II

106TH CONGRESS

1ST SESSION S. 1400

To protect women’s reproductive health and constitutional right to choice,

and for other purposes.

IN THE SENATE OF THE UNITED STATES

JULY 20, 1999

Mrs. BOXER (for herself, Mrs. MURRAY, Mr. KENNEDY, Mr. LAUTENBERG,

and Mr. SCHUMER) introduced the following bill; which was read twice

and referred to the Committee on Health, Education, Labor, and Pensions

A BILL

To protect women’s reproductive health and constitutional

right to choice, and for other purposes.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

4 (a) SHORT TITLE.—This Act may be cited as the

5 ‘‘Family Planning and Choice Protection Act of 1999’’.

6 (b) TABLE OF CONTENTS.—The table of contents of

7 this Act is as follows:

Sec. 1. Short title; table of contents.

Sec. 2. Findings.

TITLE I—PREVENTION
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Subtitle A—Family Planning

Sec. 101. Family planning amendments.

Sec. 102. Freedom of full disclosure.

Subtitle B—Prescription Equity and Contraceptive Coverage

Sec. 111. Short title.

Sec. 112. Findings.

Sec. 113. Amendments to the Employee Retirement Income Security Act of

1974.

Sec. 114. Amendments to the Public Health Service Act relating to the group

market.

Sec. 115. Amendment to the Public Health Service Act relating to the individual market.

Sec. 116. FEHBP coverage.

Subtitle C—Emergency Contraceptives

Sec. 121. Emergency contraceptive education.

TITLE II—CHOICE PROTECTION

Sec. 201. Medicaid funding for abortion services.

Sec. 202. Clinic violence.

Sec. 203. Approval of RU–486.

Sec. 204. Freedom of choice.

Sec. 205. Fairness in insurance.

Sec. 206. Reproductive rights of women in the military.

Sec. 207. Repeal of certain State Child Health Insurance Program limitations.

Sec. 208. Funding for certain services for women in prison.

Sec. 209. Funding for certain services for women in the District of Columbia.

Sec. 210. Funding for certain services for women under the FEHBP.

1 SEC. 2. FINDINGS.

2 Congress makes the following findings:

3 (1) Reproductive rights are central to the abil4 ity of women to exercise full enjoyment of rights se5 cured to women by Federal and State law.

6 (2) Abortion has been a legal and constitu7 tionally protected medical procedure throughout the

8 United States since 1973 and has become part of

9 mainstream medical practice as is evidenced by the

10 positions of medical institutions including the Amer11 ican Medical Association, the American College of
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1 Obstetricians and Gynecologists, the American Med2 ical Women’s Association, the American Nurses As3 sociation, and the American Public Health Associa4 tion.

5 (3) The availability of abortion services is di6 minishing throughout the United States, as evi7 denced by—

8 (A) the fact that 86 percent of counties in

9 the United States have no abortion provider;

10 and

11 (B) the fact that, between 1992 and 1996,

12 the number of abortion providers decreased by

13 14 percent.

14 (4)(A) The Department of Health and Human

15 Services and the Institute of Medicine of the Na16 tional Academy of Sciences have contributed to the

17 development of a report entitled ‘‘Healthy People

18 2000’’, which urges that the rate of unintended

19 pregnancy in the United States be reduced by nearly

20 50 percent by the year 2000.

21 (B) Nearly 50 percent, or approximately

22 3,050,000, of all pregnancies in the United States

23 each year are unintended, resulting in 1,370,000

24 abortions in the United States each year.
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1 (C) The provision of family planning services,

2 including emergency contraception, is a cost-effective

3 way of reducing the number of unintended preg4 nancies and abortions in the United States.

5 TITLE I—PREVENTION

6 Subtitle A—Family Planning

7 SEC. 101. FAMILY PLANNING AMENDMENTS.

8 Section 1001(d) of the Public Health Service Act (42

9 U.S.C. 300(d)) is amended to read as follows:

10 ‘‘(d) For the purpose of making grants and entering

11 into contracts under this section, there are authorized to

12 be appropriated $500,000,000 for each of fiscal years

13 2000 through 2004.’’.

14 SEC. 102. FREEDOM OF FULL DISCLOSURE.

15 Title XI of the Civil Rights Act of 1964 (42 U.S.C.

16 2000h et seq.) is amended by adding at the end the fol17 lowing:

18 ‘‘SEC. 1107. INFORMATION ABOUT AVAILABILITY OF REPRO19 DUCTIVE HEALTH CARE SERVICES.

20 ‘‘(a) DEFINITION.—As used in this section, the term

21 ‘governmental authority’ means any authority of the

22 United States.

23 ‘‘(b) GENERAL AUTHORITY.—Notwithstanding any

24 other provision of law, no governmental authority shall,

25 in or through any program or activity that is administered
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1 or assisted by such authority and that provides health care

2 services or information, limit the right of any person to

3 provide, or the right of any person to receive, nonfraudu4 lent information about the availability of reproductive

5 health care services, including family planning, prenatal

6 care, adoption, and abortion services.’’.

7 Subtitle B—Prescription Equity

8 and Contraceptive Coverage

9 SEC. 111. SHORT TITLE.

10 This subtitle may be cited as the ‘‘Equity in Prescrip11 tion Insurance and Contraceptive Coverage Act of 1999’’.

12 SEC. 112. FINDINGS.

13 Congress finds that—

14 (1) each year, 3,000,000 pregnancies, or one

15 half of all pregnancies, in this country are unin16 tended;

17 (2) contraceptive services are part of basic

18 health care, allowing families to both adequately

19 space desired pregnancies and avoid unintended

20 pregnancy;

21 (3) studies show that contraceptives are cost ef22 fective: for every $1 of public funds invested in fam23 ily planning, $4 to $14 of public funds is saved in

24 pregnancy and health care-related costs;
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1 (4) by reducing rates of unintended pregnancy,

2 contraceptives help reduce the need for abortion;

3 (5) unintended pregnancies lead to higher rates

4 of infant mortality, low-birth weight, and maternal

5 morbidity, and threaten the economic viability of

6 families;

7 (6) the National Commission to Prevent Infant

8 Mortality determined that ‘‘infant mortality could be

9 reduced by 10 percent if all women not desiring

10 pregnancy used contraception’’;

11 (7) most women in the United States, including

12 three-quarters of women of childbearing age, rely on

13 some form of private insurance (through their own

14 employer, a family member’s employer, or the indi15 vidual market) to defray their medical expenses;

16 (8) the vast majority of private insurers cover

17 prescription drugs, but many exclude coverage for

18 prescription contraceptives;

19 (9) private insurance provides extremely limited

20 coverage of contraceptives: half of traditional indem21 nity plans and preferred provider organizations, 20

22 percent of point-of-service networks, and 7 percent

23 of health maintenance organizations cover no contra24 ceptive methods other than sterilization;
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1 (10) women of reproductive age spend 68 per2 cent more than men on out-of-pocket health care

3 costs, with contraceptives and reproductive health

4 care services accounting for much of the difference;

5 (11) the lack of contraceptive coverage in health

6 insurance places many effective forms of contracep7 tives beyond the financial reach of many women,

8 leading to unintended pregnancies;

9 (12) the Institute of Medicine Committee on

10 Unintended Pregnancy recommended that ‘‘financial

11 barriers to contraception be reduced by increasing

12 the proportion of all health insurance policies that

13 cover contraceptive services and supplies’’;

14 (13) in 1998, Congress agreed to provide con15 traceptive coverage to the 2,000,000 women of re16 productive age who are participating in the Federal

17 Employees Health Benefits Program, the largest

18 employer-sponsored health insurance plan in the

19 world; and

20 (14) eight in 10 privately insured adults sup21 port contraceptive coverage.

22 SEC. 113. AMENDMENTS TO THE EMPLOYEE RETIREMENT

23 INCOME SECURITY ACT OF 1974.

24 (a) IN GENERAL.—Subpart B of part 7 of subtitle

25 B of title I of the Employee Retirement Income Security
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1 Act of 1974 (29 U.S.C. 1185 et seq.) is amended by add2 ing at the end the following new section:

3 ‘‘SEC. 714. STANDARDS RELATING TO BENEFITS FOR CON4 TRACEPTIVES.

5 ‘‘(a) REQUIREMENTS FOR COVERAGE.—A group

6 health plan, and a health insurance issuer providing health

7 insurance coverage in connection with a group health plan,

8 may not—

9 ‘‘(1) exclude or restrict benefits for prescription

10 contraceptive drugs or devices approved by the Food

11 and Drug Administration, or generic equivalents ap12 proved as substitutable by the Food and Drug Ad13 ministration, if such plan provides benefits for other

14 outpatient prescription drugs or devices; or

15 ‘‘(2) exclude or restrict benefits for outpatient

16 contraceptive services if such plan provides benefits

17 for other outpatient services provided by a health

18 care professional (referred to in this section as ‘out19 patient health care services’).

20 ‘‘(b) PROHIBITIONS.—A group health plan, and a

21 health insurance issuer providing health insurance cov22 erage in connection with a group health plan, may not—

23 ‘‘(1) deny to an individual eligibility, or contin24 ued eligibility, to enroll or to renew coverage under

25 the terms of the plan because of the individual’s or
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1 enrollee’s use or potential use of items or services

2 that are covered in accordance with the requirements

3 of this section;

4 ‘‘(2) provide monetary payments or rebates to

5 a covered individual to encourage such individual to

6 accept less than the minimum protections available

7 under this section;

8 ‘‘(3) penalize or otherwise reduce or limit the

9 reimbursement of a health care professional because

10 such professional prescribed contraceptive drugs or

11 devices, or provided contraceptive services, described

12 in subsection (a), in accordance with this section; or

13 ‘‘(4) provide incentives (monetary or otherwise)

14 to a health care professional to induce such profes15 sional to withhold from a covered individual contra16 ceptive drugs or devices, or contraceptive services,

17 described in subsection (a).

18 ‘‘(c) RULES OF CONSTRUCTION.—

19 ‘‘(1) IN GENERAL.—Nothing in this section

20 shall be construed—

21 ‘‘(A) as preventing a group health plan

22 and a health insurance issuer providing health

23 insurance coverage in connection with a group

24 health plan from imposing deductibles, coinsur-
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1 ance, or other cost-sharing or limitations in re2 lation to—

3 ‘‘(i) benefits for contraceptive drugs

4 under the plan, except that such a deduct5 ible, coinsurance, or other cost-sharing or

6 limitation for any such drug may not be

7 greater than such a deductible, coinsur8 ance, or cost-sharing or limitation for any

9 outpatient prescription drug otherwise cov10 ered under the plan;

11 ‘‘(ii) benefits for contraceptive devices

12 under the plan, except that such a deduct13 ible, coinsurance, or other cost-sharing or

14 limitation for any such device may not be

15 greater than such a deductible, coinsur16 ance, or cost-sharing or limitation for any

17 outpatient prescription device otherwise

18 covered under the plan; and

19 ‘‘(iii) benefits for outpatient contra20 ceptive services under the plan, except that

21 such a deductible, coinsurance, or other

22 cost-sharing or limitation for any such

23 service may not be greater than such a de24 ductible, coinsurance, or cost-sharing or

25 limitation for any outpatient health care
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1 service otherwise covered under the plan;

2 and

3 ‘‘(B) as requiring a group health plan and

4 a health insurance issuer providing health in5 surance coverage in connection with a group

6 health plan to cover experimental or investiga7 tional contraceptive drugs or devices, or experi8 mental or investigational contraceptive services,

9 described in subsection (a), except to the extent

10 that the plan or issuer provides coverage for

11 other experimental or investigational outpatient

12 prescription drugs or devices, or experimental

13 or investigational outpatient health care serv14 ices.

15 ‘‘(2) LIMITATIONS.—As used in paragraph (1),

16 the term ‘limitation’ includes—

17 ‘‘(A) in the case of a contraceptive drug or

18 device, restricting the type of health care pro19 fessionals that may prescribe such drugs or de20 vices, utilization review provisions, and limits on

21 the volume of prescription drugs or devices that

22 may be obtained on the basis of a single con23 sultation with a professional; or

24 ‘‘(B) in the case of an outpatient contra25 ceptive service, restricting the type of health
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1 care professionals that may provide such serv2 ices, utilization review provisions, requirements

3 relating to second opinions prior to the coverage

4 of such services, and requirements relating to

5 preauthorizations prior to the coverage of such

6 services.

7 ‘‘(d) NOTICE UNDER GROUP HEALTH PLAN.—The

8 imposition of the requirements of this section shall be

9 treated as a material modification in the terms of the plan

10 described in section 102(a)(1), for purposes of assuring

11 notice of such requirements under the plan, except that

12 the summary description required to be provided under the

13 last sentence of section 104(b)(1) with respect to such

14 modification shall be provided by not later than 60 days

15 after the first day of the first plan year in which such

16 requirements apply.

17 ‘‘(e) PREEMPTION.—Nothing in this section shall be

18 construed to preempt any provision of State law to the

19 extent that such State law establishes, implements, or con20 tinues in effect any standard or requirement that provides

21 protections for enrollees that are greater than the protec22 tions provided under this section.

23 ‘‘(f) DEFINITION.—In this section, the term ‘out24 patient contraceptive services’ means consultations, exami25 nations, procedures, and medical services, provided on an
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1 outpatient basis and related to the use of contraceptive

2 methods (including natural family planning) to prevent an

3 unintended pregnancy.’’.

4 (b) CLERICAL AMENDMENT.—The table of contents

5 in section 1 of the Employee Retirement Income Security

6 Act of 1974 (29 U.S.C. 1001 note) is amended by insert7 ing after the item relating to section 713 the following

8 new item:

‘‘Sec. 714. Standards relating to benefits for contraceptives.’’.

9 (c) EFFECTIVE DATE.—The amendments made by

10 this section shall apply with respect to plan years begin11 ning on or after January 1, 2000.

12 SEC. 114. AMENDMENTS TO THE PUBLIC HEALTH SERVICE

13 ACT RELATING TO THE GROUP MARKET.

14 (a) IN GENERAL.—Subpart 2 of part A of title

15 XXVII of the Public Health Service Act (42 U.S.C.

16 300gg–4 et seq.) is amended by adding at the end the

17 following new section:

18 ‘‘SEC. 2707. STANDARDS RELATING TO BENEFITS FOR CON19 TRACEPTIVES.

20 ‘‘(a) REQUIREMENTS FOR COVERAGE.—A group

21 health plan, and a health insurance issuer providing health

22 insurance coverage in connection with a group health plan,

23 may not—

24 ‘‘(1) exclude or restrict benefits for prescription

25 contraceptive drugs or devices approved by the Food
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1 and Drug Administration, or generic equivalents ap2 proved as substitutable by the Food and Drug Ad3 ministration, if such plan provides benefits for other

4 outpatient prescription drugs or devices; or

5 ‘‘(2) exclude or restrict benefits for outpatient

6 contraceptive services if such plan provides benefits

7 for other outpatient services provided by a health

8 care professional (referred to in this section as ‘out9 patient health care services’).

10 ‘‘(b) PROHIBITIONS.—A group health plan, and a

11 health insurance issuer providing health insurance cov12 erage in connection with a group health plan, may not—

13 ‘‘(1) deny to an individual eligibility, or contin14 ued eligibility, to enroll or to renew coverage under

15 the terms of the plan because of the individual’s or

16 enrollee’s use or potential use of items or services

17 that are covered in accordance with the requirements

18 of this section;

19 ‘‘(2) provide monetary payments or rebates to

20 a covered individual to encourage such individual to

21 accept less than the minimum protections available

22 under this section;

23 ‘‘(3) penalize or otherwise reduce or limit the

24 reimbursement of a health care professional because

25 such professional prescribed contraceptive drugs or
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1 devices, or provided contraceptive services, described

2 in subsection (a), in accordance with this section; or

3 ‘‘(4) provide incentives (monetary or otherwise)

4 to a health care professional to induce such profes5 sional to withhold from covered individual contracep6 tive drugs or devices, or contraceptive services, de7 scribed in subsection (a).

8 ‘‘(c) RULES OF CONSTRUCTION.—

9 ‘‘(1) IN GENERAL.—Nothing in this section

10 shall be construed—

11 ‘‘(A) as preventing a group health plan

12 and a health insurance issuer providing health

13 insurance coverage in connection with a group

14 health plan from imposing deductibles, coinsur15 ance, or other cost-sharing or limitations in re16 lation to—

17 ‘‘(i) benefits for contraceptive drugs

18 under the plan, except that such a deduct19 ible, coinsurance, or other cost-sharing or

20 limitation for any such drug may not be

21 greater than such a deductible, coinsur22 ance, or cost-sharing or limitation for any

23 outpatient prescription drug otherwise cov24 ered under the plan;
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1 ‘‘(ii) benefits for contraceptive devices

2 under the plan, except that such a deduct3 ible, coinsurance, or other cost-sharing or

4 limitation for any such device may not be

5 greater than such a deductible, coinsur6 ance, or cost-sharing or limitation for any

7 outpatient prescription device otherwise

8 covered under the plan; and

9 ‘‘(iii) benefits for outpatient contra10 ceptive services under the plan, except that

11 such a deductible, coinsurance, or other

12 cost-sharing or limitation for any such

13 service may not be greater than such a de14 ductible, coinsurance, or cost-sharing or

15 limitation for any outpatient health care

16 service otherwise covered under the plan;

17 and

18 ‘‘(B) as requiring a group health plan and

19 a health insurance issuer providing health in20 surance coverage in connection with a group

21 health plan to cover experimental or investiga22 tional contraceptive drugs or devices, or experi23 mental or investigational contraceptive services,

24 described in subsection (a), except to the extent

25 that the plan or issuer provides coverage for
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1 other experimental or investigational outpatient

2 prescription drugs or devices, or experimental

3 or investigational outpatient health care serv4 ices.

5 ‘‘(2) LIMITATIONS.—As used in paragraph (1),

6 the term ‘limitation’ includes—

7 ‘‘(A) in the case of a contraceptive drug or

8 device, restricting the type of health care pro9 fessionals that may prescribe such drugs or de10 vices, utilization review provisions, and limits on

11 the volume of prescription drugs or devices that

12 may be obtained on the basis of a single con13 sultation with a professional; or

14 ‘‘(B) in the case of an outpatient contra15 ceptive service, restricting the type of health

16 care professionals that may provide such serv17 ices, utilization review provisions, requirements

18 relating to second opinions prior to the coverage

19 of such services, and requirements relating to

20 preauthorizations prior to the coverage of such

21 services.

22 ‘‘(d) NOTICE.—A group health plan under this part

23 shall comply with the notice requirement under section

24 714(d) of the Employee Retirement Income Security Act
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1 of 1974 with respect to the requirements of this section

2 as if such section applied to such plan.

3 ‘‘(e) PREEMPTION.—Nothing in this section shall be

4 construed to preempt any provision of State law to the

5 extent that such State law establishes, implements, or con6 tinues in effect any standard or requirement that provides

7 protections for enrollees that are greater than the protec8 tions provided under this section.

9 ‘‘(f) DEFINITION.—In this section, the term ‘out10 patient contraceptive services’ means consultations, exami11 nations, procedures, and medical services, provided on an

12 outpatient basis and related to the use of contraceptive

13 methods (including natural family planning) to prevent an

14 unintended pregnancy.’’.

15 (b) EFFECTIVE DATE.—The amendments made by

16 this section shall apply with respect to group health plans

17 for plan years beginning on or after January 1, 2000.

18 SEC. 115. AMENDMENT TO THE PUBLIC HEALTH SERVICE

19 ACT RELATING TO THE INDIVIDUAL MARKET.

20 (a) IN GENERAL.—Part B of title XXVII of the Pub21 lic Health Service Act (42 U.S.C. 300gg–41 et seq.) is

22 amended—

23 (1) by redesignating the first subpart 3 (relat24 ing to other requirements) as subpart 2; and
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1 (2) by adding at the end of subpart 2 the fol2 lowing new section:

3 ‘‘SEC. 2753. STANDARDS RELATING TO BENEFITS FOR CON4 TRACEPTIVES.

5 ‘‘The provisions of section 2707 shall apply to health

6 insurance coverage offered by a health insurance issuer

7 in the individual market in the same manner as they apply

8 to health insurance coverage offered by a health insurance

9 issuer in connection with a group health plan in the small

10 or large group market.’’.

11 (b) EFFECTIVE DATE.—The amendment made by

12 this section shall apply with respect to health insurance

13 coverage offered, sold, issued, renewed, in effect, or oper14 ated in the individual market on or after January 1, 2000.

15 SEC. 116. FEHBP COVERAGE.

16 (a) PROHIBITION.—No Federal funds may be used

17 to enter into or renew a contract which includes a provi18 sion providing prescription drug coverage unless the con19 tract also includes a provision for contraceptive coverage.

20 (b) LIMITATION.—Nothing in this section shall apply

21 to a contract with—

22 (1) any of the following religious plans—

23 (A) SelectCare;

24 (B) Personal CaresHMO;

25 (C) Care Choices;
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1 (D) OSF Health Plans, Inc.;

2 (E) Yellowstone Community Health Plan;

3 and

4 (2) any existing or future plan, if the plan ob5 jects to such coverage on the basis of religious be6 liefs.

7 (c) REFUSAL TO PRESCRIBE.—In implementing this

8 section, any plan that enters into or renews a contract

9 under this section may not subject any individual to dis10 crimination on the basis that the individual refuses to pre11 scribe contraceptives because such activities would be con12 trary to the individual’s religious beliefs or moral convic13 tions.

14 Subtitle C—Emergency

15 Contraceptives

16 SEC. 121. EMERGENCY CONTRACEPTIVE EDUCATION.

17 (a) DEFINITION.—In this section:

18 (1) EMERGENCY CONTRACEPTIVE.—The term

19 ‘‘emergency contraceptive’’ means a drug or device

20 (as the terms are defined in section 201 of the Fed21 eral Food, Drug, and Cosmetic Act (21 U.S.C. 321))

22 that is designed—

23 (A) to be used after sexual relations; and
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1 (B) to prevent pregnancy, by preventing

2 ovulation, fertilization of an egg, or implanta3 tion of an egg in a uterus.

4 (2) HEALTH CARE PROVIDER.—The term

5 ‘‘health care provider’’ means anyone licensed or cer6 tified under State law to provide health care services

7 who is operating within the scope of such license.

8 (3) INSTITUTION OF HIGHER EDUCATION.—The

9 term ‘‘institution of higher education’’ has the

10 meaning given the term in section 1201(a) of the

11 Higher Education Act of 1965 (20 U.S.C. 1141(a)).

12 (b) EMERGENCY CONTRACEPTIVE PUBLIC EDU13 CATION PROGRAM.—

14 (1) IN GENERAL.—The Secretary of Health and

15 Human Services, acting through the Director of the

16 Centers for Disease Control, shall develop and dis17 seminate to the public information on emergency

18 contraceptives.

19 (2) DEVELOPMENT AND DISSEMINATION.—The

20 Secretary may develop and disseminate the informa21 tion directly or through arrangements with nonprofit

22 organizations, consumer groups, institutions of high23 er education, Federal, State, or local agencies, and

24 clinics.
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1 (3) INFORMATION.—The information shall in2 clude, at a minimum, information describing emer3 gency contraceptives, and explaining the use, effects,

4 efficacy, and availability of the contraceptives.

5 (c) EMERGENCY CONTRACEPTIVE INFORMATION

6 PROGRAM FOR HEALTH CARE PROVIDERS.—

7 (1) IN GENERAL.—The Secretary of Health and

8 Human Services, acting through the Administrator

9 of the Health Resources and Services Administra10 tion, shall develop and disseminate to health care

11 providers information on emergency contraceptives.

12 (2) INFORMATION.—The information shall in13 clude, at a minimum—

14 (A) information describing the use, effects,

15 efficacy and availability of the contraceptives;

16 (B) a recommendation from the Secretary

17 regarding the use of the contraceptives in ap18 propriate cases; and

19 (C) information explaining how to obtain

20 copies of the information developed under sub21 section (b), for distribution to the patients of

22 the providers.

23 (d) AUTHORIZATION OF APPROPRIATIONS.—There is

24 authorized to be appropriated to carry out this section
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1 $5,000,000 for the period consisting of fiscal years 2000

2 through 2002.

3 TITLE II—CHOICE PROTECTION

4 SEC. 201. MEDICAID FUNDING FOR ABORTION SERVICES.

5 Sections 508 and 509 of the Departments of Labor,

6 Health and Human Services, and Education, and Related

7 Agencies Appropriations Act, 1999 (Public Law 105–277)

8 are repealed.

9 SEC. 202. CLINIC VIOLENCE.

10 (a) FINDINGS.—Congress makes the following find11 ings:

12 (1) Federal resources are necessary to ensure

13 that women have safe access to reproductive health

14 facilities and that health professionals can deliver

15 services in a secure environment free from violence

16 and threats of force.

17 (2) It is necessary and appropriate to use Fed18 eral resources to combat the nationwide campaign of

19 violence and harassment against reproductive health

20 centers.

21 (3) The Congress should support further in22 creasing Federal resources to fully ensure the safety

23 of health professionals, center staff, and all women

24 using reproductive health center services and the

25 family members of such persons.
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1 (b) NATIONAL TASK FORCE ON VIOLENCE AGAINST

2 HEALTH CARE PROVIDERS.—

3 (1) ESTABLISHMENT.—There is established

4 within the Department of Justice a task force to be

5 known as the ‘‘Task Force on Violence Against

6 Health Care Providers’’ (referred to in this sub7 section as the ‘‘Task Force’’).

8 (2) COMPOSITION.—The Task Force shall be

9 composed of at least 1 individual to be appointed by

10 the Attorney General from each of the following:

11 (A) The Bureau of Alcohol, Tobacco and

12 Firearms.

13 (B) The Federal Bureau of Investigation.

14 (C) The United States Marshal Service.

15 (D) The United States Postal Service.

16 (E) The Civil Rights Division of the De17 partment of Justice.

18 (F) The Criminal Division of the Depart19 ment of Justice.

20 (3) POWERS AND DUTIES.—The Task Force

21 shall—

22 (A) coordinate investigative, prosecutorial

23 and enforcement efforts of Federal, State and

24 local governments in cases related to violence at
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1 reproductive health care facilities and violence

2 against health care providers;

3 (B) under the direction of the Attorney

4 General, conduct security assessments for re5 productive health care facilities; and

6 (C) provide training for local law enforce7 ment to appropriately address incidences of vio8 lence against reproductive health care facilities

9 and provide methodologies for assessing risks

10 and promoting security at reproductive health

11 care facilities.

12 (4) AUTHORIZATION OF APPROPRIATIONS.—

13 There is authorized to be appropriated $2,000,000

14 for each fiscal year to carry out this subsection.

15 (c) GRANTS FOR CLINIC SECURITY.—

16 (1) IN GENERAL.—The Office of Justice Pro17 grams within the Department of Justice shall award

18 grants to reproductive health care facilities to enable

19 such facilities to enhance security and to purchase

20 and install security devices.

21 (2) AUTHORIZATION OF APPROPRIATIONS.—

22 There is authorized to be appropriated, $5,000,000

23 for each of fiscal years 2000 through 2004 to carry

24 out this subsection.
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1 SEC. 203. APPROVAL OF RU–486.

2 The Secretary of Health and Human Services shall—

3 (1) ensure that a decision by the Food and

4 Drug Administration to approve the drug called

5 Mifepristone or RU–486 shall be made only on the

6 basis provided in law; and

7 (2) assess initiatives by which the Department

8 of Health and Human Services can promote the

9 testing, licensing, and manufacturing in the United

10 States of the drug or other antiprogestins.

11 SEC. 204. FREEDOM OF CHOICE.

12 (a) FINDINGS.—Congress finds the following:

13 (1) The 1973 Supreme Court decision in Roe v.

14 Wade, 410 U.S. 113 (1973) established constitu15 tionally based limits on the power of States to re16 strict the right of a woman to choose to terminate

17 a pregnancy. Under the strict scrutiny standard

18 enunciated in the Roe v. Wade decision, States were

19 required to demonstrate that laws restricting the

20 right of a woman to choose to terminate a pregnancy

21 were the least restrictive means available to achieve

22 a compelling State interest. Since 1992, the Su23 preme Court has no longer applied the strict scru24 tiny standard in reviewing challenges to the constitu25 tionality of State laws restricting such rights.
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1 (2) As a result of modifications made by the

2 Supreme Court of the strict scrutiny standard enun3 ciated in the Roe v. Wade decision, certain States

4 have restricted the right of women to choose to ter5 minate a pregnancy or to utilize some forms of con6 traception, and the restrictions operate cumulatively

7 to—

8 (A)(i) increase the number of illegal or

9 medically less safe abortions, often resulting in

10 physical impairment, loss of reproductive capac11 ity, or death to the women involved;

12 (ii) burden interstate and international

13 commerce by forcing women to travel from

14 States in which legal barriers render contracep15 tion or abortion unavailable or unsafe to other

16 States or foreign nations;

17 (iii) interfere with freedom of travel be18 tween and among the various States;

19 (iv) burden the medical and economic re20 sources of States that continue to provide

21 women with access to safe and legal abortion;

22 and

23 (v) interfere with the ability of medical

24 professionals to provide health services;
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1 (B) obstruct access to and use of contra2 ceptive and other medical techniques that are

3 part of interstate and international commerce;

4 (C) discriminate between women who are

5 able to afford interstate and international travel

6 and women who are not, a disproportionate

7 number of whom belong to racial or ethnic mi8 norities; and

9 (D) infringe on the ability of women to ex10 ercise full enjoyment of rights secured to

11 women by Federal and State law, both statu12 tory and constitutional.

13 (3) Although Congress may not by legislation

14 create constitutional rights, Congress may, where

15 authorized by a constitutional provision enumerating

16 the powers of Congress and not prohibited by a con17 stitutional provision, enact legislation to create and

18 secure statutory rights in areas of legitimate na19 tional concern.

20 (4) Congress has the affirmative power under

21 section 8 of article I of the Constitution and under

22 section 5 of the 14th amendment to the Constitution

23 to enact legislation to prohibit State interference

24 with interstate commerce, liberty, or equal protection

25 of the laws.
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1 (b) PURPOSE.—The purpose of this section is to es2 tablish, as a statutory matter, limitations on the power

3 of a State to restrict the freedom of a woman to terminate

4 a pregnancy in order to achieve the same limitations on

5 State action as were provided, as a constitutional matter,

6 under the strict scrutiny standard of review enunciated in

7 the Roe v. Wade decision.

8 (c) DEFINITION.—As used in this section, the term

9 ‘‘State’’ includes the District of Columbia, the Common10 wealth of Puerto Rico, and each other territory or posses11 sion of the United States.

12 (d) GENERAL AUTHORITY.—A State—

13 (1) may not restrict the freedom of a woman to

14 choose whether or not to terminate a pregnancy be15 fore fetal viability;

16 (2) may restrict the freedom of a woman to

17 choose whether or not to terminate a pregnancy

18 after fetal viability unless such a termination is nec19 essary to preserve the life or health of the woman;

20 and

21 (3) may impose requirements on the perform22 ance of abortion procedures if such requirements are

23 medically necessary to protect the health of women

24 undergoing such procedures.
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1 (e) RULES OF CONSTRUCTION.—Nothing in this sec2 tion shall be construed to—

3 (1) prevent a State from promulgating regula4 tions to protect unwilling individuals or private

5 health care institutions from being required to par6 ticipate in the performance of abortions to which the

7 individuals or institutions are conscientiously op8 posed;

9 (2) prevent a State from promulgating regula10 tions to permit the State to decline to pay for the

11 performance of abortions; or

12 (3) prevent a State from promulgating regula13 tions to require a minor to involve a parent, guard14 ian, or other responsible adult before terminating a

15 pregnancy;

16 so long as such regulations meet constitutional standards.

17 SEC. 205. FAIRNESS IN INSURANCE.

18 Notwithstanding any other provision of law, no Fed19 eral law shall be construed to prohibit a health plan from

20 offering coverage for the full range of reproductive health

21 care services, including abortion services.

22 SEC. 206. REPRODUCTIVE RIGHTS OF WOMEN IN THE MILI23 TARY.

24 Section 1093 of title 10, United States Code, is

25 amended—
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1 (1) in subsection (a), by inserting before the pe2 riod the following: ‘‘or in a case in which the preg3 nancy involved is the result of an act of rape or in4 cest or the abortion involved is medically necessary

5 or appropriate’’;

6 (2) by striking subsection (b); and

7 (3) by adding at the end the following:

8 ‘‘(b) ABORTIONS IN FACILITIES OVERSEAS.—Sub9 section (a) does not limit the performing of an abortion

10 in a facility of the uniformed services located outside the

11 48 contiguous States of the United States if—

12 ‘‘(1) the cost of performing the abortion is fully

13 paid from a source or sources other than funds

14 available to the Department of Defense;

15 ‘‘(2) abortions are not prohibited by the laws of

16 the jurisdiction where the facility is located; and

17 ‘‘(3) the abortion would otherwise be permitted

18 under the laws applicable to the provision of health

19 care to members and former members of the uni20 formed services and their dependents in such facil21 ity.’’.

22 SEC. 207. REPEAL OF CERTAIN STATE CHILD HEALTH IN23 SURANCE PROGRAM LIMITATIONS.

24 (a) IN GENERAL.—Section 2105(c) of the Social Se25 curity Act (42 U.S.C. 1397ee(c)) is amended—
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1 (1) in paragraph (1), by striking ‘‘, and any

2 health’’ and all that follows through ‘‘incest’’; and

3 (2) by striking paragraph (7).

4 (b) CHILD HEALTH ASSISTANCE.—Section

5 2110(a)(16) of the Social Security Act (42 U.S.C.

6 1397jj(a)(16)) is amended by striking ‘‘only if ’’ and all

7 that follows and inserting ‘‘services;’’.

8 SEC. 208. FUNDING FOR CERTAIN SERVICES FOR WOMEN

9 IN PRISON.

10 Sections 103 and 104 of title I of the Departments

11 of Commerce, Justice, and State, the Judiciary, and Re12 lated Agencies Appropriations Act, 1999 (Public Law

13 105–277) are repealed.

14 SEC. 209. FUNDING FOR CERTAIN SERVICES FOR WOMEN

15 IN THE DISTRICT OF COLUMBIA.

16 Section 131 of the District of Columbia Appropria17 tions Act, 1999 (Public Law 105–277) is repealed.

18 SEC. 210. FUNDING FOR CERTAIN SERVICES FOR WOMEN

19 UNDER THE FEHBP.

20 Sections 509 and 510 of the Treasury and General

21 Government Appropriations Act, 1999 (Public Law 105–

22 277) are repealed.

Æ