S.B. No. 1257 introduces a new chapter, Chapter 1373, to the Texas Insurance Code, which mandates health benefit plans to cover adverse effects and reversals related to gender transition procedures. The bill defines "gender transition" and "gender transition procedure or treatment," outlining that any health benefit plan providing coverage for such procedures must also cover all possible adverse consequences, necessary testing, and any procedures required to manage or reverse the effects of the transition. This coverage is applicable to various types of health benefit plans, including those offered by insurance companies, health maintenance organizations, and Medicaid programs, among others.

The bill specifies that coverage must be provided regardless of whether the enrollee was part of the plan at the time of the procedure. It also includes provisions for implementation, stating that if a federal waiver is needed, the state agency must request it and may delay implementation until granted. The new coverage requirements will apply to health benefit plans delivered or renewed on or after January 1, 2026, and the act will take effect on September 1, 2025.

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