An Act providing for insurance coverage for transition intervention reversal services.

PRINTER'S NO. 1170
THE GENERAL ASSEMBLY OF PENNSYLVANIA
SENATE BILL
No. 1007
Session of
2025
INTRODUCED BY BROOKS, MASTRIANO AND PENNYCUICK,
SEPTEMBER 17, 2025
REFERRED TO BANKING AND INSURANCE, SEPTEMBER 17, 2025
AN ACT
Providing for insurance coverage for transition intervention
reversal services.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Short title.
This act shall be known and may be cited as the Fairness in
Access to Interventions for Reversal of Covered Alteration or
Reassignment Encounters Act.
Section 2. Definitions.
The following words and phrases when used in this act shall
have the meanings given to them in this section unless the
context clearly indicates otherwise:
"Department." The Department of Human Services of the
Commonwealth.
"Gender transition intervention." A drug, device, surgery,
procedure or counseling service that is intended to, or is
reasonably expected to, alter physical, physiological,
psychological or behavioral traits in order to present, appear
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or identify as a sex different from the individual's biological
sex.
"Health insurance policy." The term shall mean the same as
defined under 40 Pa.C.S. § 4001 (relating to definitions).
"Transition intervention reversal service." The following:
(1) Health care services, including hormonal, surgical
or behavioral health treatments, that are reasonably
indicated for an individual who has previously undergone a
gender transition intervention and who seeks to restore
physical or functional characteristics consistent with the
individual's biological sex.
(2) The term includes:
(i) counseling and mental health care related to
reversal; and
(ii) hormonal therapies, reconstructive procedures
and behavioral health care.
(3) The term does not include any procedure, treatment
or counseling that constitutes or promotes a gender
transition intervention.
Section 3. Insurance coverage required.
(a) Private insurance.--A health insurance policy delivered,
issued for delivery or renewed within this Commonwealth shall
provide coverage for medically necessary transition intervention
reversal services if the health insurance policy previously
covered a gender transition intervention for the same
individual.
(b) Medical assistance and Children's Health Insurance
Program.--The department shall ensure that coverage for
transition intervention reversal services is provided under all
programs administered or funded by the Commonwealth, including
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medical assistance and the Children's Health Insurance Program
if the program previously covered a gender transition
intervention for the same individual.
(c) Compliance.--The Insurance Department shall ensure
compliance with this section through review of insurance policy
forms and any other appropriate regulatory oversight mechanisms.
Section 4. Reporting.
(a) Duty of insurers.--
(1) A health insurer providing coverage in this
Commonwealth shall annually report to the Insurance
Department, in a manner and form prescribed by the Insurance
Department, the number of individuals for whom transition
intervention reversal services were covered, the general
categories of services provided and the total expenditures.
(2) Within 12 months of the effective date of this
paragraph, and annually thereafter, the Insurance Department
shall submit a report to the chairperson and minority
chairperson of the Banking and Insurance Committee of the
Senate and the Insurance Committee of the House of
Representatives summarizing implementation and utilization of
coverage under private health insurance policies. The report
shall include the number of covered individuals and claims
submitted for transition intervention reversal services in
aggregate form.
(b) Duty of department.--Within 12 months of the effective
date of this subsection, and annually thereafter, the department
shall submit a report to the chairperson and minority
chairperson of the Health and Human Services Committee of the
Senate and the Human Services Committee of the House of
Representatives summarizing the number and type of transition
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intervention reversal services covered under medical assistance
and the Children's Health Insurance Program. The report shall
include only aggregate data and may not contain individually
identifiable health information.
Section 5. Abrogation.
All regulations or parts of regulations inconsistent with
this act are abrogated.
Section 6. Effective date.
This act shall take effect immediately.
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