under this subsection, the Director shall ensure that no multi-State qualified health plan offered in an Exchange provides health benefits coverage for which the expenditure of Federal funds is prohibited under chapter 4 of title 1, United States Code. . (c) Effective date The amendments made by subsection (a) shall apply to taxable years ending after the date that is one year after the date of enactment of this Act, but only with respect to plan years beginning after such date, and the amendment made by subsection (b) shall apply to plan years beginning after such date. IV Additional Provisions 401. Prohibition on institutions of higher education and accrediting agencies or associations (a) Prohibition on institutions of higher education Section 487(a) of the Higher Education Act of 1965 (20 U.S.C. 1094(a)) is amended by adding at the end the following: (30) The institution will not offer instruction in gender-affirming care (as defined in section 2260B of title 18, United States Code). . (b) Prohibition on accrediting agencies or associations Section 496(a) of the Higher Education Act of 1965 (20 U.S.C. 1099b(a)) is amended— (1) by striking and at the end of paragraph (7)