,,ii ,calendar ,no4 #bf #aahth ,,congress #ast ,session ,s4 #gja ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,march #h1 #bjbc,ms4 ,baldwin 7for herself1 ,mr4 ,blumenthal1 ,mrs4 ,murray1 ,mr4 ,schumer1 ,ms4 ,warren1 ,ms4 ,cortez ,masto1 ,ms4 ,klobuchar1 ,ms4 ,stabenow1 ,mrs4 ,gillibrand1 ,mr4 ,murphy1 ,mr4 ,bennet1 ,mr4 ,booker1 ,mr4 ,brown1 ,ms4 ,cantwell1 ,mr4 ,cardin1 ,mr4 ,carper1 ,mr4 ,coons1 ,ms4 ,duckworth1 ,mr4 ,durbin1 ,mrs4 ,feinstein1 ,mr4 ,fetterman1 ,ms4 ,hassan1 ,mr4 ,heinrich1 ,mr4 ,hickenlooper1 ,ms4 ,hirono1 ,mr4 ,kaine1 ,mr4 ,kelly1 ,mr4 ,king1 ,mr4 ,lujn1 ,mr4 ,markey1 ,mr4 ,menendez1 ,mr4 ,merkley1 ,mr4 ,ossoff1 ,mr4 ,padilla1 ,mr4 ,peters1 ,mr4 ,reed1 ,ms4 ,rosen1 ,mr4 ,sanders1 ,mr4 ,schatz1 ,mrs4 ,shaheen1 ,ms4 ,sinema1 ,ms4 ,smith1 ,mr4 ,tester1 ,mr4 ,van ,hollen1 ,mr4 ,warner1 ,mr4 ,warnock1 ,mr4 ,welch1 ,mr4 ,whitehouse1 and ,mr4 ,wyden7 introduced the following bill2 which was read the first time ,march #i1 #bjbc,read the second time and placed on the calendar ,a ,,bill ,to protect a person's ability to determine whether to continue or end a pregnancy1 and to protect a health care provider's ability to provide abortion services4 #a4 ,short title ,this ,act may be cited as the ,women's ,health ,protection ,act of #bjbc4 #b4 ,purpose ,the purposes of this ,act are as follows3 7#a7 ,to permit people to seek and obtain abortion services1 and to permit health care providers to provide abortion services1 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 procedures1 do not significantly advance reproductive health or the safety of abortion services1 or make abortion services more difficult to access4 7#b7 ,to promote access to abortion services and thereby protect women's ability to participate equally in the economic and social life of the ,united ,states4 7#c7 ,to protect people's ability to make decisions about their bodies1 medical care1 family1 and life's course4 7#d7 ,to eliminate unwarranted burdens on commerce and the right to travel4 ,abortion bans and restrictions invariably affect commerce over which the ,united ,states has jurisdiction4 ,health care providers engage in economic and commercial activity when they provide abortion services4 ,moreover1 there is an interstate market for abortion services and1 in order to provide such services1 health care providers engage in interstate commerce to purchase medicine1 medical equipment1 and other necessary goods and services2 to obtain and provide training2 and to employ and obtain commercial services from health care personnel1 many of whom themselves engage in interstate commerce1 including by traveling across ,state lines4 ,congress has the authority to enact this ,act to protect access to abortion services pursuant to-- 7,a7 its powers under the commerce clause of section #h of article ,i of the ,constitution of the ,united ,states2 7,b7 its powers under section #e of the ,fourteenth ,amendment to the ,constitution of the ,united ,states to enforce the provisions of section #a of the ,fourteenth ,amendment2 and 7,c7 its powers under the necessary and proper clause of section #h of ,article ,i of the ,constitution of the ,united ,states4 #c4 ,definitions ,in this ,act3 7#a7 ,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 7whether or not provided at the same time or on the same day as the abortion74 7#b7 ,government ,the term government includes each branch1 department1 agency1 instrumentality1 and official of the ,united ,states or a ,state4 7#c7 ,health care provider ,the term health care provider means any entity 7including any hospital1 clinic1 or pharmacy7 or individual 7including any physician1 certified nurse-midwife1 nurse practitioner1 pharmacist1 or physician assistant7 that-- 7,a7 is engaged or seeks to engage in the delivery of health care services1 including abortion services2 and 7,b7 if required by law or regulation to be licensed or certified to engage in the delivery of such services-- 7i7 is so licensed or certified2 or 7ii7 would be so licensed or certified but for their past1 present1 or potential provision of abortion services protected by section #d4 7#d7 ,medically comparable procedures ,the term medically comparable procedures means medical procedures that are similar in terms of health and safety risks to the patient1 complexity1 or the clinical setting that is indicated4 7#e7 ,pregnancy ,the term pregnancy refers to the period of the human reproductive process beginning with the implantation of a fertilized egg4 7#f7 ,state ,the term ,state includes the ,district of ,columbia1 the ,commonwealth of ,puerto ,rico1 and each territory and possession of the ,united ,states1 and any subdivision of any of the foregoing1 including any unit of local government1 such as a county1 city1 town1 village1 or other general purpose political subdivision of a ,state4 7#g7 ,viability ,the term viability means the point in a pregnancy at which1 in the good-faith medical judgment of the treating health care provider1 and based on the particular facts of the case before the health care provider1 there is a reasonable likelihood of sustained fetal survival outside the uterus with or without artificial support4 #d4 ,protected activities and services 7a7 ,general rules 7#a7 ,pre-viability ,a health care provider has a right under this ,act to provide abortion services1 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 requirements3 7,a7 ,a prohibition on abortion prior to viability1 including a prohibition or restriction on a particular abortion procedure or method1 or a prohibition on providing or obtaining such abortions4 7,b7 ,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 judgment1 or a limitation on a patient's ability to receive or use such drugs1 other than a limitation generally applicable to the prescription1 dispensing1 or distribution of drugs4 7,c7 ,a limitation on a health care provider's ability to provide1 or a patient's ability to receive1 abortion services via telemedicine1 other than a limitation generally applicable to the provision of medically comparable services via telemedicine4 7,d7 ,a limitation or prohibition on a patient's ability to receive1 or a provider's ability to provide1 abortion services in a ,state based on the ,state of residency of the patient1 or a prohibition or limitation on the ability of any individual to assist or support a patient seeking abortion4 7,e7 ,a requirement that a health care provider perform specific tests or medical procedures in connection with the provision of abortion services 7including prior to or subsequent to the abortion71 unless generally required for the provision of medically comparable procedures4 7,f7 ,a requirement that a health care provider offer or provide a patient seeking abortion services medically inaccurate information4 7,g7 ,a limitation or requirement concerning the physical plant1 equipment1 staffing1 or hospital transfer arrangements of facilities where abortion services are provided1 or the credentials or hospital privileges or status of personnel at such facilities1 that is not imposed on facilities or the personnel of facilities where medically comparable procedures are performed4 7,h7 ,a requirement that1 prior to obtaining an abortion1 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 services4 7,i7 ,a limitation on a health care provider's ability to provide immediate abortion services when that health care provider believes1 based on the good-faith medical judgment of the provider1 that delay would pose a risk to the patient's life or health4 7,j7 ,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 services1 or a limitation on providing or obtaining abortion services at any point or points in time prior to viability based on any actual1 perceived1 or potential reason or reasons of the patient for obtaining abortion services1 regardless of whether the limitation is based on a health care provider's actual or constructive knowledge of such reason or reasons4 7#b7 ,post-viability 7,a7 ,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 when1 in the good-faith medical judgement of the treating health care provider1 it is necessary to protect the life or health of the patient4 ,this subparagraph shall not otherwise apply after viability4 7,b7 ,additional circumstances ,a ,state may provide additional circumstances under which post viability abortions are permitted under this paragraph4 7,c7 ,limitation ,in the case where a termination of a pregnancy after viability1 in the good-faith medical judgement of the treating health care provider1 is necessary to protect the life or health of the patient1 a ,state shall not impose any of the limitations or requirements described in paragraph 7#a7 7b7 ,other limitations or requirements ,the rights described in subsection 7a7 shall not be limited or otherwise infringed through any other limitation or requirement that-- 7#a7 expressly1 effectively1 implicitly1 or as implemented1 singles out abortion1 the provision of abortion services1 individuals who seek abortion services or who provide assistance and support to those seeking abortion services1 health care providers who provide abortion services1 or facilities in which abortion services are provided2 and 7#b7 impedes access to abortion services4 7c7 ,factors for consideration ,a court may consider the following factors1 among others1 in determining whether a limitation or requirement impedes access to abortion services for purposes of subsection 7b77#b73 7#a7 ,whether the limitation or requirement1 in a provider's good-faith medical judgment1 interferes with a health care provider's ability to provide care and render services1 or poses a risk to the patient's health or safety4 7#b7 ,whether the limitation or requirement is reasonably likely to delay or deter a patient in accessing abortion services4 7#c7 ,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 travel1 childcare1 or time off work4 7#d7 ,whether the limitation or requirement is reasonably likely to have the effect of necessitating patient travel that would not otherwise have been required1 including by making it necessary for a patient to travel out of ,state to obtain services4 7#e7 ,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 region4 7#f7 ,whether the limitation or requirement imposes penalties that are not imposed on other health care providers for comparable conduct or failure to act1 or that are more severe than penalties imposed on other health care providers for comparable conduct or failure to act4 7#g7 ,the cumulative impact of the limitation or requirement combined with other limitations or requirements4 7d7 ,exception ,to defend against a claim that a limitation or requirement violates a health care provider's or patient's rights under subsection 7b7 a party must establish1 by clear and convincing evidence1 that the limitation or requirement is essential to significantly advance the safety of abortion services or the health of the 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 7b774 #e4 ,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 residence1 including to obtain reproductive health services such as prenatal1 childbirth1 fertility1 and abortion services1 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 section4 #f4 ,applicability and preemption 7a7 ,in general 7#a7 ,superseding inconsistent laws ,except as provided under subsection 7b71 this ,act shall supersede any inconsistent ,federal or ,state law1 and the implementation of such law1 whether statutory1 common law1 or otherwise1 and whether adopted prior to or after the date of enactment of this ,act4 ,a ,federal or ,state government official shall not administer1 implement1 or enforce any law1 rule1 regulation1 standard1 or other provision having the force and effect of law that conflicts with any provision of this ,act1 notwithstanding any other provision of ,federal law1 including the ,religious ,freedom ,restoration ,act of #aiic 7#db ,u4,s4,c4 #bjjj;bb et seq474 7#b7 ,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 ,act4 7b7 ,limitations ,the provisions of this ,act shall not supersede or apply to-- 7#a7 laws regulating physical access to clinic entrances2 7#b7 laws regulating insurance or medical assistance coverage of abortion services2 7#c7 the procedure described in section #aeca7;b77#a7 of title #ah1 ,united ,states ,code2 or 7#d7 generally applicable ,state contract law4 7c7 ,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 #d or section #e or against any person or entity who has taken any step to assist any such person or entity in exercising such right1 this ,act shall also apply to1 and may be raised as a defense by1 such person or entity1 in addition to the remedies specified in section #h4 #g4 ,rules of construction 7a7 ,liberal construction by courts ,in any action before a court under this ,act1 the court shall liberally construe the provisions of this ,act to effectuate the purposes of the ,act4 7b7 ,protection of life and health ,nothing in this ,act shall be construed to authorize any government official to interfere with1 diminish1 or negatively affect a person's ability to obtain or provide abortion services prior to viability or after viability when1 in the good-faith medical judgment of the treating health care provider1 continuation of the pregnancy would pose a risk to the pregnant patient's life or health4 7c7 ,government officials ,any person who1 by operation of a provision of ,federal or ,state law1 is permitted to implement or enforce a limitation or requirement that violates section #d or #e shall be considered a government official for purposes of this ,act4 #h4 ,enforcement 7a7 ,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 violates1 or against any government official 7including a person described in section #g7;c77 who implements or enforces a limitation or requirement that violates1 section #d or #e4 ,the court shall declare unlawful the limitation or requirement if it is determined to be in violation of this ,act4 7b7 ,private right of action 7#a7 ,in general ,any individual or entity adversely affected by an alleged violation of this ,act1 including any person or health care provider1 may commence a civil action against any government official 7including a person described in section #g7;c77 that implements or enforces a limitation or requirement that violates1 section #d or #e4 ,the court shall declare unlawful the limitation or requirement if it is in violation of this ,act4 7#b7 ,health care provider ,a health care provider may commence an action for relief on its own behalf1 on behalf of the provider's staff1 and on behalf of the provider's patients who are or may be adversely affected by an alleged violation of this ,act4 7c7 ,pre-enforcement challenges ,a suit under subsection 7a7 or 7b7 may be brought to prevent enforcement or implementation by any government of a ,state limitation or requirement that is inconsistent with section #d or #e4 7d7 ,declaratory and equitable relief ,in any action under this section1 the court may award appropriate declaratory and equitable relief1 including temporary1 preliminary1 or permanent injunctive relief4 7e7 ,costs ,in any action under this section1 the court shall award costs of litigation1 as well as reasonable attorney's fees1 to any prevailing plaintiff4 ,a plaintiff shall not be liable to a defendant for costs or attorney's fees in any non-frivolous action under this section4 7f7 ,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 law4 7g7 ,abrogation of state immunity ,neither a ,state that enforces or maintains1 nor a government official 7including a person described in section #g7;c77 who is permitted to implement or enforce any limitation or requirement that violates section #d or #e shall be immune under the ,tenth ,amendment to the ,constitution of the ,united ,states1 the ,eleventh ,amendment to the ,constitution of the ,united ,states1 or any other source of law1 from an action in a ,federal or ,state court of competent jurisdiction challenging that limitation or requirement1 unless such immunity is required by clearly established ,federal law1 as determined by the ,supreme ,court of the ,united ,states4 #i4 ,effective date ,this ,act shall take effect upon the date of enactment of this ,act4 #aj4 ,severability ,if any provision of this ,act1 or the application of such provision to any person1 entity1 government1 or circumstance1 is held to be unconstitutional1 the remainder of this ,act1 or the application of such provision to all other persons1 entities1 governments1 or circumstances1 shall not be affected thereby4 ,march #i1 #bjbc,read the second time and placed on the calendar