaluation of the previous program's effectiveness, which might result in financial inefficiencies.
Impact on the Public
Broadly speaking, this bill could have wide-ranging effects on public healthcare offerings, particularly in children's hospitals. It restricts funding for hospitals that engage in specific types of care for minors, potentially leading to reduced access to certain medical treatments. This limitation might especially affect transgender youth seeking gender-affirming healthcare. The financial consequences of enforcing these provisions may also translate to indirect costs for taxpayers without definitive evidence of program effectiveness.
Impact on Specific Stakeholders
For hospitals, particularly those specializing in pediatric care, the bill introduces a significant compliance challenge. Hospitals offering comprehensive services for gender dysphoria may face a financial dilemma if they choose to continue providing these services without federal funding.
For healthcare providers, especially those specializing in adolescent and transgender health, the bill's constraints may compel them to reconsider their practice operations or face limitations in treatment offerings.
Families of minors needing gender-affirming care may find access to necessary health services curtailed, particularly in regions where alternative healthcare providers are scarce. This restriction could exacerbate mental and physical health disparities.
On the legislative and advocacy front, this bill might serve as a focal point for discussions on the boundaries of federal influence in medical practice, potentially sparking broader debates about the rights of minors and parental consent in healthcare decisions.
Overall, while the bill primarily seeks to reauthorize and extend funding for graduate medical education, its additional provisions introduce contentious conditions that could affect healthcare practices, provoke legal challenges, and influence political and social discourse on healthcare rights and ethics.
Financial Assessment
The bill, H.R. 2107, focuses on reauthorizing funding programs that support children's hospitals which operate graduate medical education programs. The key financial element of this bill involves specific monetary allocations to be distributed over several fiscal years.
Financial Allocations
The bill outlines substantial financial distributions to support these educational programs. It specifies that for each of the fiscal years from 2026 through 2030, a sum of $124,000,000 is allocated. Additionally, for this same period, another allocation of $261,000,000 is set aside. These allocations represent a significant investment intended to enhance the educational environment and resources for hospitals that provide medical training to graduate students.
Relevance to Identified Issues
Prohibition on Certain Payments
One of the major issues with the bill is the prohibition related to payments to hospitals that provide specified gender-related procedures or drugs to minors. This aspect can limit the hospitals’ funding availability, potentially impacting their financial stability and ability to provide a wide range of essential services. If a hospital is compliant with the bill's restrictions, it will continue to receive the allocated funds, but the prohibition could disproportionately affect facilities that provide what the legislature deems non-compliant treatments, despite the medical necessity for some patients. This highlights a fundamental tension between the financial policy of the bill and the practical healthcare needs of the institutions and the individuals they serve.
Potential Legal and Ethical Concerns
A detailed list of prohibited procedures and medications is outlined in the bill, which includes what explicitly should not be funded. The exhaustive nature of this list, and the definitions applied, such as the determination of what constitutes "sex," may lead to legal disputes. Hospitals may face financial uncertainties if there is ambiguity in interpreting this long list of conditions and procedures, affecting their operations and possibly leading to confusion regarding what treatments ensure continued funding.
Conclusion
H.R. 2107 proposes significant financial investments into children's hospitals with graduate medical education programs with clearly delineated budgets extending through 2030. However, the attached conditions regarding the provision of specific medical procedures place restrictions that could have broader implications for hospital operations. This intersection of financial provisions and medical ethics presents a complex landscape that policymakers and healthcare providers must navigate carefully. The broader concern is ensuring that the intended financial allocations support educational objectives without inadvertently compromising comprehensive patient care.
Issues
The prohibition on payments to hospitals that furnish specified procedures and drugs to minors (Section 2, subsection (e)) could disproportionately affect hospitals providing legitimate and medically necessary treatments, possibly limiting access to essential health care for children with specific conditions.
The extensive and detailed definition of 'specified procedures and drugs' in Section 2, subsection (g) may make enforcement challenging and could lead to potential legal disputes, especially regarding surgeries and hormone treatments.
The determination of 'sex' based on factors such as chromosomes and genitalia as defined in Section 2, subsection (g)(4)(C) is a complex and potentially contentious issue, as it might not align with current medical or scientific understandings of sex, potentially sparking political and ethical debates.
The language related to exceptions for specified procedures and drugs in Section 2, subsection (g)(4)(B) might be unclear or overly complex, contributing to ambiguity in distinguishing prohibited from medically necessary procedures or drugs.
The rule of construction in Section 2, subsection (e)(4)(C) allowing payments for mental or behavioral health services related to gender dysphoria might conflict with the prohibition on payments for specified medical procedures, leading to potential ambiguity and misinterpretation.
The bias or favoritism against hospitals providing gender-affirming care as indicated in Section 2, subsection (e) might not align with the current medical consensus on the treatment of gender dysphoria, raising ethical and political concerns.
The extension of payments through 2030 as noted in Section 2, subsection (f)(1) and (f)(2) without a clear assessment of the program's effectiveness could lead to potential wasteful spending, raising financial accountability issues for taxpayers.
Sections
Sections are presented as they are annotated in the original legislative text. Any missing headers, numbers, or non-consecutive order is due to the original text.
1. Short title Read Opens in new tab
Summary AI
The first section of the Act states that the official name for the legislation is the "Children’s Hospital GME Support Reauthorization Act of 2025."
2. Program of payments to children's hospitals that operate graduate medical education programs Read Opens in new tab
Summary AI
The section amends the Public Health Service Act to extend funding for children's hospitals with graduate medical education programs until 2030, but prohibits payments to hospitals that perform specific gender-transition procedures or provide certain drugs to minors. It details exemptions for necessary medical treatments and conditions, and defines terms related to the procedures and drugs impacted by the amendments.
Money References
- “(C) RULE OF CONSTRUCTION.—Nothing in this paragraph shall be construed as prohibiting payments for a fiscal year (or, in the case of payments for fiscal year 2026, during the portion of such fiscal year described in subparagraph (B)(i)) to a hospital that, during the preceding fiscal year (or, in the case of payments for fiscal year 2026, during the period described in subparagraph (B)(ii)), furnished mental or behavioral health services to individuals under 18 years of age for the treatment of gender dysphoria not consisting of specified procedures and drugs.”; (4) in subsection (f)— (A) in paragraph (1)(A)— (i) in clause (v), by striking “and” at the end; (ii) in clause (vi), by striking the period at the end and inserting “; and”; and (iii) by adding at the end the following: “(vii) for each of fiscal years 2026 through 2030, $124,000,000.”; and (B) in paragraph (2)— (i) in subparagraph (E), by striking “and” at the end; (ii) in subparagraph (F), by striking the period at the end and inserting “; and”; and (iii) by adding at the end the following: “(G) for each of fiscal years 2026 through 2030, $261,000,000”; and (5) in subsection (g), by adding at the end the following new paragraph: “(4) SPECIFIED PROCEDURES AND DRUGS.— “(A) IN GENERAL.—Except as provided in subparagraph (B), the term ‘specified procedures and drugs’ means, with respect to an individual, any of the following: “(i) Performing any surgery for the purpose of changing the body of such individual to no longer correspond to the individual’s sex, including— “(I) castration; “(II) orchiectomy; “(III) scrotoplasty; “(IV) vasectomy; “(V) hysterectomy; “(VI) oophorectomy; “(VII) ovariectomy; “(VIII) metoidioplasty; “(IX) penectomy; “(X) phalloplasty; “(XI) vaginoplasty; “(XII) vaginectomy; “(XIII) vulvoplasty; “(XIV) reduction thyrochondroplasty; “(XV) chondrolaryngoplasty, or any plastic surgery that feminizes or masculinizes the facial features; “(XVI) mastectomy, or any placement of chest implants to create feminine breasts; and “(XVII)