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 the medical processes involved. It specifies that health benefit plans providing coverage for gender transition must also cover all possible adverse consequences, necessary testing, and any procedures required to manage or reverse the effects of such treatments. This coverage applies to various types of health benefit plans, including those for small employers and Medicaid programs, and is required regardless of the enrollee's gender identity designation in their medical records.

The bill also stipulates that if a state agency determines a federal waiver is needed for implementation, it may delay the provision until such authorization is granted. The provisions of Section 1373.003 will only apply to health benefit plans that are delivered, issued for delivery, or renewed on or after January 1, 2026. The act is set to take effect on September 1, 2025.

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