,i  #aah? ,,congress  #a/ ,session  ,h4 
,r4 #dcjc  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,june #bb1 #bjbc,ms4  
,pressley 7= h]self1 ,ms4 ,williams (   
,georgia1 ,ms4 ,escob>1 ,ms4 ,bu%1 &    
,mr4 ,fro/7 introduc$ ! foll[+ bill2 :i*
 0 ref]r$ to ! ,committee on ,en]gy &   
,comm]ce1 & 9 addition to ! ,committees 
on ,ways & ,means1 ! ,judici>y1 ,natural
 ,res\rces1 ,arm$ ,s]vices1 ,vet]ans'   
,affairs1 ,ov]sight & ,acc\ntability1 & 
,=eign ,affairs1 = 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 exp& access to  
abortion c>e4  #a4 ,%ort title ,?is ,act
 may be cit$ z ! ,abortion ,ju/ice ,act 
( #bjbc4  #b4 ,f9d+s ,congress f9ds !   
foll[+3 7#a7 ,abortion c>e is ess5tial  
heal? c>e t %\ld be af=dable1 available1
 & support$ = ev]yone :o ne$s x4  7#b7  
,on ,june #bd1 #bjbb1 ! ,supreme ,c\rt  
ov]turn$ ,roe v4 ,wade & #ej ye>s (     
legal prec$5t1 & ,roe v4 ,wade 0 nev]   

en\gh4 ,)\t ! ability to access         
abortion1 ! legal "r did n help _m p    
work+ to make ends meet1 :o are ,black1 
,indig5\s1 ,asian1 ,pacific ,isl&]1     
,lat9x1 "y p1 ,,lgbtq p1 immigrants1    
disabl$ p & g5d] noncon=m+ p4  7#c7     
,almo/ "o-?ird 7#bi p]c5t7 ( ! total    
,unit$ ,/ates population ( wom5 (       
reproductive age are curr5tly liv+ 9    
,/ates :]e abortion is ei!r unavailable 
or sev]ely re/rict$ & a doz5 o!r ,/ates 
are c]ta9 or likely to ban abortion 9 ! 
future4  7#d7 ,sy/emic racism1 economic 
insecurity1 abelism1 & a dehumaniz+     
immigration sy/em exac]bate !           
already-massive b>ri]s to abortion c>e4 
7#e7 ,:ile abortion bans & o!r legal    
re/rictions h>m all p :o are or may     
become pregnant1 !y cause ev5 great] h>m
 to ^? already subject to sy/emic racism
 & economic inju/ice4  7#f7 ,pregnancy  
is less safe = "s ?an o!rs because (    
hi/oric & ongo+ racism & discrim9ation 9
 heal? c>e sett+s1 & ,black & ,indig5\s 
individuals face two to ?ree times !    

risk ( dy+ f pregnancy-relat$ causes4   
,individuals 9 ,/ates bann+ or sev]ely  
re/rict+ access to abortion c>e also h  
worse mat]nal heal? outcomes4  7#g7 ,=c$
 pregnancy is always unconscionable1 &  
p>ticul>ly s = individuals fac+ height5$
 risk ( mat]nal mortality & morbidity1  
:]e pregnancy is less safe = "s ?an o!rs
 because ( hi/oric & ongo+ racism &     
discrim9ation 9 heal? c>e sett+s4  7#h7 
,mat]nal dea?s 9 #bjbj 7 #fb p]c5t high]
 9 ,/ates :]e abortion is heavily       
re/rict$ ?an 9 ,/ates :]e abortion 0    
available1 & a ,f$]al ban on abortion   
w\ld increase mat]nal mortality by an   
e/imat$ #bd p]c5t4  7#i7 ,congress has !
 au?ority to act pursuant to ! comm]ce  
clause1 ! necess>y & prop] clause1 &    
section #e ( ! #ad? ,am5dm5t4  7#aj7    
,attacks on bodily autonomy are n limit$
 to ?reats on abortion c>e4 ,?is ye>    
alone1 m ?an #abj bills h be5 introduc$ 
attack+ g5d]-affirm+ c>e4 ,/ates h      
attempt$ to outlaw _m =ms ( bir?        
control1 & #ae ,/ates h ne> total       

abortion bans4  7#aa7 ,sev]al ,/ate     
c\rts h f\nd t abortion re/rictions     
violate ! "r to bodily autonomy4  7#ab7 
,! crim9alization ( abortion c>e =ces p 
to travel hundr$s ( miles out ( _!      
community to try to get c>e4  7#ac7 ,z 9
 o!r =ms ( crim9alization1 ! p t>get$ = 
pregnancy loss & self-manag$ abortion   
prosecution are disproportionately p (  
color1 immigrants1 & p exp]i5c+ economic
 insecurity4  7#ad7 ,?r\gh\t ! m ?an #bj
 ye>s t x has be5 us$ 9 ! ,unit$ ,/ates1
 m$ication abortion has be5 prov5 to be 
ov]:elm+ly safe & effective1 & has exp&$
 ! way p *oose to self manage _!        
abortion4  7#ae7 ,all ,food & ,drug     
,adm9i/ration-approv$ drugs mu/ be      
available 9 all ,/ates & t]ritories4    
7#af7 ,rese>* %[s t ) access to safe1   
effective me?ods & accurate in=mation1 p
 may safely self-manage an abortion on  
_! own4 ,anyone :o decides to end a     
pregnancy %\ld be able to *oose to      
self-manage an abortion at home ) m$ical
 guidance & ! support !y want4  7#ag7   

,abortion ne$s to be accessible :]e p   
live & :]e !y access heal? c>e4 ,= "y   
adults on college campuses1 /ud5t heal? 
c5t]s are (t5 :]e !y access ! full range
 ( c>e !y ne$1 & m$ication abortion mu/ 
be accessible & available to "y adults  
:o get _! heal? insurance ?r\gh _! ,/ate
 colleges & univ]sities1 & ?ree ,/ates  
7,massa*usetts1 ,new ,york1 & ,cali=nia7
 h pass$ laws ensur+ access to m$ication
 abortion on college campuses4  7#ah7   
,/ates h cont9ually craft$ legal        
re/rictions to ensure t abortion c>e is 
burd5some or impossible to obta94 ,?is  
/rategy has l$ to m ?an #a1cjj abortion 
re/rictions enact$ s9ce ,roe v4 ,wade 0 
orig9ally decid$ 9 #aigc4 ,^! attacks   
are root$ 9 racism & comp\nd ! failures 
( ! heal? c>e & economic sy/ems to      
provide communities liv+ ) l[ incomes   
access to high-quality1 af=dable heal?  
c>e1 & safe & su/a9able communities4    
7#ai7 ,a lack ( inve/m5t 9 bo? teleheal?
 & reproductive heal? c>e is a          
significant b>ri] to an equitable       

exp]i5ce ( teleheal? = m$ication        
abortion c>e4 ,actualiz+ ! promise (    
teleheal? & te*nology requires c5t]+    
equity by inve/+ 9 broadb&1 cultural    
compet5cy1 heal? lit]acy1 & digital &   
physical infra/ructure developm5t4      
7#bj7 ,bans on insurance cov]age (      
abortion comp\nd b>ri]s to heal? c>e    
access = immigrant & migrant            
communities1 :i* c also include         
logi/ical b>ri]s l travel co/s & di/ance
 to cl9ics1 lodg+ ne$s & co/s1 *ildc>e  
co/s & availability1 limit$ access to   
translation s]vices1 culturally compet5t
 c>e inclusive ( l[-lit]acy s]vices1 lo/
 wages1 & lack ( paid "t (f = heal? c>e 
appo9tm5ts c all delay or prohibit      
abortion c>e4  7#ba7 ,ne>ly two out (   
?ree p live )9 ! #ajj-mile bord] zone t 
all[s = int]ior ,cu/oms & ,bord]        
,protection *eckpo9ts :]e immigration   
(fic]s h increas$ discretion to deta9 & 
"q individuals4  7#bb7 ,immigrants ( all
 /atuses & p :o are undocum5t$ or 9     
mix$-/atus families are depriv$ ( !     

fre$om to travel because ( 9-,/ate      
immigration *eckpo9ts t put !m at ev5   
great] risk ( crim9alization1 all ( :i* 
contribute to a *ill+ effect = abortion 
access due to height5$ ?reats ( family  
sep>ation1 det5tion1 & deportation4     
7#bc7 ,9 #bjai1 noncitiz5 immigrants ag$
 #ae to #di _h ?ree times ! un9sur$ rate
 ( naturaliz$ citiz5s or p born 9 !     
,unit$ ,/ates 7#cf p]c5t vs4 #ab p]c5t71
 & immigrants ) l[ incomes f>$ worse1   
:]e 9 #bjai #ej p]c5t ( noncitiz5       
immigrants ag$ #ae to #di ) a family    
income bel[ ! ,f$]al pov]ty level 7e>n+ 
less ?an #ba1ccj = a family ( ?ree7 7   
un9sur$4  7#bd7 ,p held 9 immigration   
det5tion c5t]s :o are sep>at$ f _!      
*ildr5 & families face additional b>ri]s
 to abortion c>e because ( f9ancial     
b>ri]s due to ! abortion cov]age bans & 
o!r re/rictions4  7#be7 ,on ,novemb]    
#aj1 #bjbb1 ! ,(fice ( ,refugee         
,resettlem5t 7,,orr7 issu$ new guidance 
to ensure t unaccompani$ immigrant m9ors
 h access to abortion :ile 9 ,,orr      

cu/ody await+ reunification ) family 9 !
 ,unit$ ,/ates4 ,! ,f$]al ,gov]nm5t %\ld
 implem5t policies reg>d+ ! det5tion (  
pregnant1 po/p>tum1 & nurs+ p1 to ensure
 t no pregnant p]son is deta9$ & if su* 
det5tion occurs1 t !re is no b>ri] to   
abortion :ile deta9$ reg>dless ( !      
deta9+ ag5cy4  7#bf7 ,m ?an #dj p]c5t ( 
y\? & *ildr5 "u age #ai & #ab p]c5t ( "y
 p age #ai to #be h heal? insurance     
?r\gh gov]nm5t programs4  7#bg7         
,pregnant p y\ng] ?an #ah face          
additional b>ri]s to access+ abortion   
c>e4  7#bh7 ,"y p face p>5tal involvem5t
 laws 9 #bb ,/ates :]e abortion is /ill 
available1 or ! ex]cise ( a judicial    
bypass :i* requires m9ors to receive    
c\rt approval to access abortion c>e :5 
!y d n h _! p>5ts' k or cons5t4  7#bi7  
,judicial bypass is n a mean+ful        
alt]native b in/ead ano!r hurdle fac$ by
 "y p4 ,_m m9ors d n "k judicial bypass 
is available or d n "k h[ to get x1 d n 
h access to transportation to travel to 
! necess>y c\rts1 or simply are d5i$    

bypass by resi/ant or bias$ judges4     
7#cj7 ,abortion is "o ( ! safe/ m$ical  
proc$ures 9 ! c\ntry & lead+ public     
heal? organizations su* z ! ,am]ican    
,college ( ,ob/etricians &              
,gynecologi/s1 ! ,am]ican ,m$ical       
,association1 & ! ,am]ican ,academy (   
,family ,physicians /rongly oppose ef=ts
 to imp$e access to abortion c>e or     
int]f]e 9 ! relation%ip betwe5 a p]son &
 heal? c>e provid]4  7#ca7 ,! #bjbb     
,viol5ce & ,disruption ,report ( !      
,national ,abortion ,f$]ation f\nd an   
al>m+ escalation 9 incid5ts (           
ob/ruction1 v&alism1 & trespass+ at     
abortion cl9ics1 ) abortion provid]s    
report+ an al>m+ rate ( dea? ?reats &   
?reats ( h>m1 & docum5t$ #bah incid5ts 9
 #bjbb1 a #bj-p]c5t increase 9 dea?     
?reats & ?reats ( h>m ov] #bjba4  7#cb7 
,black1 ,indig5\s1 & o!r provid]s &     
pati5ts ( color face height5$ levels (  
?reats1 h>assm5t1 & viol5ce z comp>$ to 
_! ,:ite c\nt]p>ts4  7#cc7 ,9 ! face (  
multifacet$ attacks on _! "w1 abortion  

provid]s rema9 an ess5tial & valu$ "p ( 
_! communities1 provid+ high-quality1   
compassionate1 & necess>y heal? c>e4    
7#cd7 ,!re is a critical %ortage ( heal?
 c>e provid]s1 includ+ abortion c>e     
provid]s1 & x is e/imat$ t #bh p]c5t (  
,,ob_/,,gyn resid5cy programs are bas$ 9
 ,/ates or t]ritories t are curr5tly    
en=c+ abortion bans4  7#ce7 ,resid5ts   
desir+ abortion c>e tra9+ liv+ 9 ho/ile 
,/ates are =c$ to travel to ,/ates )\t  
abortion re/rictions4  7#cf7 ,abortion  
c>e tra9+ resid5ts face b>ri]s to tra9+ 
includ+ obta9+ lic5sure & liability     
insurance1 mak+ x difficult = ! next    
g5]ation ( abortion provid]s to provide 
compreh5sive sexual & reproductive heal?
 c>e 9 _! communities4  7#cg7 ,9 ! face 
( ! fe> & /igma foll[+ ! ,dobbs         
decision1 heal? c>e facilities h d5i$   
pati5ts lawful em]g5cy c>e because ( !  
simil>ities 9 abortion c>e & misc>riage 
managem5t4  7#ch7 #ia facilities t      
provide abortion c>e h clos$ s9ce !     
,supreme ,c\rt's decision 9 ,dobbs v4   

,jackson ,wom5's ,heal? ,organization4  
,( ^!1 #fb facilities clos$ z a direct  
consequ5ce ( ,dobbs & en=c$ or          
anticipat$ abortion bans4  7#ci7 ,!     
ability to mean+fully access abortion   
gives mean+ to ! "r to abortion4  7#dj7 
,9 ! ,unit$ ,/ates !re is an exi/+      
support network1 includ+ abortion funds1
 provid]s1 d\las1 & _m m1 to help       
abortion seek]s access c>e & navigate   
re/rictions ) exp]tise 9 provid+        
pati5t-c5t]$ c>e4  7#da7 ,inve/m5ts to  
improve teleheal? w\ld improve c>e = p )
 b>ri]s to access+ 9-p]son c>e1 p )     
disabilities1 & rural communities1 by   
provid+ exp&$ autonomy & decreas$ b>ri]s
 to access4  7#db7 ,creat+ m            
opportunities = teleheal? s]vices %\ld n
 sub/itute build+ mu* ne$$ capacity =   
high-quality1 9-p]son c>e1 p>ticul>ly 9 
und]s]v$ rural1 l[-income1 & ,black1    
,indig5\s1 & p ( color communities4     
7#dc7 ,remov+ ,f$]al re/rictions to     
abortion tra9+ & inve/+ 9 cl9ic         
infra/ructure1 includ+ cl9ic security1 w

 all[ m p to provide & m p to access    
abortion 9 a safe & heal?y environm5t & 
help to alleviate ! dra/ic %ortage 9    
abortion provid]s4  7#dd7 ,critical     
inve/m5ts 9 evid5ce-bas$1 pati5t-c5t]$  
rese>* & innovation is ne$$ to ensure   
abortion c>e cont9ues to meet ! ne$s (  
pati5ts across ! c\ntry & w help to     
improve access & quality ( c>e4  #c4    
,grant = fund+ to support individuals :o
 ne$ to access abortion c>e  7a7 ,9     
g5]al ,! ,secret>y ( ,heal? & ,human    
,s]vices 79 ?is section ref]r$ to z !   
,secret>y7 %all aw>d grants to entities 
to increase abortion access or to       
support individuals :o ne$ access to    
abortion c>e4  7b7 ,tim+ ,n lat] ?an    
#ahj days aft] ! date ( enactm5t ( ?is  
,act1 ! ,secret>y %all aw>d grants "u   
?is section4  7c7 ,use ( funds ,a grant 
receiv$ "u ?is section %all be us$ to   
increase abortion access or to support  
individuals :o ne$ access to abortion1  
:i* may include-- 7#a7 provid+ abortion 
c>e 9 p]son or by means ( teleheal?2    

7#b7 tra9+ heal? c>e pr(essionals 9 !   
provision ( abortion c>e2  7#c7 (f]+    
fund+ to individuals seek+ abortion c>e 
= bo? ! direct co/s ( ! c>e & associat$ 
co/s ( travel1 lodg+1 & *ildc>e2  7#d7  
conduct+ ph>maceutical & te*nological   
rese>* & innovation 9 abortion c>e2     
7#e7 employ+ pati5t navigators2  7#f7   
provid+ l+ui/ically appropriate &       
culturally compet5t legal assi/ance1    
case managem5t1 translation &           
int]pretation s]vices1 or c>e =         
individuals 9 ne$ ( su* s]vices relat$  
to access+ abortion c>e2  7#g7 provid+ !
 full spectrum ( d\la c>e & ! full      
spectrum ( d\la tra9+2  7#h7 provid+    
escorts to support abortion seek]s z !y 
access c>e2  7#i7 con/ruct+1 in/all+1 or
 improv+ facilities & o!r infra/ructure 
= heal? c>e provid]s t provide or are   
seek+ to provide abortion c>e1 includ+  
by increas+ physical security & upgrad+ 
digital infra/ructure su* z by swit*+ to
 broadb& int]net s]vice2 &  7#aj7       
o!rwise assi/+ abortion provid]s or     

individuals seek+ abortion c>e4  7d7    
,prioritization ,9 aw>d+ grants "u ?is  
section1 ! ,secret>y %all give priority 
to applicants propos+ to use ! aw>d to  
support individuals :o ne$ access to    
abortion c>e 9 m$ically und]s]v$        
communities4  7e7 ,au?orization (       
appropriations ,to c>ry out ?is section1
 !re is au?oriz$ to be appropriat$      
#cej1jjj1jjj = fiscal ye> #bjbd & ea*   
subsequ5t fiscal ye>1 to rema9 available
 until exp5d$4  #d4 ,facilities &       
provid]s  7a7 ,increase ! numb] (       
abortion provid]s ,! ,public ,heal?     
,s]vice ,act is am5d$ by /rik+ section  
#bde ( su* ,act 7#db ,u4,s4,c4 #bchn74  
7b7 ,requirem5t ,to provide abortion c>e
 ,z a condition on ! direct or indirect 
receipt ( any ,f$]al funds1 a heal? c>e 
facility %all agree to provide pati5ts  
)1 or ref] pati5ts to-- 7#a7 all        
m$ically appropriate reproductive heal? 
c>e1 includ+ abortion c>e1 t is )9 !    
capability ( ! /aff & m$ical equipm5t ( 
! heal? c>e facility provid+ ! c>e2 &   

7#b7 any r\t9ely available ancill>y     
s]vices4  7c7 ,univ]sity /ud5t heal?    
c5t]s  7#a7 ,9 g5]al ,z a condition on !
 direct or indirect receipt ( any ,f$]al
 funds1 an in/itution ( high] education 
%all agree to provide-- 7,a7 m$ication  
abortion to /ud5ts ( ! in/itution       
?r\gh-- 7i7 an on-campus /ud5t heal?    
c5t]2  7ii7 provid]s associat$ ) a      
contract$ ext]nal ag5cy2 or  7iii7      
teleheal? s]vices2 &  7,b7 ref]rals to  
o!r abortion c>e provid]s locat$ )9 a   
reasonable di/ance z ne$$ = o!r m$ically
 appropriate reproductive heal? c>e1    
includ+ abortion c>e4  7d7 ,def9itions  
,9 ?is section3 7#a7 ,! t]m in/itution (
 high] education has ! mean+ giv5 to su*
 t]m 9 subsections 7a7 & 7b7 ( section  
#aja ( ! ,high] ,education ,act ( #aife 
7#bj ,u4,s4,c4 #ajja74  7#b7 ,! t]m     
m$ically appropriate reproductive heal? 
c>e means reproductive heal? c>e t is-- 
7,a7 evid5ce-bas$2 &  7,b7 appropriate =
 ! pati5t4  7#c7 ,! t]m heal? c>e       
facility includes-- 7,a7 any in/itution1

 entity1 or ag5cy t provides heal? c>e  
s]vices2 &  7,b7 any community ph>macy1 
hospital1 doctor's (fice1 heal? cl9ic1  
family plann+ cl9ic1 em]g5t or urg5t c>e
 facility1 or community heal? c5t]4  #e4
 ,compreh5sive cov]age  7a7 ,9 g5]al ,! 
,secret>y ( ,heal? & ,human ,s]vices    
%all issue a rule ensur+ t all heal?    
programs or plans provide               
consum]-fri5dly in=mation ab\t abortion 
cov]age provid$ by heal? programs or    
plans4  7b7 ,reimbursem5t = abortion c>e
  7#a7 ,9 g5]al ,ea* p]son insur$ by1   
enroll$ 91 or o!rwise receiv+ m$ical c>e
 f heal? programs or plans describ$ 9   
subsection 7c7 %all receive cov]age (   
abortion s]vices4 ,heal? programs or    
plans describ$ 9 section 7c7 %all       
provide cov]age ( abortion s]vices4     
7#b7 ,am\nts ,! ,secret>y ( ,heal? &    
,human ,s]vices %all issue a rule ensur+
 t reimbursem5t rates = su* cov]age are 
simil> to l c>e & suffici5t to cov] !   
co/ ( c>e4  7c7 ,def9ition ,! t]m heal? 
program or plan means a public heal?    

insurance program or private heal?      
insurance plan t provides1 or pays ! co/
 (1 m$ical c>e 7z su* t]m is def9$ 9 #db
 ,u4,s4,c4  #cjj;gg-#ia74 ,su* t]ms     
include b are n limit$ to ! foll[+1 &   
any comb9ation !re(3 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$ical c>e &     
heal? b5efits "u ! ,,tric>e program 7#aj
 ,u4,s4,c4 #ajga et seq474  7#g7        
,b5efits = vet]ans "u *apt] #ag ( title 
#ch1 ,unit$ ,/ates ,code1 & m$ical c>e =

 survivors & dep5d5ts ( vet]ans 7#ch    
,u4,s4,c4 #agha et seq474  7#h7 ,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#i7 ,m$ical c>e =        
individuals 9 ! c>e or cu/ody ( !       
,dep>tm5t ( ,homel& ,security pursuant  
to any ( section #bce1 #bcf1 or #bda ( !
 ,immigration & ,nationality ,act 7#h   
,u4,s4,c4 #abbe1 #abbf1 #abca74  7#aj7  
,m$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#aa7 ,m$ical         
assi/ance to refugees "u section #dab ( 

! ,immigration & ,nationality ,act 7#h  
,u4,s4,c4 #aebb74  7#ab7 ,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 ( #aihf 7#bf     
,u4,s4,c4 #ejjj;,a7f77#a77;,e774  7#ac7 
,! ,f$]al ,employees ,heal? ,b5efit     
,plan "u *apt] #hi ( title #e1 ,unit$   
,/ates ,code4  7#ad7 ,m$ical c>e =      
individuals "u ! c>e or cu/ody ( !      
,dep>tm5t ( ,ju/ice pursuant to *apt]   
#cja ( title #ah 7#ah ,u4,s4,c4 #djja et
 seq474  7#ae7 ,m$ical c>e = ,peace     
,corps volunte]s "u section #e7;e7 ( !  
,peace ,corps ,act 7#bb ,u4,s4,c4       
#bejd7;e774  7#af7 ,o!r                 
gov]nm5t-sponsor$ programs e/abli%$ aft]
 ! date ( ! enactm5t ( ?is ,act4  7#ag7 
,plans 9 ! ,f$]al m>ketplace or an      
individual m>ketplace )9 a ,/ate4  7#ah7
 ,eligible employ]-sponsor$ plan z def9$
 9 #bf ,u4,s4,c4 #ejjj;,a7f77#b74  7#ai7

 ,gr&fa!r$ heal? plan z def9$ 9 #db     
,u4,s4,c4 #ahjaa7;e74  7#bj7 ,a /&>d    
heal? plan e/abli%$ ?r\gh a ,/ate basic 
heal? program z def9$ 9 #db ,u4,s4,c4   
#ahjea4  7#ba7 ,o!r cov]age1 su* z a    
,/ate heal? b5efits risk pool1 z !      
,secret>y ( ,heal? & ,human ,s]vices1 9 
coord9ation ) ! ,secret>y ( ! ,int]nal  
,rev5ue ,s]vices1 recognizes = purposes 
( #bf ,u4,s4,c4  #ejjj;,a7f77,e74  7d7  
,repeal ,section #acjc ( ! ,pati5t      
,protection & ,af=dable ,c>e ,act 7#db  
,u4,s4,c4 #ahjbc7 is repeal$4  7e7      
,remov+ b>ri]s to cov]age = immigrant   
families  7#a7 ,9 g5]al ,section        
#aijc7v77#d7 ( ! ,social ,security ,act 
7#db ,u4,s4,c4 #acif;b7v77#d77 is       
am5d$-- 7,a7 by am5d+ subp>agraph 7,a7  
to read z foll[s3  7,a7 ,not)/&+        
sections #dja7;a71 #djb7;b71 #djc1 &    
#dba ( ! ,p]sonal ,responsibility & ,"w 
,opportunity ,reconciliation ,act (     
#aiif1 a ,/ate %all provide m$ical      
assi/ance "u ?is title1 to individuals  
:o are lawfully resid+ 9 ! ,unit$ ,/ates

 7includ+ individuals describ$ 9        
p>agraph 7#a71 batt]$ individuals       
describ$ 9 section #dca7;c7 ( su* ,act1 
& individuals ) an approv$ or p5d+      
application = def]r$ action or o!r      
f$]ally au?oriz$ pres5ce71 if !y o!rwise
 meet ! eligibility requirem5ts = m$ical
 assi/ance "u ! ,/ate plan approv$ "u   
?is title 7o!r ?an ! requirem5t ( !     
receipt ( aid or assi/ance "u title     
,,iv1 supplem5tal security income       
b5efits "u title ,,xvi1 or a ,/ate      
supplem5t>y paym5t74  2  7,b7 by am5d+  
subp>agraph 7,b7 to read z foll[s3  7,b7
 ,no debt %all accrue "u an affidavit ( 
support aga9/ any sponsor ( an          
individual provid$ m$ical assi/ance "u  
subp>agraph 7,a7 on ! basis ( provision 
( assi/ance to su* individual & ! co/ ( 
su* assi/ance %all n be consid]$ z an   
unreimburs$ co/4  2 &  7,c7 9           
subp>agraph 7,c7-- 7i7 by /rik+ an      
election by ! ,/ate "u subp>agraph 7,a7 
& ins]t+ ! application ( subp>agraph    
7,a72  7ii7 by ins]t+ or be lawfully    

pres5t aft] lawfully reside2 &  7iii7 by
 ins]t+ or pres5t aft] lawfully resid+  
ea* place x appe>s4  7#b7 ,,*ip         
,subp>agraph 7,n7 ( section             
#bajg7;e77#a7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acig;gg7e77#a77 is     
am5d$ to read z foll[s3  7,n7 ,p>agraph 
7#d7 ( section #aijc7v7 7relat+ to      
lawfully pres5t individuals74  4  7#c7  
,effective date  7,a7 ,9 g5]al ,except z
 provid$ 9 subp>agraph 7,a71 ! am5dm5ts 
made by ?is subsection %all take effect 
on ! date ( enactm5t ( ?is ,act & %all  
apply to s]vices furni%$ on or aft] !   
date t is #ij days aft] su* date (      
enactm5t4  7,b7 ,exception if /ate      
legislation requir$ ,9 ! case ( a ,/ate 
plan = m$ical assi/ance "u title ,,xix1 
or a ,/ate *ild heal? plan "u title     
,,xxi1 ( ! ,social ,security ,act :i* ! 
,secret>y ( ,heal? & ,human ,s]vices    
det]m9es requires ,/ate legislation 7o!r
 ?an legislation appropriat+ funds7 9   
ord] = ! plan to meet ! additional      
requirem5ts impos$ by ! am5dm5ts made by

 ?is section1 ! respective ,/ate plan   
%all n be reg>d$ z fail+ to comply ) !  
requirem5ts ( su* title solely on !     
basis ( its failure to meet ^!          
additional requirem5ts be=e ! fir/ day (
 ! fir/ cal5d> qu>t] beg9n+ aft] ! close
 ( ! fir/ regul> session ( ! ,/ate      
legislature t beg9s aft] ! date (       
enactm5t ( ?is ,act4 ,= purposes ( !    
previ\s s5t5ce1 9 ! case ( a ,/ate t has
 a #b-ye> legislative session1 ea* ye> (
 su* session %all be deem$ to be a      
sep>ate regul> session ( ! ,/ate        
legislature4  7e7 ,cov]age = individuals
 ) f$]al au?oriz$ pres5ce1 includ+      
def]r$ action  7#a7 ,9 g5]al ,= purposes
 ( eligibility "u any ( ! provisions    
describ$ 9 p>agraph 7#b71 all           
individuals grant$ f$]ally au?oriz$     
pres5ce 9 ! ,unit$ ,/ates %all be       
consid]$ to be lawfully pres5t 9 !      
,unit$ ,/ates4  7#b7 ,provisions        
describ$ ,! provisions describ$ 9 ?is   
p>agraph are ! foll[+3 7,a7 ,ex*ange    
eligibility ,section #adaa ( ! ,pati5t  

,protection & ,af=dable ,c>e ,act 7#db  
,u4,s4,c4 #ahjca74  7,b7 ,r$uc$ co/-%>+ 
eligibility ,section #adjb ( ! ,pati5t  
,protection & ,af=dable ,c>e ,act 7#db  
,u4,s4,c4 #ahjga74  7,c7 ,premium       
subsidy eligibility ,section #cf;,b ( ! 
,int]nal ,rev5ue ,code ( #aihf 7#bf     
,u4,s4,c4 #cf;,b74  7,d7 ,m$icaid & *ip 
eligibility ,titles ,,xix & ,,xxi ( !   
,social ,security ,act1 includ+ "u      
section #aijc7v7 ( su* ,act 7#db        
,u4,s4,c4 #acif;b7v774  7#c7 ,transition
 ?r\gh special enrollm5t p]iod ,9 ! case
 ( an individual describ$ 9 p>agraph    
7#a7 :o1 be=e ! fir/ day ( ! fir/ annual
 op5 enrollm5t p]iod "u subp>agraph 7,b7
 ( section #acaa7;c77#f7 ( ! ,pati5t    
,protection & ,af=dable ,c>e ,act 7#db  
,u4,s4,c4 #ahjca7;c77#f77 beg9n+ aft] ! 
date ( enactm5t ( ?is ,act1 is grant$   
f$]ally au?oriz$ pres5ce 9 ! ,unit$     
,/ates & :o1 z a result ( su*           
subsection1 qualifies = a subsidy "u a  
provision describ$ 9 subp>agraph 7,b7 or
 7,c7 ( p>agraph 7#b71 ! ,secret>y (    

,heal? & ,human ,s]vices %all e/abli% a 
special enrollm5t p]iod "u subp>agraph  
7,c7 ( su* section #acaa7;c77#f7 dur+   
:i* su* individual may enroll 9 qualifi$
 heal? plans ?r\gh ,ex*anges "u title ,i
 ( ! ,pati5t ,protection & ,af=dable    
,c>e ,act & qualify = su* a subsidy4 ,= 
su* an individual :o has be5 grant$     
f$]ally au?oriz$ pres5ce 9 ! ,unit$     
,/ates z ( ! date ( enactm5t ( ?is ,act1
 su* special enrollm5t p]iod %all beg9 n
 lat] ?an #ij days aft] su* date (      
enactm5t4 ,no?+ 9 ?is p>agraph %all be  
con/ru$ z affect+ ! au?ority ( !        
,secret>y to e/abli% additional special 
enrollm5t p]iods "u su* subp>agraph     
7,c74  7f7 ,remov+ ,citiz5%ip &         
,immigration b>ri]s ,to access ,,aca c>e
 -- 7#a7 ,9 g5]al  7,a7 ,premium tax    
cr$its ,section #cf;,b ( ! ,int]nal     
,rev5ue ,code ( #aihf is am5d$-- 7i7 9  
subsection 7c77#a77;,b7-- 7,i7 by am5d+ 
! head+ to read z foll[s3 ,,special     
,,rule ,,= ,,c]ta9 ,,individuals        
,,ineligible ,,= ,,m$icaid ,,due ,,to   

,,/atus2 &  7,,ii7 by am5d+ clause 7ii7 
to read z foll[s3  7ii7 ! taxpay] is a  
noncitiz5 :o is n eligible = ! ,m$icaid 
program "u title ,,xix ( ! ,social      
,security ,act by reason ( !            
individual's immigration /atus1  2 &    
7ii7 by /rik+ subsection 7e74  7,b7     
,co/-%>+ r$uctions ,section #adjb ( !   
,pati5t ,protection & ,af=dable ,c>e    
,act 7#db ,u4,s4,c4 #ahjga7 is am5d$ by 
/rik+ subsection 7e7 & r$esignat+       
subsection 7f7 z subsection 7e74  7,c7  
,basic heal? program eligibility        
,section #acca7;e77#a77;,b7 ( ! ,pati5t 
,protection & ,af=dable ,c>e ,act 7#db  
,u4,s4,c4 #ahjea7;e77#a77;,b77 is am5d$ 
by /rik+ lawfully pres5t 9 ! ,unit$     
,/ates14  7,d7 ,re/rictions on f$]al    
paym5ts ,section #adab ( ! ,pati5t      
,protection & ,af=dable ,c>e ,act 7#db  
,u4,s4,c4 #ahjhb7 is am5d$ by /rik+     
subsection 7d7 & r$esignat+ subsection  
7e7 z subsection 7d74  7,e7 ,requirem5t 
to ma9ta9 m9imum ess5tial cov]age       
,subsection 7d7 ( section #ejjj;,a ( !  

,int]nal ,rev5ue ,code ( #aihf is am5d$ 
by /rik+ p>agraph 7#c7 & by r$esignat+  
p>agraph 7#d7 z p>agraph 7#c74  7g7     
,con=m+ am5dm5ts  7#a7 ,e/abli%m5t (    
program ,section #adaa7;a7 ( ! ,pati5t  
,protection & ,af=dable ,c>e ,act 7#db  
,u4,s4,c4 #ahjha7;a77 is am5d$ by /rik+ 
p>agraph 7#a7 & r$esignat+ p>agraphs    
7#b71 7#c71 & 7#d7 z p>agraphs 7#a71    
7#b71 & 7#c71 respectively4  7#b7       
,qualifi$ individuals ,section #acab7;f7
 ( ! ,pati5t ,protection & ,af=dable    
,c>e ,act 7#db ,u4,s4,c4 #ahjcb7;f77 is 
am5d$-- 7,a7 9 ! head+1 by /rik+ 2      
,,access ,,limit$ ,,to ,,citiz5s ,,&    
,,lawful ,,resid5ts2 &  7,b7 by /rik+   
p>agraph 7#c74  7h7 ,effective date ,!  
am5dm5ts made by ?is section %all apply 
to ye>s1 plan ye>s1 & taxable ye>s1 z   
applicable1 beg9n+ aft] ,decemb] #ca1   
#bjba4  7i7 ,access to cov]age  7#a7 ,9 
g5]al ,no?+ 9 ?is ,act1 includ+ !       
am5dm5ts made by ?is ,act1 %all prev5t  
lawfully pres5t noncitiz5s :o are       
ineligible = full b5efits "u ! ,m$icaid 

program "u title ,,xix ( ! ,social      
,security ,act f secur+ a cr$it = :i*   
su* lawfully pres5t noncitiz5s w\ld be  
eligible "u section #cf;,b7c77#a77;,b7 (
 ! ,int]nal ,rev5ue ,code ( #aihf & "u !
 ,m$icaid provisions = lawfully pres5t  
noncitiz5s1 z 9 effect on ! date prior  
to ! date ( enactm5t ( ?is ,act4  7#b7  
,def9ition ,= purposes ( p>agraph 7#a71 
! t]m full b5efits means1 ) respect to  
an individual & ,/ate1 m$ical assi/ance 
= all s]vices cov]$ "u ! ,/ate plan "u  
title ,,xix ( ! ,social ,security ,act t
 is n less 9 am\nt1 duration1 or scope1 
or is det]m9$ by ! ,secret>y ( ,heal? & 
,human ,s]vices to be sub/antially      
equival5t to ! m$ical assi/ance         
available = an individual describ$ 9    
section #aijb7;a77#aj77;,a77i7 ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#acif;a7a77#aj77;,a77i774  #f4 ,rights &
 protections  7a7 ,fundam5tal "r ,all   
p]sons h a fundam5tal "r to make &      
effectuate decisions ab\t abortion &    
misc>riage4 ,pursuant to ?is "r !       

,gov]nm5t may n3 7#a7 ,d5y1 int]f]e )1  
or re/rict ! "r ( any p]son to obta9 an 
abortion4  7#b7 ,p5alize any p]son =    
provid+1 assi/+1 support+1 or facilitat+
 ano!r p]son's abortion or misc>riage4  
7#c7 ,p5alize an individual = seek+1    
induc+1 or attempt+ to induce1 !        
individual's own abortion or alleg$     
abortion4  7b7 ,civil action ,any p]son 
aggriev$ by a violation ( ?is ,act may  
br+ a civil action = a su* violation    
aga9/ a ,f$]al1 ,/ate1 or local gov]nm5t
 9 an appropriate di/rict c\rt ( !      
,unit$ ,/ates4  7c7 ,cl>ify privacy     
protections "u ,,hipaa ,! ,secret>y (   
,heal? & ,human ,s]vices %all revise    
section #afd4eab ( title #db1 ,code (   
,f$]al ,regulations1 & any associat$    
regulations "u ! ,,hipaa privacy &      
security law 7z def9$ 9 section #cjji ( 
! ,public ,heal? ,s]vice ,act 7#db      
,u4,s4,c4 #cjj;jj-#ai77 to cl>ify t su* 
regulations expressly prohibit          
disclosures ( p]sonal heal? in=mation   
)\t au?orization to law en=cem5t        

(ficials1 includ+ immigration (ficials1 
9 cases involv+ reproductive & sexual   
heal?1 includ+ 9 case ( a misc>riage1   
abortion 7:e!r self-manag$ or o!rwise71 
or /illbir?4  7d7 ,prohibition ) respect
 to immigration en=cem5t actions  7#a7  
,9 g5]al ,not)/&+ any o!r provision (   
law1 9 ord] to ensure t an individuals' 
access to abortion s]vices is protect$1 
?is ,act %all prohibit immigration      
en=cem5t actions )9 #b1jjj feet ( any   
heal? c>e facility4  7#b7 ,applicability
 ,! prohibition "u p>agraph 7#a7 %all   
apply to-- 7,a7 any (fic] or ag5t ( !   
,dep>tm5t ( ,homel& ,security1 includ+  
any (fic] or ag5t ( ! ,u4,s4            
,immigration & ,cu/oms ,en=cem5t or !   
,u4,s4 ,cu/oms & ,bord] ,protection2 or 
7,b7 any ,/ate or local employee pursu+ 
immigration en=cem5t actions4  7#c7     
,heal? c>e facility def9$ ,! t]m heal?  
c>e facility includes-- 7,a7 any        
in/itution1 entity1 or ag5cy t provides 
heal? c>e s]vices2 &  7,b7 any community
 ph>macy1 hospital1 doctor's (fice1     

heal? cl9ic1 family plann+ cl9ic1 em]g5t
 or urg5t c>e facility1 or community    
heal? c5t]4  7e7 ,abrogation ( ,/ate    
immunity ,nei!r a ,/ate t en=ces or     
ma9ta9s1 nor a gov]nm5t (ficial :o is   
p]mitt$ to implem5t or en=ce any        
limitation or requirem5t t violates ?is 
,act %all be immune "u ! ,t5? ,am5dm5t  
to ! ,con/itution ( ! ,unit$ ,/ates1 !  
,elev5? ,am5dm5t to ! ,con/itution ( !  
,unit$ ,/ates1 or any o!r s\rce ( law1 f
 an action 9 a ,f$]al or ,/ate c\rt (   
compet5t jurisdiction *all5g+ t         
limitation or requirem5t1 unless su*    
immunity is requir$ by cle>ly e/abli%$  
,f$]al law1 z det]m9$ by ! ,supreme     
,c\rt ( ! ,unit$ ,/ates4  7f7 ,sup]s$es 
,?is ,act sup]s$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