As committees of the 227th General Assembly (2026) of the Presbyterian Church (U.S.A.) prepare to meet online beginning June 22, several healthcare and employment-related issues are slated to be considered for a vote by the entire assembly.
As of March 22, overtures have yet to be assigned to committees, although the co-moderators of the 224th General Assembly (2024), Tony Larson and CeCe Armstrong, have announced committee leadership for the upcoming deliberations.
OVT-009: Supporting gender-affirming healthcare
An overture named “On Access to Healthcare” (OVT-009) calls on the assembly to: “Declare that the PC(USA) supports all individuals, including minors, to have access to all medically necessary, evidence-based gender-affirming healthcare.”
Presented to the General Assembly by Cherokee Presbytery with concurrence from Albany Presbytery, the overture’s rationale calls on the affirmation of POL-01 from the last GA, in which “gender identity” and “sexual orientation” were added to the list of those whom “[in] Christ, by the power of the Spirit, God unites persons through baptism.”
Related reading: “Amendment 24-A wins approval from a majority of presbyteries” by Gregg Brekke, Outlook reporting
The overture’s primary author, Dr. Lemuel Maxwell, an American Board of Pediatrics certified pediatrician since 1983, is a long-time advocate for LGBTQ+ healthcare who has promoted culturally competent care, including advocacy for transgender healthcare access, particularly for minors.
He hopes the overture will accompany and extend the PC(USA)’s expanded non-discrimination policy for gender identity and sexual orientation approved by General Assembly 224 and adopted by a supermajority of presbyteries last year.
“If we’re going to affirm gender identity, non-discrimination for gendered identity and sexual orientation, then we must extend that and include all aspects of life that every individual has, and that’s healthcare, civil rights — everything,” he said. “It must be there for those individuals to access, just like anybody else.”
Particularly worrisome for Maxwell is the conservative political movement’s focus on demonizing same-gender marriage and emphasis on transgender topics as a “sufficiently divisive issue to energize their base.”
Related reading: “Transgender teen’s testimony at GA challenges PC(USA) toward greater inclusivity” by Eric Ledermann, Outlook reporting
Puberty blockers are a critical intervention, Maxwell argues. They prevent transgender youth from experiencing the traumatic and often irreversible changes of a “wrong puberty” — when physical traits develop “that are the antithesis of their gender identity.”
Denying this care to transgender youth is a leading factor in suicide and mental health issues among this population and is a leading concern among physicians who have worked with transgender youth, said Maxwell.
2024 data from the Trevor Project supports this concern. The nonprofit found that 39% of LGBTQ+ young people seriously considered attempting suicide in the past year. For transgender and nonbinary youth, that number was roughly 50%. Compared to their peers, LGBTQ+ youth are four times more likely to attempt suicide.
This is a population that is being demonized and tortured essentially, and we need to support them. — Lemuel Maxwell
“I hope [the General Assembly] will approve [the overture] because it’s just very logical. This is a population that is being demonized and tortured essentially, and we need to support them,” said Maxwell. “It is really clear that we need to have as many organizations, large and small, coming to their support because what is happening is cruel and unusual punishment.”
OVT-028: Making participation in the Board of Pensions Medical Plan optional
Seeking to change the Book of Order section that specifies benefits to be provided to called ministers of Word and Sacrament, “On Removing Required Participation in the Board of Pensions Medical Plan” (OVT-028) asks to amend G-2.0804 so that a calling agency is still required to provide the income protection plan (pension) from the Board of Pensions, but is not required to purchase medical care from the Board of Pensions.
Saying the terms of call “may include participation in the [Board of Pensions] medical plan,” it goes on to say, “If a congregation and pastor elect not to participate in the medical benefits plan of the Presbyterian Church (U.S.A.), an acceptable alternative for medical coverage for the pastor and their family must be presented to the appropriate committee or commission of the presbytery for approval.”
Presented by the Presbytery of Santa Fe with concurrences from Genesee Valley Presbytery and Homestead Presbytery, the rationale for the overture, in part, says the new medical benefits plan from the Board of Pensions “has created a system that is rife with inequalities, and creates a system that places a great burden on pastors with families or churches which have pastors with families,” and, “seeks to offer a way to address those inequalities by giving pastors greater freedom and flexibility to find options that best suit their family’s needs.”
Related reading: “PC(USA) Board of Pensions announces pricing for new benefits structure” by Gregg Brekke, Outlook reporting
Seth Finch, pastor of Covenant Presbyterian Church in Albuquerque, New Mexico, is one of the overture’s primary authors. He said his family, which includes his wife, who works for the presbytery, found a health plan that would have saved $20,000 versus the Board of Pensions plan if purchased on the open market. He said this is a story replicated through the PC(USA), especially among pastors with families, as they encountered the new benefits structure that introduced new pricing for dependent care.
“One of the great frustrations we all experienced was that this was a very one-way communication. They had clearly made up their mind,” Finch said of the way in which the new pricing model was introduced to presbyteries and churches.
There are plenty of medical options out there that … treat you as a number. And I guess we all [hoped] that, being part of the church, we would experience a little bit more of a grace-filled approach …
“They were going to do this no matter how much pushback they got. And in the world that we live in, there are plenty of medical options out there that are going to treat you as a number. And I guess we all had a greater expectation that, being part of the church, we would experience a little bit more of a grace-filled approach to how they make decisions around medical care.”
It’s this mistrust, evident in the rollout of the current pricing structure and in subsequent meetings regarding OVT-028’s introduction, that gives Finch pause as he sees new subsidies being introduced by the Board of Pensions without a sustainable, long-term benefit for his family or the ministries he serves.
Related reading: “Board of Pensions announces additional support for pastors and families” — A press release from the Board of Pensions
“I understand that the Board of Pensions is doing the best they can with this,” he acknowledged. “And I don’t necessarily think this is malicious, but I do think there is a certain way in which this is what you would expect from a for-profit business and not what you would necessarily expect from an agency of the church.”
As the overture went to the Presbytery of Santa Fe for a vote, Finch noted a generational split – with older members voting against the change and younger members, who are feeling the financial implications of the new pricing structure, voting for it.
The Board of Pensions declined to comment on this article, noting its board of directors will vote on responses to overtures and that “staff do not comment independently” on them. Yet Finch said that in discussions with the Board of Pensions leadership, they told him, “They would expect that if, indeed, this goes forward, it may be the end of the medical program.”
Related reading: “Board of Pensions expands support for congregations and pastoral leaders” — A press release from the Board of Pensions
There’s no argument that even with expanding participation guidelines to include part-time employees, the number of people enrolled and the level of their premium contributions can’t match the level of past clergy participation when adjusted for current costs. It’s a tough-to-win situation, said Finch. He just hopes clergy and congregations can find a better solution than what’s currently being offered.
“I guess what I hope happens is a meaningful conversation about all those various possibilities and that the assembly does come forward with a real option that gives us a different way forward,” he said. “Because the way it is currently going is just not sustainable.”
Other considerations
Two overtures that have not yet received concurrences from another presbytery address administrative leave originated from the Presbytery of the Highlands of New Jersey.
“On Classification of Administrative Leave” (OVT-001) asks the assembly to amend section D-7.0905 of the Book of Order to include “when there are allegations of financial malfeasance, any criminal allegations, medical need, or any other causes specified in the council’s policy” as terms for a presbytery for establishing rules for administrative leave or other restrictions on a ministers service.
In its rationale, the amendment authors state the change maintains “the necessary function of administrative leave as currently found in Church Discipline, while providing new and needed flexibility for a presbytery to use that same instrument for matters such as pastoral care.”
“On Paid Administrative Leave” (OVT-015) asks the assembly to appoint a team of 12-15 “ruling and teaching elders to review the implications of D-7.0902b, which mandates that administrative leave be paid leave.”
Its rationale affirms the value of due process for ministers accused of misconduct, yet argues that without guidance, the implications of paid administrative leave in some situations “could prove devastating financially” to churches and presbyteries.
Without a concurrence by a second presbytery, these two overtures will not be referred to the General Assembly for consideration.
