TX SB1257

Requires health benefit plans that cover or have ever covered gender transition procedures to also cover all adverse consequences, short- and long-term side effects, baseline and follow-up testing/screening at least annually, and any procedures necessary to manage, reverse, or recover from gender transition treatments

Applies to a broad range of health plans including private insurance, HMOs, state employee plans, teacher retirement plans, Medicaid, CHIP, county employee benefits, and school district health coverage

Plans offering gender transition coverage must provide reversal/adverse effect coverage to any enrollee who has undergone such procedures, even if they were not enrolled in that plan at the time of the original treatment

Exempts self-funded ERISA plans from the requirements; allows state agencies to delay implementation if federal waivers are needed

Takes effect September 1, 2025, with coverage requirements applying to plans delivered, issued, or renewed on or after January 1, 2026; passed Senate 20-11 on April 24, 2025, and House 87-58 on May 12, 2025