Health Care Conscience Rights Act - Amends title I of the Patient Protection and Affordable Care Act to declare that nothing in such title shall require an individual to purchase individual health insurance coverage that includes coverage of an abortion or other item or service to which the individual has a moral or religious objection, or prevent an issuer from offering or issuing, to that individual, individual coverage excluding such item or service.
Makes similar denials about requiring a sponsor to sponsor, purchase, or provide such coverage, or a health insurance issuer or group health plan sponsor to cover an abortion or other item or service to which the sponsor or issuer has a moral or religious objection.
Denies also that such title authorizes imposition of a tax, penalty, fee, fine, or other sanction, or imposition of coverage of such an item or service, in relation to health insurance coverage or a group health plan that excludes such an item or service.
Amends the Public Health Service Act to codify the prohibition against any action by the federal government and any state or local government receiving federal financial assistance to subject a health professional, a hospital, a provider-sponsored organization, a health maintenance organization, an accountable care organization, a health insurance plan, or any other kind of health care facility, organization, or plan to discrimination on the basis that the entity refuses to participate in abortion-related activities.
Requires the Secretary of Health and Human Services to designate the Director of the Office for Civil Rights of the Department of Health and Human Services (HHS) to receive and investigate complaints alleging a violation of abortion discrimination prohibition.
Creates a cause of action for the Attorney General or any person or entity adversely affected to obtain equitable or legal relief for any violation of this abortion discrimination prohibition. Allows commencement of an action to be commenced and the granting of relief without a prerequisite pursuit of administrative remedies. Allows such an action against a federal or state governmental entity.
[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[S. 1204 Introduced in Senate (IS)]
113th CONGRESS
1st Session
S. 1204
To amend the Patient Protection and Affordable Care Act to protect
rights of conscience with regard to requirements for coverage of
specific items and services, to amend the Public Health Service Act to
prohibit certain abortion-related discrimination in governmental
activities, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
June 20, 2013
Mr. Coburn (for himself and Mrs. Fischer) introduced the following
bill; which was read twice and referred to the Committee on Health,
Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To amend the Patient Protection and Affordable Care Act to protect
rights of conscience with regard to requirements for coverage of
specific items and services, to amend the Public Health Service Act to
prohibit certain abortion-related discrimination in governmental
activities, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Health Care Conscience Rights Act''.
SEC. 2. FINDINGS.
Congress finds as follows:
(1) As Thomas Jefferson declared to New London Methodists
in 1809, ``[n]o provision in our Constitution ought to be
dearer to man than that which protects the rights of conscience
against the enterprises of the civil authority''.
(2) Jefferson's conviction on respect for conscience is
deeply embedded in the history and traditions of our Nation,
and codified in numerous Federal laws approved by congressional
majorities and Presidents of both parties, including in the
Public Health Service Act (42 U.S.C. 201 et seq.); the United
States Leadership Against HIV/AIDS, Tuberculosis, and Malaria
Act of 2003 (22 U.S.C. 7601 et seq.); the Religious Freedom
Restoration Act of 1993 (42 U.S.C. 2000bb et seq.);
longstanding provisions on respect for conscience rights in the
Federal Employees Health Benefits Program and District of
Columbia appropriations; and laws to protect individuals from
being forced to participate in Federal executions or
prosecutions.
(3) Following enactment of the Patient Protection and
Affordable Care Act (Public Law 111-148, in this section
referred to as ``PPACA''), the Federal Government has sought to
impose specific requirements that infringe on the rights of
conscience of those who offer or purchase health coverage.
(4) While PPACA provides an exemption for some religious
groups that object to participation in health insurance
generally, and exempts millions of Americans from most of the
Act's provisions, including the preventive services mandate, it
fails to provide statutory protection for those seeking to
offer or to purchase health coverage who have a religious or
moral objection only to specific items or services.
(5) Nurses and other health care providers have
increasingly been subjected to discrimination for abiding by
their conscience rather than providing, paying for, or
referring for abortion.
(6) Conscience rights protections for health care providers
are an important part of civil rights protections in Federal
law and are indispensable to the continued viability of the
health care system in the United States. The increasingly
significant discrimination suffered by faith-based nonprofit
health care providers risks undermining access to high-quality
compassionate care for some of the most vulnerable populations
in our country.
SEC. 3. APPLYING LONGSTANDING POLICY ON CONSCIENCE RIGHTS TO THE
AFFORDABLE CARE ACT.
(a) In General.--Title I of the Patient Protection and Affordable
Care Act (Public Law 111-148) is amended--
(1) by redesignating the second section 1563 (relating to
conforming amendments and as redesignated by section
10107(b)(1) of the Patient Protection and Affordable Care Act)
as section 1564;
(2) by redesignating the third section 1563 (relating to
the Sense of the Senate promoting fiscal responsibility) as
section 1565; and
(3) by adding at the end the following new section:
``SEC. 1566. RESPECTING CONSCIENCE RIGHTS IN HEALTH COVERAGE.
``(a) In General.--Notwithstanding any other provision of this
title, no provision of this title (and no amendment made by this title)
shall--
``(1) require an individual to purchase individual health
insurance coverage that includes coverage of an abortion or
other item or service to which such individual has a moral or
religious objection, or prevent an issuer from offering or
issuing, to such individual, individual health insurance
coverage that excludes such item or service;
``(2) require a sponsor (or, in the case of health
insurance coverage offered to students through an institution
of higher education, the institution of higher education
offering such coverage) to sponsor, purchase, or provide any
health benefits coverage or group health plan that includes
coverage of an abortion or other item or service to which such
sponsor or institution, respectively, has a moral or religious
objection, or prevent an issuer from offering or issuing to
such sponsor or institution, respectively, health insurance
coverage that excludes such item or service;
``(3) require an issuer of health insurance coverage or the
sponsor of a group health plan to include, in any such coverage
or plan, coverage of an abortion or other item or service to
which such issuer or sponsor has a moral or religious
objection; or
``(4) authorize the imposition of a tax, penalty, fee,
fine, or other sanction, or the imposition of coverage of the
item or service to which there is a moral or religious
objection, in relation to health insurance coverage or a group
health plan that excludes an item or service pursuant to this
section.
``(b) Restriction on Contrary Governmental Action.--No provision in
this title (or amendment made by this title) or law, regulation,
guideline or other governmental action that implements such provision
or amendment, or derives its authority therefrom, shall be given legal
effect to the extent that it violates this section.
``(c) No Effect on Other Laws.--Nothing in this section shall be
construed to preempt, modify, or otherwise have any effect on--
``(1) the Civil Rights Act of 1964;
``(2) the Americans with Disabilities Act of 1990;
``(3) the Pregnancy Discrimination Act of 1978;
``(4) the Mental Health Parity Act of 1996; or
``(5) any other State or Federal law, other than a
provision in this title (or an amendment made by this title) or
a law, regulation, guideline or other governmental action that
implements such provision or amendment or derives its authority
therefrom.
``(d) Aggregate Actuarial Value.--Nothing in this section shall be
construed to prohibit the Secretary from issuing regulations or other
guidance to ensure that health insurance coverage or group health plans
excluding abortion or other items or services under this section shall
have an aggregate actuarial value at least equivalent to that of health
insurance coverage or group health plans at the same level of coverage
that do not exclude such items or services.
``(e) Continued Application of Nondiscrimination Rules.--Nothing in
this section shall be construed to permit a health insurance issuer,
group health plan, or other health care provider to act in a manner
inconsistent with subparagraph (B) or (D) of section 1302(b)(4).''.
(b) Clerical Amendment.--The table of contents of the Patient
Protection and Affordable Care Act (Public Law 111-148) is amended--
(1) by striking the following items:
``1563. Conforming amendments.
``1563. Sense of the Senate promoting fiscal responsibility.'';
and
(2) by inserting after the item relating to the section
1563 relating to small business procurement the following
items:
``1564. Conforming amendments.
``1565. Sense of the Senate promoting fiscal responsibility.
``1566. Respecting conscience rights in health coverage.''.
SEC. 4. ABORTION NONDISCRIMINATION FOR HEALTH CARE PROVIDERS.
Section 245 of the Public Health Service Act (42 U.S.C. 238n) is
amended--
(1) in the section heading, by striking ``and licensing of
physicians'' and inserting ``, licensing, and practice of
physicians and other health care entities'';
(2) in subsection (a), by amending paragraph (1) to read as
follows:
``(1) the entity refuses--
``(A) to undergo training in the performance of
induced abortions;
``(B) to require or provide such training;
``(C) to perform, participate in, provide coverage
of, or pay for induced abortions; or
``(D) to provide referrals for such training or
such abortions;'';
(3) in subsection (b)(1), by striking ``standards'' and
inserting ``standard'';
(4) in subsection (c), by amending paragraphs (1) and (2)
to read as follows:
``(1) The term `financial assistance', with respect to a
government program, means governmental payments to cover the
cost of health care services or benefits, or other Federal
payments, grants, or loans to promote or otherwise facilitate
health-related activities.
``(2) The term `health care entity' includes an individual
physician or other health professional, a postgraduate
physician training program, a participant in a program of
training in the health professions, a hospital, a provider-
sponsored organization as defined in section 1855(d) of the
Social Security Act, a health maintenance organization, an
accountable care organization, an issuer of health insurance
coverage, any other kind of health care facility, organization,
or plan, and an entity that provides or authorizes referrals
for health care services.'';
(5) by adding at the end of subsection (c) the following
new paragraph:
``(4) The term `State or local government that receives
Federal financial assistance' includes any agency or other
governmental unit of a State or local government if such
government receives Federal financial assistance.'';
(6) by redesignating subsection (c) as subsection (d); and
(7) by inserting after subsection (b) the following new
subsection:
``(c) Administration.--The Secretary shall designate the Director
of the Office for Civil Rights of the Department of Health and Human
Services--
``(1) to receive complaints alleging a violation of this
section, section 1566 of the Patient Protection and Affordable
Care Act, or any of subsections (b) through (e) of section 401
of the Health Programs Extension Act of 1973; and
``(2) to pursue the investigation of such complaints, in
coordination with the Attorney General.''.
SEC. 5. REMEDIES FOR VIOLATIONS OF FEDERAL CONSCIENCE LAWS.
Title II of the Public Health Service Act (42 U.S.C. 202 et seq.)
is amended by inserting after section 245 the following:
``SEC. 245A. CIVIL ACTION FOR CERTAIN VIOLATIONS.
``(a) In General.--A qualified party may, in a civil action, obtain
appropriate relief with regard to a designated violation.
``(b) Definitions.--In this section--
``(1) the term `qualified party' means--
``(A) the Attorney General; or
``(B) any person or entity adversely affected by
the designated violation; and
``(2) the term `designated violation' means an actual or
threatened violation of section 245 of this Act, section 1566
of the Patient Protection and Affordable Care Act, or any of
subsections (b) through (e) of section 401 of the Health
Programs Extension Act of 1973.
``(c) Administrative Remedies Not Required.--An action under this
section may be commenced, and relief may be granted, without regard to
whether the party commencing the action has sought or exhausted
available administrative remedies.
``(d) Defendants in Actions Under This Section May Include
Governmental Entities as Well as Others.--
``(1) In general.--An action under this section may be
maintained against, among others, a party that is a Federal or
State governmental entity. Relief in an action under this
section may include money damages even if the defendant is such
a governmental entity.
``(2) Definition.--For the purposes of this subsection, the
term `State governmental entity' means a State, a local
government within a State, or any agency or other governmental
unit or authority of a State or of such a local government.
``(e) Nature of Relief.--The court shall grant--
``(1) all necessary equitable and legal relief, including,
where appropriate, declaratory relief and compensatory damages,
to prevent the occurrence, continuance, or repetition of the
designated violation and to compensate for losses resulting
from the designated violation; and
``(2) to a prevailing plaintiff, reasonable attorneys' fees
and litigation expenses as part of the costs.''.
<all>
Introduced in Senate
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
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