Bill · S. 5030· Senate(119-S-5030)
TRUTH in Coverage Act of 2026
- Introduced
- 7/16/2026
- Last activity
- 7/16/2026 — Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
- Sponsored by
- Roger Marshall
- Cosponsors
- - 1 - 0
- Introduced
- In Committee
What this bill would do
This bill is known as the TRUTH in Coverage Act of 2026. It amends the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986. The legislation requires group health plans and health insurance issuers that offer benefits for sex-rejecting procedures to also provide benefits for items and services that address the harms caused by those procedures. This required coverage includes restorative care to restore healthy human form and functioning to the greatest extent practicable. The bill applies these requirements regardless of whether the individual received the original procedure under their current plan or coverage. These amendments take effect for plan years beginning on or after January 1, 2027.
Yes
Does this make health care easier to get in general?+6
The legislation ensures insurance coverage for medical items and services intended to address the harms of and provide restorative care following gender-affirming procedures.
Does this make mental health care easier to get?+5
The bill explicitly includes psychiatric and psychological conditions associated with gender-affirming procedures in its restorative care coverage mandate.
Does this give the federal government more power?+3
The bill imposes new federal insurance mandates on group health plans and issuers across the Public Health Service Act, ERISA, and the Internal Revenue Code.
The opposite
Would LGBTQ people be better off under this?-7
The legislation frames gender transition procedures negatively and mandates coverage specifically focused on reversing or treating complications from them.
Does this expand the rights of LGBTQ people?-6
The bill targets gender-affirming medical care by defining such interventions pejoratively as 'sex-rejecting procedures' and mandating coverage for reversing them.
Does this lower what people pay for private health insurance?-2
Mandating additional coverage for restorative care could lead to adjustments in health plan offerings or potential premium increases.
Who it would affect, and how
Potential Positive Impacts for People
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Coverage for Restorative Care: Under sections 2, 727, and 9827, group health plans and health insurance issuers that provide benefits for sex-rejecting procedures are required to provide benefits for items and services furnished to individuals to address the harms of such procedures, including restorative care. This ensures that individuals can receive insurance coverage for medical items and services intended to restore healthy human form and functioning, regardless of whether their plan covered the original procedure.
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Protection from Excessive Financial and Treatment Limits: Under sections 2, 727, and 9827, health plans must ensure that financial requirements, such as cost-sharing and aggregate limits, applied to restorative care are no more restrictive than those applied to substantially all medical and surgical benefits. Additionally, treatment limitations for these services cannot be more restrictive than those applied to general medical and surgical benefits, and separate cost-sharing or treatment limitations cannot be applied exclusively to these services.
Potential Negative Impacts for People
- Potential Premium Increases or Benefit Alterations: While the text does not explicitly detail negative impacts, the mandate under sections 2, 727, and 9827 requiring health plans and insurers that cover sex-rejecting procedures to also cover a broad range of restorative care items and services could potentially lead to adjustments in health plan offerings or increased financial burdens for group health plans and issuers, which may indirectly affect plan participants.
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Hover a score for the reason it gave.
- Healthcare
- Improves Healthcare Access+6Improves Mental Health Access+5Reduces Private Insurance Premiums-2
- Demographic And Interest Groups
- Good For L G B T Q Community-7
- Social Issues And Justice
- Improves L G B T Q Rights-6
- Governance And Ideology
- Increases Federal Power+3
- 7/16/2026
- Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
- 1 Cosponsor added.
- Introduced in Senate
One bill Congress.gov lists as related to this one — companions in the other chamber, earlier versions, and bills this one absorbed or was folded into.
Cynthia LummisRepublican · Wyoming