House Bill 660 By: Representatives Cox of the 28th, Jasperse of the 11th, Rice of the 139th, Scoggins of the 14th, and McDonald III of the 26th A BILL TO BE ENTITLED AN ACT To amend Chapter 18 of Title 45, Chapter 4 of Title 49, and Chapter 1 of Title 50 of the Official Code of Georgia Annotated, relating to the employees' insurance and benefits plans, public assistance, and general provisions relative to state government, respectively, so as to prohibit coverage of expenses for any transition related intervention under the state health benefit plan or with any state funds; to provide for definitions; to prohibit state healthcare facilities and healthcare providers employed by the state from providing any transition related intervention; to prohibit correctional facilities owned or operated by the state and healthcare providers employed at such facilities from providing any transition related intervention; to provide for related matters; to provide for legislative findings; to provide for an effective date; to repeal conflicting laws; and for other purposes. BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA: SECTION 1. The General Assembly finds that: (1) The State of Georgia has taken measures to protect individuals from a radical gender ideology that has, among other things, resulted in a massive unexplained rise in diagnoses of gender dysphoria; (2) Senate Bill 140 enacted by the General Assembly in the 2023 regular session broadly banned procedures or treatments performed for the purpose of enabling a minor to identify with or live as a purported identity inconsistent with such minor's sex or treating purported discomfort or distress from a discordance between a minor's sex and asserted identity, and similar bills from other states have been upheld by a federal appeals court; and (3) It is the policy of the State of Georgia that these procedures or treatments shall neither be covered by the state health benefit plan nor otherwise paid for through the use of any state funds. SECTION 2. Chapter 18 of Title 45 of the Official Code of Georgia Annotated, relating to employees' insurance and benefits plans, is amended by adding a new Code section to read as follows: "45-18-4.2. (a) As used in this Code section, the term: (1) 'Congenital defect' means a physical or chemical abnormality present in a minor that is inconsistent with the normal development of a human being of such minor's sex, including abnormalities caused by a medically verifiable disorder of sex development. Such term does not include gender dysphoria, gender identity disorder, gender incongruence, or any mental condition, disorder, disability, or abnormality. (2) 'Medical procedure' means a surgical procedure or nonsurgical treatment consisting of: (A) Surgically removing, modifying, altering, artificially constructing, or entering into tissues, cavities, or organs of a human being; or (B) Prescribing, administering, or dispensing any puberty blocker or supraphysiological hormone dosage to a human being. (3) 'Puberty blocker' means a drug or device that suppresses the production of hormones in a minor's body to stop, delay, or suppress pubertal development. (4) 'Sex' means an individual's immutable characteristics of the reproductive system that define such individual as male or female, as determined by anatomy and genetics existing at the time of birth. (5) 'State health plan' means any healthcare benefits provided pursuant to Subpart 2 of Part 6 of Article 17 of Chapter 2 of Title 20, Subpart 3 of Part 6 of Article 17 of Chapter 2 of Title 20, Code Section 31-2-4, and Article 1 of Chapter 18 of this title. (6) 'Transition related intervention' means any medical procedure performed for the purpose of: (A) Enabling an individual to identify with or live as a purported identity inconsistent with such individual's sex; or (B) Treating an individual's purported discomfort or distress from a discordance between such individual's sex and asserted identity. (b) On or after January 1, 2026, the state health plan shall not include expenses for any transition related intervention except as provided in subsection (c) of this Code section. (c) The board shall adopt rules and regulations regarding the exclusion of expenses for any transition related intervention as provided for in subsection (b) of this Code section; provided, however, that it is not a violation of this Code section if a healthcare provider performs or administers a medical procedure for the purpose of treating: (1) A minor's congenital defect, precocious puberty, disease, or physical injury; provided, however, that the term 'disease' does not include gender dysphoria, gender identity disorder, gender incongruence, or any mental condition, disorder, disability, or abnormality; and (2) Any infection, injury, disease, or disorder that has been caused or exacerbated by the performance of a medical procedure, including a transition related intervention, whether or not such procedure was performed in accordance with federal or state law; provided, however, that the purpose of such medical procedure shall not be to continue any transition related intervention for gender dysphoria, gender identity disorder, gender incongruence, or any mental condition, disorder, disability, or abnormality." SECTION 3. Chapter 4 of Title 49 of the Official Code of Georgia Annotated, relating to public assistance, is amended by adding a new Code section to read as follows: "49-4-159.5. The department shall prohibit the coverage of any transition related intervention as provided for in Code Section 45-18-4.2 for recipients of medical assistance." SECTION 4. Chapter 1 of Title 50 of the Official Code of Georgia Annotated, relating to general provisions relative to state government, is amended by adding a new Code section to read as follows: "50-1-14. (a) No state funds shall be expended for health benefits coverage that includes coverage for any transition related intervention as provided for in Code Section 45-18-4.2. (b) No healthcare facility owned or operated by the state and no physician or other healthcare provider employed by an agency or entity of this state shall provide any transition related intervention as provided for in Code Section 45-18-4.2. (c) No correctional facility owned or operated by the state and no physician or other healthcare provider employed by such facility shall provide any transition related intervention as provided for in Code Section 45-18-4.2 to any individual incarcerated at such facility. (d) Nothing in this Code section shall be construed as: (1) Prohibiting any individual, entity, or local government from purchasing separate coverage for any transition related intervention or health benefits coverage that includes any transition related intervention, provided that such coverage is paid for entirely using only funds not authorized or appropriated by the state; or (2) Restricting the ability of any nonstate health benefits coverage provider from offering coverage for any transition related intervention or the ability of a local government to contract separately with such a provider for such coverage, provided that such coverage is paid for entirely using only funds not authorized or appropriated by the state." SECTION 5. This Act shall become effective upon its approval by the Governor or upon its becoming law without such approval. SECTION 6. All laws and parts of laws in conflict with this Act are repealed.