Sec. 201 Clarifying application of prohibition to premium credits and cost-sharing reductions under ACA
“(C) Separate coverage or plan for gender reassignment medical interventions allowed
“(i) Option to purchase separate coverage or plan—Nothing in subparagraph (A) shall be construed as prohibiting any individual from purchasing separate coverage for gender reassignment medical interventions described in such subparagraph, or a health plan that includes such gender reassignment medical interventions, so long as no credit is allowed under this section with respect to the premiums for such coverage or plan.
“(ii) Option to offer coverage or plan—Nothing in subparagraph (A) shall restrict any non-Federal health insurance issuer offering a health plan from offering separate coverage for gender reassignment medical interventions described in such subparagraph, or a plan that includes such gender reassignment medical interventions, so long as premiums for such separate coverage or plan are not paid for with any amount attributable to the credit allowed under this section (or the amount of any advance payment of the credit under section 1412 of the Patient Protection and Affordable Care Act).”
“(1) In general—Any term”
“(2) Exclusion of health plans including coverage for gender reassignment medical interventions
“(A) In general—The term qualified health plan does not include any health plan that includes coverage for gender reassignment medical interventions (other than any gender reassignment medical intervention or treatment described in section 306 or 307 of title 1, United States Code).
“(B) Separate coverage or plan for gender reassignment medical interventions allowed
“(i) Option to purchase separate coverage or plan—Nothing in subparagraph (A) shall be construed as prohibiting any employer from purchasing for its employees separate coverage for gender reassignment medical interventions described in such subparagraph, or a health plan that includes such gender reassignment medical interventions, so long as no credit is allowed under this section with respect to the employer contributions for such coverage or plan.
“(ii) Option to offer coverage or plan—Nothing in subparagraph (A) shall restrict any non-Federal health insurance issuer offering a health plan from offering separate coverage for gender reassignment medical interventions described in such subparagraph, or a plan that includes such gender reassignment medical interventions, so long as such separate coverage or plan is not paid for with any employer contribution eligible for the credit allowed under this section.”
“(7) Coverage consistent with Federal policy regarding gender reassignment medical interventions—In entering into contracts under this subsection, the Director shall ensure that no multi-State qualified health plan offered in an Exchange provides health benefits coverage for which the expenditure of Federal funds is prohibited under chapter 4 of title 1, United States Code.”