,i  #aac? ,,congress  #a/ ,session  ,h4 
,r4 #idj  ,,9 ,,! ,,h\se ,,(            
,,repres5tatives  ,m>* #d1 #bjac ,mrs4  
,black 7= h]self1 ,mr4 ,flem+1 ,mr4     
,=t5b]ry1 ,mr4 ,da9es1 ,mr4 ,b\/any1    
,mr4 ,jones1 ,mr4 ,cassidy1 ,mr4 ,rog]s 
( ,alabama1 ,mr4 ,nunnelee1 ,mr4        
,lip9ski1 ,mr4 ,hultgr51 ,mr4 ,bonn]1   
,mr4 ,cram]1 ,mr4 ,br\n ( ,georgia1 ,mr4
 ,johnson ( ,ohio1 ,mr4 ,walb]g1 ,mr4   
,tib]i1 ,mr4 ,kelly1 ,mr4 ,neugebau]1   
,mr4 ,flores1 ,mrs4 ,ellm]s1 ,mr4 ,g+rey
 ( ,georgia1 ,mr4 ,pompeo1 ,mr4 ,roe (  
,t5nessee1 ,mr4 ,k+ ( ,i[a1 ,mr4 ,murphy
 ( ,p5nsylvania1 ,mr4 ,b5tivolio1 ,ms4  
,foxx1 ,mr4 ,rodney ,davis ( ,ill9ois1  
,mr4 ,wilson ( ,s\? ,c>ol9a1 ,mr4 ,poe (
 ,texas1 ,mr4 ,f9*]1 ,mr4 ,we/morel&1   
,mr4 ,graves ( ,georgia1 ,mr4 ,ba*us1   
,mr4 ,b>letta1 ,mr4 ,jordan1 ,mrs4      
,wagn]1 ,mr4 ,b5i%ek1 ,mrs4 ,blackburn1 
,mr4 ,w5/rup1 ,mr4 ,s\!rl&1 ,mr4        
,s*weik]t1 ,mr4 ,huelskamp1 ,mr4 ,h>ris1
 ,mrs4 ,h>tzl]1 ,mr4 ,mill] ( ,florida1 
,mr4 ,smi? ( ,new ,j]sey1 ,mr4 ,roskam1 

,mr4 ,pe>ce1 & ,mrs4 ,walorski7         
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,en]gy & ,comm]ce1 & 9 
addition to ! ,committee on ,ways &     
,means1 = a p]iod to be subsequ5tly     
det]m9$ by ! ,speak]1 9 ea* case =      
consid]ation ( su* provisions z fall )9 
! jurisdiction ( ! committee conc]n$  ,a
 ,,bill  ,to am5d ! ,pati5t ,protection 
& ,af=dable ,c>e ,act to protect rights 
( consci5ce ) reg>d to requirem5ts =    
cov]age ( specific items & s]vices1 to  
am5d ! ,public ,heal? ,s]vice ,act to   
prohibit c]ta9 abortion-relat$          
discrim9ation 9 gov]nm5tal activities1 &
 = o!r purposes4  #a4 ,%ort title ,?is  
,act may be cit$ z ! ,heal? ,c>e        
,consci5ce ,rights ,act4  #b4 ,f9d+s    
,congress f9ds ! foll[+3  7#a7 ,z ,?omas
 ,jeff]son decl>$ to ,new ,london       
,me?odi/s 9 #ahji1 no provision 9 our   
,con/itution ought to be de>] to man ?an
 t :i* protects ! rights ( consci5ce    
aga9/ ! ent]prises ( ! civil au?ority4  
7#b7 ,jeff]son's conviction on respect =

 consci5ce is deeply emb$d$ 9 ! hi/ory &
 traditions ( our ,nation1 & codifi$ 9  
num]\s ,f$]al laws approv$ by           
congressional majorities & ,presid5ts ( 
bo? p>ties1 includ+ 9 ! ,public ,heal?  
,s]vice ,act2 ! ,unit$ ,/ates ,lead]%ip 
,aga9/ ,,hiv_/,,aids1 ,tub]culosis1 &   
,mal>ia ,act2 ! ,religi\s ,fre$om       
,re/oration ,act2 long/&+ provisions on 
respect = consci5ce rights 9 ! ,f$]al   
,employees ,heal? ,b5efits ,program &   
,di/rict ( ,columbia appropriations2 &  
laws to protect individuals f be+ =c$ to
 p>ticipate 9 ,f$]al executions or      
prosecutions4  7#c7 ,foll[+ enactm5t ( !
 ,pati5t ,protection & ,af=dable ,c>e   
,act 7,public ,law #aaa-adh1 9 ?is      
section ref]r$ to z ,,ppaca71 ! ,f$]al  
,gov]nm5t has s\ght to impose specific  
requirem5ts t infr+e on ! rights (      
consci5ce ( ^? :o (f] or pur*ase heal?  
cov]age4  7#d7 ,:ile ,,ppaca provides an
 exemption = "s religi\s gr\ps t object 
to p>ticipation 9 heal? insurance       
g5]ally1 & exempts millions ( ,am]icans 

f mo/ ( ! ,act's provisions1 includ+ !  
prev5tive s]vices m&ate1 x fails to     
provide /atutory protection = ^? seek+  
to (f] & pur*ase heal? cov]age :o h a   
religi\s or moral objection only to     
specific items or s]vices4  7#e7 ,nurses
 & o!r heal? c>e provid]s h increas+ly  
be5 subject$ to discrim9ation = abid+ by
 _! consci5ce r ?an provid+1 pay+ =1 or 
ref]r+ = abortion4  7#f7 ,consci5ce     
rights protections = heal? c>e provid]s 
are an important "p ( civil rights      
protections 9 ,f$]al law & are          
indisp5sable to ! cont9u$ viability ( ! 
heal? c>e sy/em 9 ! ,unit$ ,/ates4 ,!   
increas+ly significant discrim9ation    
suff]$ by fai?-bas$ nonpr(it heal? c>e  
provid]s risks und]m9+ access to        
high-quality compassionate c>e = "s ( ! 
mo/ vuln]able populations 9 our c\ntry4 
#c4 ,apply+ long/&+ policy on consci5ce 
rights to ! ,af=dable ,c>e ,act  7a7 ,9 
g5]al ,title ,i ( ! ,pati5t ,protection 
& ,af=dable ,c>e ,act 7,public ,law     
#aaa-adh7 is am5d$--  7#a7 by r$esignat+

 ! second section #aefc 7relat+ to      
con=m+ am5dm5ts & z r$esignat$ by       
section #ajajg7;b77#a7 ( ! ,pati5t      
,protection & ,af=dable ,c>e ,act7 z    
section #aefd2  7#b7 by r$esignat+ !    
?ird section #aefc 7relat+ to ! ,s5se ( 
! ,s5ate promot+ fiscal responsibility7 
z section #aefe2 &  7#c7 by add+ at !   
end ! foll[+ new section3  #aeff4       
,respect+ consci5ce rights 9 heal?      
cov]age  7a7 ,9 g5]al ,not)/&+ any o!r  
provision ( ?is title1 no provision (   
?is title 7& no am5dm5t made by any su* 
provision7 %all--  7#a7 require an      
individual to pur*ase individual heal?  
insurance cov]age t includes cov]age (  
an abortion or o!r item or s]vice to :i*
 su* individual has a moral or religi\s 
objection1 or prev5t an issu] f (f]+ or 
issu+1 to su* individual1 individual    
heal? insurance cov]age t excludes su*  
item or s]vice2  7#b7 require a sponsor 
7or1 9 ! case ( heal? insurance cov]age 
(f]$ to /ud5ts ?r\gh an in/itution (    
high] education1 ! in/itution ( high]   

education (f]+ su* cov]age7 to sponsor1 
pur*ase1 or provide any heal? b5efits   
cov]age or gr\p heal? plan t includes   
cov]age ( an abortion or o!r item or    
s]vice to :i* su* sponsor or in/itution1
 respectively1 has a moral or religi\s  
objection1 or prev5t an issu] f (f]+ or 
issu+ to su* sponsor or in/itution1     
respectively1 heal? insurance cov]age t 
excludes su* item or s]vice2  7#c7      
require an issu] ( heal? insurance      
cov]age or ! sponsor ( a gr\p heal? plan
 to include1 9 any su* cov]age or plan1 
cov]age ( an abortion or o!r item or    
s]vice to :i* su* issu] or sponsor has a
 moral or religi\s objection2 or  7#d7  
au?orize ! imposition ( a tax1 p5alty1  
fee1 f9e1 or o!r sanction1 or !         
imposition ( cov]age ( ! item or s]vice 
to :i* !re is a moral or religi\s       
objection1 9 relation to heal? insurance
 cov]age or a gr\p heal? plan t excludes
 an item or s]vice pursuant to ?is      
section4  7b7 ,re/riction on contr>y    
gov]nm5tal action ,no provision 9 ?is   

title 7or am5dm5t made by su* provision7
 or law1 regulation1 guidel9e or o!r    
gov]nm5tal action t implem5ts su*       
provision or am5dm5t1 or d]ives its     
au?ority !refrom1 %all be giv5 legal    
effect to ! ext5t t x violates ?is      
section4  7c7 ,no effect on o!r laws    
,no?+ 9 ?is section %all be con/ru$ to  
preempt1 modify1 or o!rwise h any effect
 on--  7#a7 ! ,civil ,rights ,act (     
#aifd2  7#b7 ! ,am]icans ) ,disabilities
 ,act ( #aiij2  7#c7 ! ,pregnancy       
,discrim9ation ,act ( #aigh2  7#d7 !    
,m5tal ,heal? ,p>ity ,act ( #aiif2 or   
7#e7 any o!r ,/ate or ,f$]al law1 o!r   
?an a provision 9 ?is title 7or an      
am5dm5t made by su* provision7 or a law1
 regulation1 guidel9e or o!r gov]nm5tal 
action t implem5ts su* provision or     
am5dm5t or d]ives its au?ority !refrom4 
7d7 ,aggregate actu>ial value ,no?+ 9   
?is section %all be con/ru$ to prohibit 
! ,secret>y f issu+ regulations or o!r  
guidance to ensure t heal? insurance    
cov]age or gr\p heal? plans exclud+     

abortion or o!r items or s]vices "u ?is 
section %all h an aggregate actu>ial    
value at lea/ equival5t to t ( heal?    
insurance cov]age or gr\p heal? plans at
 ! same level ( cov]age t d n exclude   
su* items or s]vices4  7e7 ,cont9u$     
application ( nondiscrim9ation rules    
,no?+ 9 ?is section %all be con/ru$ to  
p]mit a heal? insurance issu]1 gr\p     
heal? plan1 or o!r heal? c>e provid] to 
act 9 a mann] inconsi/5t ) subp>agraph  
7,b7 or 7,d7 ( section #acjb7;b77#d74  4
  7b7 ,cl]ical am5dm5t ,! table (       
cont5ts ( ! ,pati5t ,protection &       
,af=dable ,c>e ,act 7,public ,law       
#aaa-adh7 is am5d$--  7#a7 by /rik+ !   
foll[+ items3  #aefc4 ,con=m+ am5dm5ts4 
#aefc4 ,s5se ( ! ,s5ate promot+ fiscal  
responsibility4  2  &  7#b7 by ins]t+   
aft] ! item relat+ to ! section #aefc   
relat+ to small bus9ess procurem5t !    
foll[+ items3  #aefd4 ,con=m+ am5dm5ts4 
#aefe4 ,s5se ( ! ,s5ate promot+ fiscal  
responsibility4 #aeff4 ,respect+        
consci5ce rights 9 heal? cov]age4  4    

#d4 ,abortion nondiscrim9ation = heal?  
c>e provid]s ,section #bde ( ! ,public  
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#bchn7 is am5d$--  7#a7 9 ! section     
head+1 by /rik+ & lic5s+ ( physicians & 
ins]t+ 1 lic5s+1 & practice ( physicians
 & o!r heal? c>e entities2  7#b7 9      
subsection 7a71 by am5d+ p>agraph 7#a7  
to read z foll[s3  7#a7 ! entity        
refuses--  7,a7 to und]go tra9+ 9 !     
p]=mance ( induc$ abortions2  7,b7 to   
require or provide su* tra9+2  7,c7 to  
p]=m1 p>ticipate 91 provide cov]age (1  
or pay = induc$ abortions2 or  7,d7 to  
provide ref]rals = su* tra9+ or su*     
abortions2  2  7#c7 9 subsection        
7b77#a71 by /rik+ /&>ds & ins]t+ /&>d2  
7#d7 9 subsection 7c71 by am5d+         
p>agraphs 7#a7 & 7#b7 to read z foll[s3 
7#a7 ,! t]m f9ancial assi/ance1 )       
respect to a gov]nm5t program1 means    
gov]nm5tal paym5ts to cov] ! co/ ( heal?
 c>e s]vices or b5efits1 or o!r ,f$]al  
paym5ts1 grants1 or loans to promote or 
o!rwise facilitate heal?-relat$         

activities4  7#b7 ,! t]m heal? c>e      
entity includes an individual physician 
or o!r heal? pr(essional1 a po/graduate 
physician tra9+ program1 a p>ticipant 9 
a program ( tra9+ 9 ! heal? pr(essions1 
a hospital1 a provid]-sponsor$          
organization z def9$ 9 section #ahee7;d7
 ( ! ,social ,security ,act1 a heal?    
ma9t5ance organization1 an acc\ntable   
c>e organization1 an issu] ( heal?      
insurance cov]age1 any o!r k9d ( heal?  
c>e facility1 organization1 or plan1 &  
an entity t provides or au?orizes       
ref]rals = heal? c>e s]vices4  2  7#e7  
by add+ at ! end ( subsection 7c7 !     
foll[+ new p>agraph3  7#d7 ,! t]m ,/ate 
or local gov]nm5t t receives ,f$]al     
f9ancial assi/ance includes any ag5cy or
 o!r gov]nm5tal unit ( a ,/ate or local 
gov]nm5t if su* gov]nm5t receives ,f$]al
 f9ancial assi/ance4  2  7#f7 by        
r$esignat+ subsection 7c7 z subsection  
7d72 &  7#g7 by ins]t+ aft] subsection  
7b7 ! foll[+ new subsection3  7c7       
,adm9i/ration ,! ,secret>y %all         

designate ! ,director ( ! ,(fice =      
,civil ,rights ( ! ,dep>tm5t ( ,heal? & 
,human ,s]vices--  7#a7 to receive      
compla9ts alleg+ a violation ( ?is      
section1 section #aeff ( ! ,pati5t      
,protection & ,af=dable ,c>e ,act1 or   
any ( subsections 7b7 ?r\gh 7e7 (       
section #dja ( ! ,heal? ,programs       
,ext5sion ,act ( #aigc2 &  7#b7 to      
pursue ! inve/igation ( su* compla9ts1 9
 coord9ation ) ! ,attorney ,g5]al4  4   
#e4 ,rem$ies = violations ( ,f$]al      
consci5ce laws ,title ,,ii ( ! ,public  
,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bjb 
et seq47 is am5d$ by ins]t+ aft] section
 #bde ! foll[+3  #bde;,a4 ,civil action 
= c]ta9 violations  7a7 ,9 g5]al ,a     
qualifi$ p>ty may1 9 a civil action1    
obta9 appropriate relief ) reg>d to a   
designat$ violation4  7b7 ,def9itions ,9
 ?is section--  7#a7 ! t]m qualifi$ p>ty
 means--  7,a7 ! ,attorney ,g5]al2 or   
7,b7 any p]son or entity adv]sely       
affect$ by ! designat$ violation2 &     
7#b7 ! t]m designat$ violation means an 

actual or ?reat5$ violation ( section   
#bde ( ?is ,act1 section #aeff ( !      
,pati5t ,protection & ,af=dable ,c>e    
,act1 or any ( subsections 7b7 ?r\gh 7e7
 ( section #dja ( ! ,heal? ,programs    
,ext5sion ,act ( #aigc4  7c7            
,adm9i/rative rem$ies n requir$ ,an     
action "u ?is section may be comm5c$1 & 
relief may be grant$1 )\t reg>d to :e!r 
! p>ty comm5c+ ! action has s\ght or    
exhau/$ available adm9i/rative rem$ies4 
7d7 ,def5dants 9 actions "u ?is section 
may include gov]nm5tal entities z well z
 o!rs  7#a7 ,9 g5]al ,an action "u ?is  
section may be ma9ta9$ aga9/1 among     
o!rs1 a p>ty t is a ,f$]al or ,/ate     
gov]nm5tal entity4 ,relief 9 an action  
"u ?is section may include money damages
 ev5 if ! def5dant is su* a gov]nm5tal  
entity4  7#b7 ,def9ition ,= ! purposes (
 ?is subsection1 ! t]m ,/ate gov]nm5tal 
entity means a ,/ate1 a local gov]nm5t  
)9 a ,/ate1 or any ag5cy or o!r         
gov]nm5tal unit or au?ority ( a ,/ate or
 ( su* a local gov]nm5t4  7e7 ,nature ( 

relief ,! c\rt %all grant--  7#a7 all   
necess>y equitable & legal relief1      
includ+1 :]e appropriate1 decl>atory    
relief & comp5satory damages1 to prev5t 
! occurr5ce1 cont9uance1 or repetition (
 ! designat$ violation & to comp5sate = 
losses result+ f ! designat$ violation2 
&  7#b7 to a prevail+ pla9tiff1         
reasonable attorneys' fees & litigation 
exp5ses z "p ( ! co/s4  4