,,ii  #aag? ,,congress  #a/ ,session    
,s4 #ajba  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,m>* #be1 #bjba ,ms4   
,duckwor? 7= h]self1 ,mrs4 ,murray1 ,ms4
 ,hirono1 ,ms4 ,cortez ,ma/o1 ,mrs4     
,%ahe51 ,ms4 ,klobu*>1 ,mr4 ,blum5?al1  
,mr4 ,br[n1 ,ms4 ,w>r51 ,mrs4 ,gillibr&1
 ,mr4 ,:iteh\se1 ,ms4 ,ros51 ,mrs4      
,fe9/e91 ,mr4 ,m]kley1 ,ms4 ,hassan1    
,mr4 ,b5net1 ,mr4 ,m>key1 ,ms4 ,smi?1   
,mr4 ,murphy1 ,mr4 ,book]1 ,mr4 ,van    
,holl51 ,mr4 ,s&]s1 ,mr4 ,wyd51 ,mr4    
,padilla1 & ,mr4 ,lujn7 introduc$ !     
foll[+ bill2 :i* 0 read twice & ref]r$  
to ! ,committee on ,heal?1 ,education1  
,labor1 & ,p5sions  ,a ,,bill  ,to      
ensure af=dable abortion cov]age & c>e =
 e p]son1 & = o!r purposes4  #a4 ,%ort  
title ,?is ,act may be cit$ z ! ,equal  
,access to ,abortion ,cov]age 9 ,heal?  
,insurance ,act ( #bjba or ! ,,ea* ,act 
( #bjba4  #b4 ,f9d+s ,congress makes !  
foll[+ f9d+s3  7#a7 ,all p %\ld h access
 to abortion s]vices reg>dless ( actual 
or p]ceiv$ race1 color1 e?nicity1       

language1 ance/ry1 citiz5%ip1           
immigration /atus1 sex 7includ+ a sex   
/]eotype2 pregnancy1 *ildbir?1 or a     
relat$ m$ical condition2 sexual         
ori5tation or g5d] id5tity2 & sex       
*>act]i/ics71 age1 disability1 or sex "w
 /atus or behavior4  7#b7 ,a p]son's    
income level1 weal?1 or type ( insurance
 %\ld n prev5t !m f hav+ access to a    
full range ( pregnancy-relat$ heal? c>e1
 includ+ abortion s]vices4  7#c7 ,no    
p]son %\ld h ! decision to h1 or n to h1
 an abortion made = !m bas$ on ! ability
 or inability to af=d ! heal? c>e       
s]vice4  7#d7 ,s9ce #aigf1 ! ,f$]al     
,gov]nm5t has bann$ ! use ( ,f$]al funds
 to pay = abortion s]vices & all[s =    
exceptions only 9 v n>r[ circum/ances4  
,?is ban affects p ( reproductive age 9 
! ,unit$ ,/ates :o are insur$ ?r\gh !   
,m$icaid program1 z well z individuals  
:o receive insurance or c>e ?r\gh o!r   
f$]ally fund$ heal? programs & plans4   
7#e7 ,wom5 make up ! majority ( ,m$icaid
 enrollees 7#ed p]c5t7 &1 9 #bjai1      

approximately #ad1jjj1jjj wom5 (        
reproductive age reli$ on ! program =   
c>e4 ,due to sy/ematic b>ri]s &         
discrim9ation1 a disproportionately     
high] numb] ( wom5 ( color & ,lesbian1  
,gay1 ,bisexual1 ,transg5d]1 or ,que]   
7,,lgbtq7 individuals are enroll$ 9 !   
program4  7#f7 ,wom5 ( color are m      
likely to be insur$ by ! ,m$icaid       
program4 ,nationwide1 #bi p]c5t ( ,black
 wom5 & #be p]c5t ( ,hispanic wom5 ag$  
#ae to #di 7 enroll$ 9 ,m$icaid 9 #bjah1
 comp>$ ) #ae p]c5t ( ,:ite wom54  7#g7 
,9 ! aggregate1 ne>ly "o-fif? 7#ai      
p]c5t7 ( ,asian-,am]ican &              
,pacific-,isl&] wom5 are enroll$ 9 !    
,m$icaid program1 :ile enrollm5t rates =
 c]ta9 ,asian e?nic subgr\ps are mu*    
high] 7at #fb p]c5t ( ,bhutanese wom51  
#dc p]c5t ( ,hmong wom5 & #cb p]c5t (   
,paki/ani wom574  7#h7 ,m$icaid also    
provides cov]age to m ?an #a 9 #d 7#bg  
p]c5t7 non-eld]ly ,am]ican ,indian &    
,alaska ,native 7,,aian7 adults & half (
 ,,aian *ildr54  7#i7 ,9 a #bjad        

nationwide survey ( ,,lgbt p ) incomes  
less ?an #djj p]c5t ,f$]al ,pov]ty      
,level 7,,fpl71 #fa p]c5t ( all         
respond5ts _h incomes 9 ! ,m$icaid      
expansion range--up to #ach p]c5t ( !   
,,fpl--includ+ #gc p]c5t (              
,african-,am]ican respond5ts1 #fg p]c5t 
( ,lat9o respond5ts1 & #ec p]c5t ( ,:ite
 respond5ts4 ,ano!r survey f\nd t #cb   
p]c5t ( ,asian & ,native                
,hawaiian_/,pacific ,isl&] transg5d] p 7
 liv+ 9 pov]ty4  7#aj7 ,( wom5 ag$ #ae  
?r\gh #dd enroll$ 9 ,m$icaid 9 #bjah1   
#ee p]c5t liv$ 9 ! #cd ,/ates & !       
,di/rict ( ,columbia :]e ,m$icaid does n
 cov] abortion s]vices except 9 limit$  
circum/ances4 ,?is am\nt$ to #g1bjj1jjj 
wom5 ( reproductive age1 includ+        
#c1jjj1jjj wom5 liv+ bel[ ! ,,fpl4 ,(   
?is population1 ,black1 ,indig5\s1 & o!r
 ,p ( ,color 7,,bipoc7 wom5 acc\nt$ =   
#ea p]c5t ( ^? enroll$4  7#aa7 ,!       
,indian ,heal? ,s]vice 7,,ihs7 is !     
f$]ally fund$ heal? program = ,am]ican  
,indians & ,alaska ,natives4 ,! ,,ihs   

s]ves a population ( approximately      
#b1efj1jjj & z a f$]ally fund$ sy/em1   
s9ce #aihh1 x has be5 b>r$ f provid+    
abortion s]vices except = v limit$      
cases4 ,am]ican ,indians & ,alaska      
,natives (t5 face high] levels ( pov]ty 
& limit$ access to heal? c>e = a numb] (
 int]sect+ oppressions ?us leav+ !m )\t 
rec\rse = ! ,f$]al ban on abortion      
s]vices4  7#ab7 ,moreov]1 #bf ,/ates    
also prohibit cov]age ( abortion s]vices
 9 ! m>ketplaces & #aa prohibit cov]age 
9 private heal? insurance plans "u !    
,pati5t ,protection & ,af=dable ,c>e    
,act 7,public ,law #aaa-adh74  7#ac7 ,a 
rec5t report details h[ re/rictions on  
abortion s]vices cov]age int]f]e ) a    
p]son's individual decision mak+1 ) _!  
heal? & well-be+1 ) _! economic         
security1 ) _! vuln]ability to intimate 
p>tn] viol5ce1 & ) _! con/itutionally   
protect$ "r to a safe & normal heal? c>e
 s]vice4  7#ad7 ,ab\t #be p]c5t ( wom5  
cov]$ by ,m$icaid seek+ abortion s]vices
 mu/ c>ry _! pregnancies to t]m because 

!y are unable to obta9 funds = _! c>e4  
,gov]nm5t-impos$ b>ri]s to abortion     
s]vices re/rict p's decisions on if1 :51
 & h[ to p>5t1 & h long-la/+ &          
life-alt]+ h>mful effects on ! pregnant 
p]son1 _! families & _! communities4 ,^?
 :o seek & are d5i$ abortion s]vices are
 m likely to rema9 9 or fall into pov]ty
 ?an ^? :o access ! c>e !y ne$4  7#ae7  
,re/rictions on abortion s]vice cov]age 
h a disproportionately h>mful impact on 
wom5 ) l[ incomes1 wom5 ( color1        
immigrant wom51 ,,lgbtq p1 & "y wom54   
,additionally1 num]\s ,/ate-impos$      
b>ri]s make x disp>ately difficult =    
l[-income p1 p ( color1 immigrants1     
,,lgbtq p1 & "y p to access ! heal? c>e 
& res\rces necess>y to prev5t un9t5d$   
pregnancy or to assure t !y are able to 
c>ry heal?y pregnancies to t]m4         
,fur!rmore1 "y p ( reproductive age     
7ages #ae to #bd7 are m likely to h a   
l[] income ?an ^? old] ?an t1 & ?is     
income gap is great] = "y ,,bipoc4 ,m   
?an #dj p]c5t ( y\? & *ildr5 "u age #ai 

& almo/ a qu>t] ( "y p age #ai to #be h 
heal? insurance ?r\gh gov]nm5t programs4
 ,)\t insurance cov]age = abortion      
s]vices1 "y p are at great] risk ( n    
hav+ ! economic means to af=d c>e       
outside ( insurance4 ,"y p face         
disproportionate access b>ri]s to       
abortion s]vices1 includ+ p>5tal        
involvem5t requirem5t 7notification &   
cons5t7 & co/1 9 addition to b>ri]s to  
contraception & inadequate & incomplete 
sexual & sexuality education4 ,^!       
*all5ges1 :i* are magnifi$ = ,,bipoc &  
que]1 trans1 & nonb9>y y\?1 c cause     
significant delays 9 access to ne$$ c>e1
 & c\ld ultimately h>m ! life ( ! "y    
p]son seek+ abortion s]vices4 ,^!       
in/itutionaliz$ b>ri]s d5y "y p's "r to 
bodily autonomy & c =ce "y p to enc\nt] 
an abusive p>5t or gu>dian1 ignores     
tru/$ relation%ips "y p may h ) adults  
o!r ?an a p>5t or legal gu>dian1 & 9 !  
case ( ! judicial bypass process1 may   
=ce "y ,,bipoc to int]act ) a legal     
sy/em t has hi/orically t>get$ & caus$  

h>m to communities ( color4  7#af7 ,^! &
 o!r gov]nm5t-creat$ &                  
gov]nm5t-in/itutionaliz$ b>ri]s--includ+
 ! re/riction on fund+ = abortion       
s]vices 9 ,f$]al programs--exac]bate &  
create pov]ty & racial inequality 9     
income1 weal?-g5]ation1 & access to     
s]vices4  7#ag7 ,access to heal? c>e1   
includ+ abortion s]vices1 promotes !    
g5]al welf>e ( p liv+ 9 ! ,unit$ ,/ates4
 ,s+l+ out abortion s]vices = fund+     
re/rictions 9 heal? c>e programs o!rwise
 design$ to promote ! heal? & well-be+ (
 p 9 ! ,unit$ ,/ates has co/ pregnant p 
_! lives1 _! livelihoods1 _! ability to 
obta9 or ma9ta9 economic security =     
!mselves & _! families1 _! ability to   
meet _! family's basic ne$s1 _! ability 
to cont9ue _! education )\t disruption1 
& _! ability to break free ( abusive    
relation%ips4  7#ah7 ,l o!r heal? c>e & 
heal? insurance m>kets 9 ! ,unit$       
,/ates1 abortion s]vices & public       
insurance programs are comm]cial        
activities t affect int]/ate comm]ce4   

,provid]s & pati5ts travel across ,/ate 
l9es1 & o!rwise engage 9 int]/ate       
comm]ce1 to provide & access abortion   
s]vices4 ,mat]ial goods1 s]vices1 &     
f$]ally regulat$ m$ications us$ 9       
abortion s]vices circulate 9 int]/ate   
comm]ce4  7#ai7 ,congress has ! au?ority
 to enact ?is ,act to ensure af=dable   
cov]age ( abortion s]vices pursuant to--
 7,a7 its p[]s "u ! necess>y & prop]    
clause ( ,section #h1 ,article ,i ( !   
,con/itution ( ! ,unit$ ,/ates2  7,b7   
its p[]s "u ! comm]ce clause ( ,section 
#h1 ,article #a ( ! ,con/itution ( !    
,unit$ ,/ates2  7,c7 its p[]s to tax &  
sp5d = ! g5]al welf>e "u ,section #h1   
,article #a ( ! ,con/itution ( ! ,unit$ 
,/ates2 &  7,d7 its p[]s to en=ce       
section #a ( ! ,f\rte5? ,am5dm5t "u     
,section #e ( ! ,f\rte5? ,am5dm5t to !  
,con/itution ( ! ,unit$ ,/ates4  7#bj7  
,congress has ex]cis$ ^! con/itutional  
p[]s to create1 exp&1 & insure heal? c>e
 access = p 9 ! ,unit$ ,/ates = decades4
 ,pursuant to ?is con/itutional         

au?ority1 ,congress has enact$1 &       
subsequ5tly reau?oriz$1 num]\s heal? c>e
 programs includ+ title ,,xviii ( !     
,social ,security ,act 7,m$ic>e1 enact$ 
9 #aife72 title ,,xix ( ! ,social       
,security ,act 7,m$icaid1 enact$ 9      
#aife72 & title ,,xxi ( ! ,social       
,security ,act 7,*ildr5's ,heal?        
,insurance ,program1 enact$ 9 #aiig74   
#c4 ,def9itions ,= purposes ( ?is ,act3 
7#a7 ,abortion s]vices ,! t]m abortion  
s]vices means an abortion & any s]vices 
relat$ to1 & provid$ 9 conjunction )1 an
 abortion1 :e!r or n provid$ at ! same  
"t or on ! same day z ! abortion4  7#b7 
,heal? program or plan ,! t]m heal?     
program or plan means ! foll[+ heal?    
programs or plans t pay ! co/ (1 or     
provide1 heal? c>e3 7,a7 ,! ,m$icaid    
program "u title ,,xix ( ! ,social      
,security ,act 7#db ,u4,s4,c4 #acif et  
seq474  7,b7 ,! ,*ildr5's ,heal?        
,insurance ,program "u title ,,xxi ( !  
,social ,security ,act 7#db ,u4,s4,c4   
#acig et seq474  7,c7 ,! ,m$ic>e program

 "u title ,,xviii ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #acie et seq474     
7,d7 ,a m$ic>e supplem5tal policy z     
def9$ 9 section #ahhb7;g77#a7 ( !       
,social ,security ,act 7#db ,u4,s4,c4   
#aciess7g77#a774  7,e7 ,! ,indian ,heal?
 ,s]vice program "u ! ,indian ,heal?    
,c>e ,improvem5t ,act 7#be ,u4,s4,c4    
#afja et seq474  7,f7 ,m$ical c>e &     
heal? b5efits "u ! ,,tric>e program 7z  
def9$ 9 section #ajgb7g7 ( title #aj1   
,unit$ ,/ates ,code74  7,g7 ,b5efits "u 
! uni=m heal? b5efits program =         
employees ( ! ,dep>tm5t ( ,def5se       
assign$ to a nonappropriat$ fund        
in/rum5tality ( ! ,dep>tm5t e/abli%$ "u 
section #cdi ( ! ,national ,def5se      
,au?orization ,act = ,fiscal ,ye> #aiie 
7,public ,law #ajc-ccg2 #aj ,u4,s4,c4   
#aehg note74  7,h7 ,b5efits = vet]ans "u
 *apt] #ag ( title #ch1 ,unit$ ,/ates   
,code4  7,i7 ,m$ical c>e = survivors &  
dep5d5ts ( vet]ans "u section #agha (   
title #ch1 ,unit$ ,/ates ,code4  7,j7   
,m$ical c>e = individuals 9 ! c>e or    

cu/ody ( ! ,dep>tm5t ( ,homel& ,security
 pursuant to any ( sections #bce1 #bcf1 
or #bda ( ! ,immigration & ,nationality 
,act 7#h ,u4,s4,c4 #abbe1 #abbf1 #abca74
  7,k7 ,m$ical c>e = individuals 9 ! c>e
 or cu/ody ( ! ,dep>tm5t ( ,heal? &     
,human ,s]vices1 ,(fice ( ,refugee      
,resettlem5t "u section #bce ( !        
,william ,wilb]=ce ,traffick+ ,victims  
,protection ,reau?orization ,act ( #bjjh
 7#h ,u4,s4,c4 #abcb7 or section #dfb ( 
! ,homel& ,security ,act ( #bjjb 7#f    
,u4,s4,c4 #bgi74  7,l7 ,m$ical assi/ance
 to refugees "u section #dab ( !        
,immigration & ,nationality ,act 7#h    
,u4,s4,c4 #aebb74  7,m7 ,o!r cov]age1   
su* z a ,/ate heal? b5efits risk pool1 z
 ! ,secret>y ( ,heal? & ,human ,s]vices1
 9 coord9ation ) ! ,secret>y ( !        
,treasury1 recognizes = purposes (      
section #ejjj;,a7f77#a77;,e7 ( !        
,int]nal ,rev5ue ,code ( #aihf4  7,n7 ,!
 ,f$]al ,employees ,heal? ,b5efit ,plan 
"u *apt] #hi ( title #e1 ,unit$ ,/ates  
,code4  7,o7 ,m$ical c>e = individuals  

"u ! c>e or cu/ody ( ! ,dep>tm5t (      
,ju/ice pursuant to *apt] #cja ( title  
#ah1 ,unit$ ,/ates ,code4  7,p7 ,m$ical 
c>e = ,peace ,corps volunte]s "u section
 #e7;e7 ( ! ,peace ,corps ,act 7#bb     
,u4,s4,c4 #bejd7;e774  7,q7 ,o!r        
gov]nm5t-sponsor$ programs e/abli%$ aft]
 ! date ( ! enactm5t ( ?is ,act4  #d4   
,abortion cov]age & c>e reg>dless (     
income or s\rce ( insurance  7a7 ,ensur+
 ,abortion ,cov]age & ,c>e ,?r\gh !     
,f$]al ,gov]nm5t 9 its ,role z an       
,insur] & ,employ] ,ea* p]son insur$ by1
 enroll$ 91 or o!rwise receiv+ m$ical   
c>e f heal? programs or plans describ$ 9
 section #c7b7 %all receive cov]age (   
abortion s]vices4 ,heal? programs or    
plans describ$ 9 section #c7b7 %all     
provide cov]age ( abortion s]vices4  7b7
 ,ensur+ ,abortion ,cov]age & ,c>e      
,?r\gh ! ,f$]al ,gov]nm5t 9 its ,role z 
a ,heal? ,c>e ,provid] ,9 its role z a  
provid] ( heal? s]vices1 includ+ "u     
heal? programs describ$ 9 section #c7b7 
& heal? s]vices cov]$ by heal? plans    

describ$ 9 section #c7b71 ! ,f$]al      
,gov]nm5t %all ensure access to abortion
 s]vices = individuals :o are eligible  
to receive m$ical c>e 9 its own         
facilities or 9 facilities ) :i* x      
contracts to provide m$ical c>e4  7c7   
,prohibit+ ,re/rictions ,on ,private    
,insurance ,cov]age ,( ,abortion        
,s]vices ,! ,f$]al ,gov]nm5t %all n     
prohibit1 re/rict1 or o!rwise inhibit   
insurance cov]age ( abortion s]vices by 
,/ate or local gov]nm5t or by private   
heal? plans4  #e4 ,repeal ( section     
#acjc  7a7 ,9 g5]al ,section #acjc ( !  
,pati5t ,protection & ,af=dable ,c>e    
,act 7#db ,u4,s4,c4 #ahjbc7 is repeal$4 
7b7 ,con=m+ am5dm5ts  7#a7 ,basic heal? 
plans ,section #acca7;d7 ( ! ,pati5t    
,protection & ,af=dable ,c>e ,act 7#db  
,u4,s4,c4 #ahjea7;d77 is am5d$ by /rik+ 
p>agraph 7#d74  7#b7 ,multi-,/ate plans 
,section #accd7;a7 ( ! ,pati5t          
,protection & ,af=dable ,c>e ,act       
7,public ,law #aaa-adh7 is am5d$--  7,a7
 by /rik+ p>agraph 7#f72 &  7,b7 by     

r$esignat+ p>agraph 7#g7 z p>agraph     
7#f74  #f4 ,s5se ( ,congress ,x is !    
s5se ( ,congress t-- 7#a7 ! ,f$]al      
,gov]nm5t1 act+ 9 its capacity z an     
insur]1 employ]1 or heal? c>e provid]1  
%\ld s]ve z a model = ! ,nation to      
ensure cov]age ( abortion s]vices2 &    
7#b7 re/rictions on cov]age ( abortion  
s]vices 9 ! private insurance m>ket mu/ 
end4  #g4 ,rule ( con/ruction ,no?+ 9   
?is ,act %all be con/ru$ to h any effect
 on any ,f$]al1 ,/ate1 or local law t   
includes m protections = abortion       
cov]age or abortion s]vices ?an ^? set  
=? 9 ?is ,act4  #h4 ,relation%ip to     
,f$]al law ,?is ,act sup]s$es & applies 
to all ,f$]al law1 & ! implem5tation ( t
 law1 :e!r /atutory or o!rwise1 & :e!r  
adopt$ be=e or aft] ! date ( enactm5t ( 
?is ,act & is n subject to ! ,religi\s  
,fre$om ,re/oration ,act ( #aiic 7#db   
,u4,s4,c4 #bjjj;bb et seq474  #i4       
,sev]ability ,if any portion ( ?is ,act 
or ! application !re( to any p]son1     
entity1 gov]nm5t1 or circum/ances is    

held invalid1 su* invalidity %all n     
affect ! portions or applications ( ?is 
,act :i* c be giv5 effect )\t ! invalid 
portion or application4