Women's Health Protection Act of 2023
This bill prohibits governmental restrictions on the provision of, and access to, abortion services.
Before fetal viability, governments may not restrict providers from
Furthermore, governments may not require providers to
Additionally, governments may not require patients to make medically unnecessary in-person visits before receiving abortion services or disclose their reasons for obtaining services.
After fetal viability, governments may not restrict providers from performing abortions when necessary to protect a patient's life and health. The same provisions that apply to abortions before viability also apply to necessary abortions after viability. Additionally, states may authorize post-viability abortions in circumstances beyond those that the bill considers necessary.
Further, the bill recognizes an individual's right to interstate travel, including for abortion services.
The bill also prohibits governments from implementing measures that are similar to those restricted by the bill or that otherwise single out and impede access to abortion services, unless the measure significantly advances the safety of abortion services or health of patients and cannot be achieved through less restrictive means.
The Department of Justice, individuals, or providers may sue states or government officials to enforce this bill, regardless of certain immunity that would otherwise apply.
[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 12 Introduced in House (IH)]
<DOC>
118th CONGRESS
1st Session
H. R. 12
To protect a person's ability to determine whether to continue or end a
pregnancy, and to protect a health care provider's ability to provide
abortion services.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 30, 2023
Ms. Chu (for herself, Ms. Adams, Mr. Aguilar, Mr. Allred, Mr.
Auchincloss, Ms. Balint, Ms. Barragan, Mrs. Beatty, Mr. Bera, Mr.
Beyer, Mr. Blumenauer, Ms. Blunt Rochester, Ms. Bonamici, Mr. Bowman,
Ms. Brown, Ms. Brownley, Ms. Budzinski, Ms. Bush, Ms. Caraveo, Mr.
Carbajal, Mr. Cardenas, Mr. Carson, Mr. Carter of Louisiana, Mr.
Cartwright, Mr. Casar, Mr. Casten, Ms. Castor of Florida, Mr. Castro of
Texas, Mr. Cicilline, Ms. Clarke of New York, Mr. Cleaver, Mr. Cohen,
Mr. Connolly, Mr. Courtney, Ms. Craig, Ms. Crockett, Mr. Crow, Ms.
Davids of Kansas, Mr. Davis of Illinois, Ms. Dean of Pennsylvania, Ms.
DeGette, Ms. DeLauro, Ms. DelBene, Mr. Deluzio, Mr. DeSaulnier, Mrs.
Dingell, Mr. Doggett, Ms. Escobar, Mr. Espaillat, Mr. Evans, Mrs.
Fletcher, Mr. Foster, Ms. Lois Frankel of Florida, Mr. Frost, Mr.
Garamendi, Ms. Garcia of Texas, Mr. Robert Garcia of California, Mr.
Garcia of Illinois, Ms. Perez, Mr. Goldman of New York, Mr. Gomez, Mr.
Gottheimer, Mr. Green of Texas, Mr. Grijalva, Mr. Himes, Mr. Horsford,
Ms. Houlahan, Ms. Hoyle of Oregon, Mr. Huffman, Mr. Ivey, Mr. Jackson
of North Carolina, Ms. Jackson Lee, Ms. Jacobs, Ms. Jayapal, Mr.
Jeffries, Ms. Kamlager-Dove, Ms. Kelly of Illinois, Mr. Khanna, Mr.
Kildee, Mr. Kilmer, Mr. Krishnamoorthi, Ms. Kuster, Mr. Larsen of
Washington, Mr. Larson of Connecticut, Mrs. Lee of Nevada, Ms. Lee of
California, Ms. Lee of Pennsylvania, Mr. Levin, Mr. Lieu, Ms. Lofgren,
Mr. Lynch, Mr. Magaziner, Ms. Manning, Ms. Matsui, Mrs. McBath, Mrs.
McClellan, Ms. McCollum, Mr. McGovern, Mr. Gallego, Mr. Meeks, Ms.
Meng, Ms. Moore of Wisconsin, Mr. Morelle, Mr. Moskowitz, Mr. Moulton,
Mr. Mrvan, Mr. Mullin, Mr. Nadler, Mrs. Napolitano, Mr. Neal, Mr.
Nickel, Mr. Norcross, Ms. Norton, Ms. Omar, Mr. Pallone, Mr. Panetta,
Mr. Pascrell, Mr. Payne, Ms. Pelosi, Mr. Peters, Ms. Pettersen, Ms.
Pingree, Mr. Pocan, Ms. Porter, Ms. Pressley, Mr. Quigley, Mr. Raskin,
Mr. Thanedar, Ms. Ross, Mr. Ruppersberger, Mr. Ryan, Ms. Salinas, Ms.
Sanchez, Mr. Sarbanes, Ms. Scanlon, Ms. Schakowsky, Mr. Schiff, Mr.
Schneider, Ms. Schrier, Mr. Scott of Virginia, Ms. Sewell, Mr. Sherman,
Ms. Sherrill, Ms. Slotkin, Mr. Smith of Washington, Mr. Sorensen, Ms.
Stansbury, Mr. Stanton, Ms. Stevens, Ms. Strickland, Mr. Swalwell, Mrs.
Sykes, Mr. Takano, Mr. Thompson of California, Mr. Thompson of
Mississippi, Ms. Titus, Ms. Tlaib, Ms. Tokuda, Mr. Tonko, Mrs. Torres
of California, Mr. Torres of New York, Mrs. Trahan, Mr. Trone, Ms.
Underwood, Ms. Velazquez, Ms. Wasserman Schultz, Mrs. Watson Coleman,
Ms. Wexton, Ms. Wild, Ms. Williams of Georgia, Ms. Wilson of Florida,
Mrs. Hayes, Mr. Mfume, Mr. Johnson of Georgia, Mr. Kim of New Jersey,
Mr. Costa, Ms. Leger Fernandez, Ms. Clark of Massachusetts, Ms. Eshoo,
Mr. Vasquez, Ms. Spanberger, Mr. Landsman, Mr. Keating, Mrs. Foushee,
Mr. Menendez, Mr. Hoyer, Mr. Boyle of Pennsylvania, Mr. Soto, Ms.
Ocasio-Cortez, Mr. Phillips, Ms. Plaskett, Mr. Golden of Maine, Mr.
McGarvey, Mr. Ruiz, Ms. Scholten, Mrs. Peltola, Ms. Kaptur, Mr. Case,
Mr. Neguse, Mr. Bishop of Georgia, Mr. Jackson of Illinois, Ms. Waters,
Mr. Vargas, Mrs. Ramirez, Mr. Clyburn, Mr. Veasey, and Mr. Correa)
introduced the following bill; which was referred to the Committee on
Energy and Commerce, and in addition to the Committee on the Judiciary,
for a period to be subsequently determined by the Speaker, in each case
for consideration of such provisions as fall within the jurisdiction of
the committee concerned
_______________________________________________________________________
A BILL
To protect a person's ability to determine whether to continue or end a
pregnancy, and to protect a health care provider's ability to provide
abortion services.
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 ``Women's Health Protection Act of
2023''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) Abortion services are essential health care, and access
to those services is central to people's ability to participate
equally in the economic and social life of the United States.
Abortion access allows people who are pregnant to make their
own decisions about their pregnancies, their families, and
their lives.
(2) Reproductive justice requires every individual to have
the right to make their own decisions about having children
regardless of their circumstances and without interference and
discrimination. Reproductive justice is a human right that can
and will be achieved when all people, regardless of actual or
perceived race, color, national origin, immigration status, sex
(including gender identity, sex stereotyping, or sexual
orientation), age, or disability status have the economic,
social, and political power and resources to define and make
decisions about their bodies, health, sexuality, families, and
communities in all areas of their lives, with dignity and self-
determination.
(3) Abortion care, like all health care, is a human right
that should not depend on one's ZIP Code or region, age, actual
or perceived race, national origin, immigration status, sex, or
disability status. Unfortunately, this is the current reality
for millions, creating a patchwork of abortion access across
the United States. Protecting the right to determine whether to
continue or end a pregnancy, and the right of health care
providers to provide abortion care, is necessary and essential
to achieving this human right, and ultimately reproductive
justice.
(4) On June 24, 2022, in its decision in Dobbs v. Jackson
Women's Health Organization, the Supreme Court overruled Roe v.
Wade, reversing decades of precedent recognizing a
constitutional right to terminate a pregnancy before fetal
viability.
(5) The effects of the Dobbs decision were immediate and
disastrous. In the aftermath of the Dobbs decision, many States
imposed near-total bans on abortion. As of March 2023, abortion
is unavailable in 14 States, leaving 17.8 million women of
reproductive age (15-49) and transgender and gender
nonconforming individuals with the capacity to become pregnant
without abortion access in their home State. Within 100 days of
the ruling, 66 clinics across 15 States were forced to stop
offering abortions.
(6) Travel time to an abortion clinic, already a burden for
abortion seekers under Roe, has more than tripled since Dobbs.
As distance to an abortion facility increases, so do the
accompanying (and potentially prohibitive) burdens of time off
work or school, lost wages, transportation costs, lodging,
child care costs, and other ancillary costs.
(7) Even before the Dobbs decision, access to abortion
services had long been obstructed across the United States in
various ways, including: prohibitions of, and restrictions on,
insurance coverage; mandatory parental involvement laws;
restrictions that shame and stigmatize people seeking abortion
services; and medically unnecessary regulations that fail to
further the safety of abortion services, but instead cause harm
people by delaying, complicating access to, and reducing the
availability of, abortion services.
(8) Being denied an abortion can have serious consequences
for people's physical, mental, and economic health and well-
being, and that of their families. According to the Turnaway
Study, a longitudinal study published by Advancing New
Standards In Reproductive Health (ANSIRH) in 2019, individuals
who are denied a wanted abortion are more likely to experience
economic insecurity than individuals who receive a wanted
abortion. After following participants for five years, the
study found that people who were denied abortion care were more
likely to live in poverty, experience debt, and have lower
credit scores for several years after the denial. These
findings demonstrate that when people have control over when to
have children and how many children to have, their children
benefit through increased economic security and better maternal
bonding.
(9) Abortion bans and restrictions have repercussions for a
broad range of health care beyond pregnancy termination,
including exacerbating the existing maternal health crisis
facing the United States. The United States has the highest
maternal mortality rate of any industrialized nations, and
Black women and birthing people face three times the risk of
dying from pregnancy related causes as their white
counterparts. Even prior to Dobbs, research found that States
that enacted abortion restrictions based on gestation increased
their maternal mortality rate by 38 percent. Research has found
that a nationwide ban would increase the United States maternal
mortality rate by an additional 24 percent. Furthermore, States
that have banned, are planning to ban, or have severely
restricted abortion care have fewer maternal health providers,
more maternity care deserts, higher rates of both maternal and
infant mortality, and greater racial inequity in health care.
(10) Abortion bans and restrictions additionally harm
people's health by reducing access to other essential health
care services offered by many of the providers targeted by the
restrictions, including--
(A) screenings and preventive services, including
contraceptive services;
(B) testing and treatment for sexually transmitted
infections;
(C) LGBTQ health services; and
(D) referrals for primary care, intimate partner
violence prevention, prenatal care, and adoption
services.
(11) This ripple effect has only worsened since the Dobbs
decision. Clinicians and pharmacists have denied access to
essential medication for conditions including gastric ulcers
and autoimmune diseases because those drugs are also used for
medication abortion care. Patients are reporting being denied
or delayed in their receipt of necessary and potentially
lifesaving treatment for ectopic pregnancies and miscarriage
management because of the newfound legal risks facing
providers.
(12) Reproductive justice seeks to address restrictions on
reproductive health, including abortion, that perpetuate
systems of oppression, lack of bodily autonomy, white
supremacy, and anti-Black racism. This violent legacy has
manifested in policies including enslavement, rape, and
experimentation on Black women; forced sterilizations, medical
experimentation on low-income women's reproductive systems; and
the forcible removal of Indigenous children. Access to
equitable reproductive health care, including abortion
services, has always been deficient in the United States for
Black, Indigenous, Latina/x, Asian American and Pacific
Islander, and People of Color (BIPOC) and their families.
(13) The legacy of restrictions on reproductive health,
rights, and justice is not a dated vestige of a dark history.
Data show the harms of abortion-specific restrictions fall
especially heavily on people with low incomes, people of color,
immigrants, young people, people with disabilities, and those
living in rural and other medically underserved areas. Abortion
bans and restrictions are compounded further by the ongoing
criminalization of people who are pregnant, including those who
are incarcerated, living with HIV, or with substance-use
disorders. These populations already experience health
disparities due to social, political, and environmental
inequities, and restrictions on abortion services exacerbate
these harms. Removing bans and restrictions on abortion
services would constitute one important step on the path toward
realizing reproductive justice by ensuring that the full range
of reproductive health care is accessible to all who need it.
(14) Abortion bans and restrictions are tools of gender
oppression, as they target health care services that are used
primarily by women. These paternalistic bans and restrictions
rely on and reinforce harmful stereotypes about gender roles
and women's decisionmaking, undermining their ability to
control their own lives and well-being. These restrictions harm
the basic autonomy, dignity, and equality of women.
(15) The terms ``woman'' and ``women'' are used in this
bill to reflect the identity of the majority of people targeted
and most directly affected by bans and restrictions on abortion
services, which are rooted in misogyny. However, access to
abortion services is critical to the health of every person
capable of becoming pregnant. This Act is intended to protect
all people with the capacity for pregnancy--cisgender women,
transgender men, nonbinary individuals, those who identify with
a different gender, and others--who are unjustly harmed by
restrictions on abortion services.
(16) Pregnant individuals will continue to experience a
range of pregnancy outcomes, including abortion, miscarriage,
stillbirths, and infant losses regardless of how the State
attempts to exert power over their reproductive decisionmaking,
and will continue to need support for their health and well-
being through their reproductive lifespans.
(17) Evidence from the United States and around the globe
bears out that criminalizing abortion invariably leads to
arrests, investigations, and imprisonment of people who end
their pregnancies or experience pregnancy loss, leading to
violations of fundamental rights to liberty, dignity, bodily
autonomy, equality, due process, privacy, health, and freedom
from cruel and inhumane treatment.
(18) All major experts in public health and medicine such
as the American Medical Association, American Public Health
Association, American Academy of Pediatrics, American Society
of Addiction Medicine, and the American College of
Obstetricians and Gynecologists, oppose the criminalization of
pregnancy outcomes because the threat of being subject to
investigation or punishment through the criminal legal system
when seeking health care threatens pregnant people's lives and
undermines public health by deterring people from seeking care
for obstetrical emergencies.
(19) Antiabortion stigma that is compounded by abortion
bans and restrictions also contributes to violence and
harassment that put both people seeking and people providing
abortion care at risk. From 1977 to 2021, there were 11
murders, 42 bombings, 196 acts of arson, 491 assaults, and
thousands of other incidents of criminal activity directed at
abortion seekers, providers, volunteers, and clinic staff. This
violence existed under Roe and has been steadily escalating for
years. The presence of dangerous protestors and organized
extremists acts as yet another barrier to abortion care, and
this threat has become even more urgent as abortion bans
proliferate and stigma around abortion care increases.
(20) Abortion is one of the safest medical procedures in
the United States. An independent, comprehensive review of the
state of science on the safety and quality of abortion
services, published by the National Academies of Sciences,
Engineering, and Medicine in 2018, found that abortion in the
United States is safe and effective and that the biggest
threats to the quality of abortion services in the United
States are State regulations that create barriers to care. Such
abortion-specific restrictions, as well as broader State bans,
conflict with medical standards and are not supported by the
recommendations and guidelines issued by leading reproductive
health care professional organizations including the American
College of Obstetricians and Gynecologists, the Society of
Family Planning, the National Abortion Federation, the World
Health Organization, and others.
(21) For over 20 years, medication abortion care has been
available in the United States as a safe, effective, Food and
Drug Administration (FDA)-approved treatment to end an early
pregnancy. Today, medication abortion care accounts for more
than half of all pregnancy terminations in the United States;
however, significant barriers to access remain in place,
particularly in States that have imposed onerous restrictions
that conflict with FDA's regulation of medication abortion.
Additionally, opponents of abortion are now deploying new
tactics to limit access to this FDA-approved medication that
would set a dangerous precedent for the Federal regulation of
medication products and have national repercussions.
(22) Health care providers are subject to licensing laws in
various jurisdictions, which are not affected by this Act
except as expressly provided in this Act.
(23) International human rights law recognizes that access
to abortion is intrinsically linked to the rights to life,
health, equality and nondiscrimination, privacy, and freedom
from ill treatment. United Nations (UN) human rights treaty
monitoring bodies have found that legal abortion services, like
other reproductive health care services, must be available,
accessible, affordable, acceptable, and of good quality. UN
human rights treaty bodies have condemned criminalization of
abortion and medically unnecessary barriers to abortion
services, including mandatory waiting periods, biased
counseling requirements, and third-party authorization
requirements.
(24) Core human rights treaties ratified by the United
States protect access to abortion. For example, in 2018, the UN
Human Rights Committee, which oversees implementation of the
International Covenant on Civil and Political Rights (ICCPR),
made clear that the right to life, enshrined in Article 6 of
the ICCPR, at a minimum requires governments to provide safe,
legal, and effective access to abortion where a person's life
and health are at risk, or when carrying a pregnancy to term
would otherwise cause substantial pain or suffering. The
Committee stated that governments must not impose restrictions
on abortion which subject women and girls to physical or mental
pain or suffering, discriminate against them, arbitrarily
interfere with their privacy, or place them at risk of
undertaking unsafe abortions. The Committee stated that
governments should not apply criminal sanctions to women and
girls who undergo abortion or to medical service providers who
assist them in doing so. Furthermore, the Committee stated that
governments should remove existing barriers that deny effective
access to safe and legal abortion, refrain from introducing new
barriers to abortion, and prevent the stigmatization of those
seeking abortion.
(25) International human rights experts have condemned the
Dobbs decision and regression on abortion rights in the United
States more generally as a violation of human rights.
Immediately upon release of the decision, then-UN High
Commissioner for Human Rights Michelle Bachelet reiterated
human rights protections for abortion and the impact that the
decision will have on the fundamental rights of millions within
the United States, particularly people with low incomes and
people belonging to racial and ethnic minorities. UN
independent human rights experts, including the UN Working
Group on discrimination against women and girls, the UN Special
Rapporteur on the right to health, and the UN Special
Rapporteur on violence against women and girls, similarly
denounced the decision. At the conclusion of a human rights
review of the United States in August 2022, the UN Committee on
the Elimination of Racial Discrimination noted deep concerns
with the Dobbs decision and recommended that the United States
address the disparate impact that it will have on racial and
ethnic minorities, Indigenous women, and those with low
incomes.
(26) Abortion bans and restrictions affect the cost and
availability of abortion services, and the settings in which
abortion services are delivered. People travel across State
lines and otherwise engage in interstate commerce to access
this essential medical care. Likewise, health care providers
travel across State lines and otherwise engage in interstate
commerce in order to provide abortion services to patients, and
more would be forced to do so absent this Act.
(27) Legal limitations and requirements imposed upon health
care providers or their patients invariably affect commerce
over which the United States has jurisdiction. Health care
providers engage in a form of economic and commercial activity
when they provide abortion services, and there is an interstate
market for abortion services.
(28) Abortion bans and restrictions substantially affect
interstate commerce in numerous ways. For example, to provide
abortion services, health care providers engage in interstate
commerce to purchase medicine, medical equipment, and other
necessary goods and services. To provide and assist others in
providing abortion services, health care providers engage in
interstate commerce to obtain and provide training. To provide
abortion services, health care providers employ and obtain
commercial services from doctors, nurses, and other personnel
who engage in interstate commerce, including by and traveling
across State lines.
(29) Congress has the authority to enact this Act to
protect access to abortion services pursuant to--
(A) its powers under the commerce clause of section
8 of article I of the Constitution of the United
States;
(B) its powers under section 5 of the Fourteenth
Amendment to the Constitution of the United States to
enforce the provisions of section 1 of the Fourteenth
Amendment; and
(C) its powers under the necessary and proper
clause of section 8 of article I of the Constitution of
the United States.
(30) Congress has used its authority in the past to protect
access to abortion services and health care providers' ability
to provide abortion services. In the early 1990s, protests and
blockades at health care facilities where abortion services
were provided, and associated violence, increased dramatically
and reached crisis level, requiring congressional action.
Congress passed the Freedom of Access to Clinic Entrances Act
(Public Law 103-259; 108 Stat. 694) to address that situation
and protect physical access to abortion services.
(31) Congressional action is necessary to put an end to
harmful restrictions, to protect access to abortion services
for everyone regardless of where they live, to protect the
ability of health care providers to provide these services in a
safe and accessible manner, and to eliminate unwarranted
burdens on commerce and the right to travel.
SEC. 3. PURPOSE.
The purposes of this Act are as follows:
(1) To permit people to seek and obtain abortion services,
and to permit health care providers to provide abortion
services, without harmful or unwarranted limitations or
requirements that single out the provision of abortion services
for restrictions that are more burdensome than those
restrictions imposed on medically comparable procedures, do not
significantly advance reproductive health or the safety of
abortion services, or make abortion services more difficult to
access.
(2) To promote access to abortion services and thereby
protect women's ability to participate equally in the economic
and social life of the United States.
(3) To protect people's ability to make decisions about
their bodies, medical care, family, and life's course.
(4) To eliminate unwarranted burdens on commerce and the
right to travel. Abortion bans and restrictions invariably
affect commerce over which the United States has jurisdiction.
Health care providers engage in economic and commercial
activity when they provide abortion services. Moreover, there
is an interstate market for abortion services and, in order to
provide such services, health care providers engage in
interstate commerce to purchase medicine, medical equipment,
and other necessary goods and services; to obtain and provide
training; and to employ and obtain commercial services from
health care personnel, many of whom themselves engage in
interstate commerce, including by traveling across State lines.
Congress has the authority to enact this Act to protect access
to abortion services pursuant to--
(A) its powers under the commerce clause of section
8 of article I of the Constitution of the United
States;
(B) its powers under section 5 of the Fourteenth
Amendment to the Constitution of the United States to
enforce the provisions of section 1 of the Fourteenth
Amendment; and
(C) its powers under the necessary and proper
clause of section 8 of article I of the Constitution of
the United States.
SEC. 4. DEFINITIONS.
In this Act:
(1) Abortion services.--The term ``abortion services''
means an abortion and any medical or non-medical services
related to and provided in conjunction with an abortion
(whether or not provided at the same time or on the same day as
the abortion).
(2) Government.--The term ``government'' includes each
branch, department, agency, instrumentality, and official of
the United States or a State.
(3) Health care provider.--The term ``health care
provider'' means any entity (including any hospital, clinic, or
pharmacy) or individual (including any physician, certified
nurse-midwife, nurse practitioner, pharmacist, or physician
assistant) that--
(A) is engaged or seeks to engage in the delivery
of health care services, including abortion services;
and
(B) if required by law or regulation to be licensed
or certified to engage in the delivery of such
services--
(i) is so licensed or certified; or
(ii) would be so licensed or certified but
for their past, present, or potential provision
of abortion services protected by section 4.
(4) Medically comparable procedures.--The term ``medically
comparable procedures'' means medical procedures that are
similar in terms of health and safety risks to the patient,
complexity, or the clinical setting that is indicated.
(5) Pregnancy.--The term ``pregnancy'' refers to the period
of the human reproductive process beginning with the
implantation of a fertilized egg.
(6) State.--The term ``State'' includes the District of
Columbia, the Commonwealth of Puerto Rico, and each territory
and possession of the United States, and any subdivision of any
of the foregoing, including any unit of local government, such
as a county, city, town, village, or other general purpose
political subdivision of a State.
(7) Viability.--The term ``viability'' means the point in a
pregnancy at which, in the good-faith medical judgment of the
treating health care provider, and based on the particular
facts of the case before the health care provider, there is a
reasonable likelihood of sustained fetal survival outside the
uterus with or without artificial support.
SEC. 5. PROTECTED ACTIVITIES AND SERVICES.
(a) General Rules.--
(1) Pre-viability.--A health care provider has a right
under this Act to provide abortion services, and a patient has
a corresponding right under this Act to terminate a pregnancy
prior to viability without being subject to any of the
following limitations or requirements:
(A) A prohibition on abortion prior to viability,
including a prohibition or restriction on a particular
abortion procedure or method, or a prohibition on
providing or obtaining such abortions.
(B) A limitation on a health care provider's
ability to prescribe or dispense drugs that could be
used for reproductive health purposes based on current
evidence-based regimens or the provider's good-faith
medical judgment, or a limitation on a patient's
ability to receive or use such drugs, other than a
limitation generally applicable to the prescription,
dispensing, or distribution of drugs.
(C) A limitation on a health care provider's
ability to provide, or a patient's ability to receive,
abortion services via telemedicine, other than a
limitation generally applicable to the provision of
medically comparable services via telemedicine.
(D) A limitation or prohibition on a patient's
ability to receive, or a provider's ability to provide,
abortion services in a State based on the State of
residency of the patient, or a prohibition or
limitation on the ability of any individual to assist
or support a patient seeking abortion.
(E) A requirement that a health care provider
perform specific tests or medical procedures in
connection with the provision of abortion services
(including prior to or subsequent to the abortion),
unless generally required for the provision of
medically comparable procedures.
(F) A requirement that a health care provider offer
or provide a patient seeking abortion services
medically inaccurate information.
(G) A limitation or requirement concerning the
physical plant, equipment, staffing, or hospital
transfer arrangements of facilities where abortion
services are provided, or the credentials or hospital
privileges or status of personnel at such facilities,
that is not imposed on facilities or the personnel of
facilities where medically comparable procedures are
performed.
(H) A requirement that, prior to obtaining an
abortion, a patient make one or more medically
unnecessary in-person visits to the provider of
abortion services or to any individual or entity that
does not provide abortion services.
(I) A limitation on a health care provider's
ability to provide immediate abortion services when
that health care provider believes, based on the good-
faith medical judgment of the provider, that delay
would pose a risk to the patient's life or health.
(J) A requirement that a patient seeking abortion
services at any point or points in time prior to
viability disclose the patient's reason or reasons for
seeking abortion services, or a limitation on providing
or obtaining abortion services at any point or points
in time prior to viability based on any actual,
perceived, or potential reason or reasons of the
patient for obtaining abortion services, regardless of
whether the limitation is based on a health care
provider's actual or constructive knowledge of such
reason or reasons.
(2) Post-viability.--
(A) In general.--A health care provider has a right
under this Act to provide abortion services and a
patient has a corresponding right under this Act to
terminate a pregnancy after viability when, in the
good-faith medical judgement of the treating health
care provider, it is necessary to protect the life or
health of the patient. This subparagraph shall not
otherwise apply after viability.
(B) Additional circumstances.--A State may provide
additional circumstances under which post viability
abortions are permitted under this paragraph.
(C) Limitation.--In the case where a termination of
a pregnancy after viability, in the good-faith medical
judgement of the treating health care provider, is
necessary to protect the life or health of the patient,
a State shall not impose any of the limitations or
requirements described in paragraph (1).
(b) Other Limitations or Requirements.--The rights described in
subsection (a) shall not be limited or otherwise infringed through any
other limitation or requirement that--
(1) expressly, effectively, implicitly, or as implemented,
singles out abortion, the provision of abortion services,
individuals who seek abortion services or who provide
assistance and support to those seeking abortion services,
health care providers who provide abortion services, or
facilities in which abortion services are provided; and
(2) impedes access to abortion services.
(c) Factors for Consideration.--A court may consider the following
factors, among others, in determining whether a limitation or
requirement impedes access to abortion services for purposes of
subsection (b)(2):
(1) Whether the limitation or requirement, in a provider's
good-faith medical judgment, interferes with a health care
provider's ability to provide care and render services, or
poses a risk to the patient's health or safety.
(2) Whether the limitation or requirement is reasonably
likely to delay or deter a patient in accessing abortion
services.
(3) Whether the limitation or requirement is reasonably
likely to directly or indirectly increase the cost of providing
abortion services or the cost for obtaining abortion services
such as costs associated with travel, childcare, or time off
work.
(4) Whether the limitation or requirement is reasonably
likely to have the effect of necessitating patient travel that
would not otherwise have been required, including by making it
necessary for a patient to travel out of State to obtain
services.
(5) Whether the limitation or requirement is reasonably
likely to result in a decrease in the availability of abortion
services in a given State or geographic region.
(6) Whether the limitation or requirement imposes penalties
that are not imposed on other health care providers for
comparable conduct or failure to act, or that are more severe
than penalties imposed on other health care providers for
comparable conduct or failure to act.
(7) The cumulative impact of the limitation or requirement
combined with other limitations or requirements.
(d) Exception.--To defend against a claim that a limitation or
requirement violates a health care provider's or patient's rights under
subsection (b) a party must establish, by clear and convincing
evidence, that the limitation or requirement is essential to
significantly advance the safety of abortion services or the health of
patients and that the safety or health objective cannot be accomplished
by a different means that does not interfere with the right protected
under subsection (b).
SEC. 6. PROTECTION OF THE RIGHT TO TRAVEL.
A person has a fundamental right under the Constitution of the
United States and this Act to travel to a State other than the person's
State of residence, including to obtain reproductive health services
such as prenatal, childbirth, fertility, and abortion services, and a
person has a right under this Act to assist another person to obtain
such services or otherwise exercise the right described in this
section.
SEC. 7. APPLICABILITY AND PREEMPTION.
(a) In General.--
(1) Superseding inconsistent laws.--Except as provided
under subsection (b), this Act shall supersede any inconsistent
Federal or State law, and the implementation of such law,
whether statutory, common law, or otherwise, and whether
adopted prior to or after the date of enactment of this Act. A
Federal or State government official shall not administer,
implement, or enforce any law, rule, regulation, standard, or
other provision having the force and effect of law that
conflicts with any provision of this Act, notwithstanding any
other provision of Federal law, including the Religious Freedom
Restoration Act of 1993 (42 U.S.C. 2000bb et seq.).
(2) Laws after date of enactment.--Federal law enacted
after the date of the enactment of this Act shall be subject to
this Act unless such law explicitly excludes such application
by reference to this Act.
(b) Limitations.--The provisions of this Act shall not supersede or
apply to--
(1) laws regulating physical access to clinic entrances;
(2) laws regulating insurance or medical assistance
coverage of abortion services;
(3) the procedure described in section 1531(b)(1) of title
18, United States Code; or
(4) generally applicable State contract law.
(c) Preemption Defense.--In any legal or administrative action
against a person or entity who has exercised or attempted to exercise a
right protected by section 4 or section 5 or against any person or
entity who has taken any step to assist any such person or entity in
exercising such right, this Act shall also apply to, and may be raised
as a defense by, such person or entity, in addition to the remedies
specified in section 8.
SEC. 8. RULES OF CONSTRUCTION.
(a) Liberal Construction by Courts.--In any action before a court
under this Act, the court shall liberally construe the provisions of
this Act to effectuate the purposes of the Act.
(b) Protection of Life and Health.--Nothing in this Act shall be
construed to authorize any government official to interfere with,
diminish, or negatively affect a person's ability to obtain or provide
abortion services prior to viability, or after viability when, in the
good-faith medical judgment of the treating health care provider,
continuation of the pregnancy would pose a risk to the pregnant
patient's life or health.
(c) Government Officials.--Any person who, by operation of a
provision of Federal or State law, is permitted to implement or enforce
a limitation or requirement that violates section 4 or 5 shall be
considered a government official for purposes of this Act.
SEC. 9. ENFORCEMENT.
(a) Attorney General.--The Attorney General may commence a civil
action on behalf of the United States in any district court of the
United States against any State that violates, or against any
government official (including a person described in section 7(c)) who
implements or enforces a limitation or requirement that violates,
section 4 or 5. The court shall declare unlawful the limitation or
requirement if it is determined to be in violation of this Act.
(b) Private Right of Action.--
(1) In general.--Any individual or entity adversely
affected by an alleged violation of this Act, including any
person or health care provider, may commence a civil action
against any government official (including a person described
in section 7(c)) that implements or enforces a limitation or
requirement that violates, section 4 or 5. The court shall
declare unlawful the limitation or requirement if it is
determined to be in violation of this Act.
(2) Health care provider.--A health care provider may
commence an action for relief on its own behalf, on behalf of
the provider's staff, and on behalf of the provider's patients
who are or may be adversely affected by an alleged violation of
this Act.
(c) Pre-Enforcement Challenges.--A suit under subsection (a) or (b)
may be brought to prevent enforcement or implementation by any
government of a State limitation or requirement that is inconsistent
with section 4 or 5.
(d) Declaratory and Equitable Relief.--In any action under this
section, the court may award appropriate declaratory and equitable
relief, including temporary, preliminary, or permanent injunctive
relief.
(e) Costs.--In any action under this section, the court shall award
costs of litigation, as well as reasonable attorney's fees, to any
prevailing plaintiff. A plaintiff shall not be liable to a defendant
for costs or attorney's fees in any non-frivolous action under this
section.
(f) Jurisdiction.--The district courts of the United States shall
have jurisdiction over proceedings under this Act and shall exercise
the same without regard to whether the party aggrieved shall have
exhausted any administrative or other remedies that may be provided for
by law.
(g) Abrogation of State Immunity.--Neither a State that enforces or
maintains, nor a government official (including a person described in
section 7(c)) who is permitted to implement or enforce any limitation
or requirement that violates section 4 or 5 shall be immune under the
Tenth Amendment to the Constitution of the United States, the Eleventh
Amendment to the Constitution of the United States, or any other source
of law, from an action in a Federal or State court of competent
jurisdiction challenging that limitation or requirement, unless such
immunity is required by clearly established Federal law, as determined
by the Supreme Court of the United States.
SEC. 10. EFFECTIVE DATE.
This Act shall take effect upon the date of enactment of this Act.
SEC. 11. SEVERABILITY.
If any provision of this Act, or the application of such provision
to any person, entity, government, or circumstance, is held to be
unconstitutional, the remainder of this Act, or the application of such
provision to all other persons, entities, governments, or
circumstances, shall not be affected thereby.
<all>
Introduced in House
Introduced in House
Referred to the Committee on Energy and Commerce, and in addition to the Committee on the Judiciary, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on the Judiciary, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Subcommittee on Health.
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