IIB 

112TH CONGRESS 

1ST SESSION H. R. 358 

IN THE SENATE OF THE UNITED STATES 

OCTOBER 17, 2011 

Received; read twice and referred to the Committee on Finance 

AN ACT 

To amend the Patient Protection and Affordable Care Act 

to modify special rules relating to coverage of abortion 

services under such Act. 

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


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Protect Life Act’’. 

3 SEC. 2. MODIFYING SPECIAL RULES RELATING TO COV4 ERAGE OF ABORTION SERVICES UNDER THE 

5 PATIENT PROTECTION AND AFFORDABLE 

6 CARE ACT TO CONFORM TO LONG-STANDING 

7 FEDERAL POLICY. 

8 (a) IN GENERAL.—Section 1303 of the Patient Pro9 tection and Affordable Care Act (Public Law 111–148), 

10 as amended by section 10104(c) of such Act, is amend11 ed— 

12 (1) by redesignating subsections (c) and (d) as 

13 subsections (e) and (f), respectively; 

14 (2) by redesignating paragraph (4) of sub15 section (b) as subsection (d) and transferring such 

16 subsection (d) after the subsection (c) inserted by 

17 paragraph (4) of this subsection with appropriate in18 dentation (and conforming the style of the heading 

19 to a subsection heading); 

20 (3) by amending subsection (b) to read as fol21 lows: 

22 ‘‘(b) SPECIAL RULES RELATING TO TRAINING IN

23 AND COVERAGE OF ABORTION SERVICES.—Nothing in 

24 this Act (or any amendment made by this Act) shall be 

25 construed to require any health plan to provide coverage 

26 of or access to abortion services or to allow the Secretary 


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1 or any other Federal or non-Federal person or entity in 

2 implementing this Act (or amendment) to require coverage 

3 of, access to, or training in abortion services.’’; 

4 (4) by inserting after subsection (b) the fol5 lowing new subsection: 

6 ‘‘(c) LIMITATION ON ABORTION FUNDING.— 

7 ‘‘(1) IN GENERAL.—No funds authorized or ap8 propriated by this Act (or an amendment made by 

9 this Act), including credits applied toward qualified 

10 health plans under section 36B of the Internal Rev11 enue Code of 1986 or cost-sharing reductions under 

12 section 1402 of this Act, may be used to pay for any 

13 abortion or to cover any part of the costs of any 

14 health plan that includes coverage of abortion, ex15 cept— 

16 ‘‘(A) if the pregnancy is the result of an 

17 act of rape or incest; or 

18 ‘‘(B) in the case where a pregnant female 

19 suffers from a physical disorder, physical in20 jury, or physical illness that would, as certified 

21 by a physician, place the female in danger of 

22 death unless an abortion is performed, includ23 ing a life-endangering physical condition caused 

24 by or arising from the pregnancy itself. 


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1 ‘‘(2) OPTION TO PURCHASE SEPARATE COV2 ERAGE OR PLAN.—Nothing in this subsection shall 

3 be construed as prohibiting any non-Federal entity 

4 (including an individual or a State or local govern5 ment) from purchasing separate coverage for abor6 tions for which funding is prohibited under this sub7 section, or a qualified health plan that includes such 

8 abortions, so long as— 

9 ‘‘(A) such coverage or plan is paid for en10 tirely using only funds not authorized or appro11 priated by this Act; and 

12 ‘‘(B) such coverage or plan is not pur13 chased using— 

14 ‘‘(i) individual premium payments re15 quired for a qualified health plan offered 

16 through an Exchange towards which a 

17 credit is applied under section 36B of the 

18 Internal Revenue Code of 1986; or 

19 ‘‘(ii) other non-Federal funds required 

20 to receive a Federal payment, including a 

21 State’s or locality’s contribution of Med22 icaid matching funds. 

23 ‘‘(3) OPTION TO OFFER COVERAGE OR PLAN.— 

24 Nothing in this subsection or section 

25 1311(d)(2)(B)(i) shall restrict any non-Federal 


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1 health insurance issuer offering a qualified health 

2 plan from offering separate coverage for abortions 

3 for which funding is prohibited under this sub4 section, or a qualified health plan that includes such 

5 abortions, so long as— 

6 ‘‘(A) premiums for such separate coverage 

7 or plan are paid for entirely with funds not au8 thorized or appropriated by this Act; 

9 ‘‘(B) administrative costs and all services 

10 offered through such coverage or plan are paid 

11 for using only premiums collected for such cov12 erage or plan; and 

13 ‘‘(C) any such non-Federal health insur14 ance issuer that offers a qualified health plan 

15 through an Exchange that includes coverage for 

16 abortions for which funding is prohibited under 

17 this subsection also offers a qualified health 

18 plan through the Exchange that is identical in 

19 every respect except that it does not cover abor20 tions for which funding is prohibited under this 

21 subsection.’’; 

22 (5) in subsection (e), as redesignated by para23 graph (1)— 

24 (A) in the heading, by striking ‘‘REGARD25 ING ABORTION’’; 


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1 (B) in the heading of each of paragraphs 

2 (1) and (2), by striking each place it appears 

3 ‘‘REGARDING ABORTION’’; 

4 (C) in paragraph (1), by striking ‘‘regard5 ing the prohibition of (or requirement of) cov6 erage, funding, or’’ and inserting ‘‘protecting 

7 conscience rights, restricting or prohibiting 

8 abortion or coverage or funding of abortion, or 

9 establishing’’; and 

10 (D) in paragraph (2)(A), by striking 

11 ‘‘Nothing’’ and inserting ‘‘Subject to subsection 

12 (g), nothing’’; 

13 (6) in subsection (f), as redesignated by para14 graph (1), by striking ‘‘Nothing’’ and inserting 

15 ‘‘Subject to subsection (g), nothing’’; and 

16 (7) by adding at the end the following new sub17 section: 

18 ‘‘(g) NONDISCRIMINATION ON ABORTION.— 

19 ‘‘(1) NONDISCRIMINATION.—A Federal agency 

20 or program, and any State or local government that 

21 receives Federal financial assistance under this Act 

22 (or an amendment made by this Act), may not sub23 ject any institutional or individual health care entity 

24 to discrimination, or require any health plan created 

25 or regulated under this Act (or an amendment made 


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1 by this Act) to subject any institutional or individual 

2 health care entity to discrimination, on the basis 

3 that the health care entity refuses to— 

4 ‘‘(A) undergo training in the performance 

5 of induced abortions; 

6 ‘‘(B) require or provide such training; 

7 ‘‘(C) perform, participate in, provide cov8 erage of, or pay for induced abortions; or 

9 ‘‘(D) provide referrals for such training or 

10 such abortions. 

11 ‘‘(2) DEFINITION.—In this subsection, the term 

12 ‘health care entity’ includes an individual physician 

13 or other health care professional, a hospital, a pro14 vider-sponsored organization, a health maintenance 

15 organization, a health insurance plan, or any other 

16 kind of health care facility, organization, or plan. 

17 ‘‘(3) REMEDIES.— 

18 ‘‘(A) IN GENERAL.—The courts of the 

19 United States shall have jurisdiction to prevent 

20 and redress actual or threatened violations of 

21 this section by issuing any form of legal or eq22 uitable relief, including— 

23 ‘‘(i) injunctions prohibiting conduct 

24 that violates this subsection; and 


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1 ‘‘(ii) orders preventing the disburse2 ment of all or a portion of Federal finan3 cial assistance to a State or local govern4 ment, or to a specific offending agency or 

5 program of a State or local government, 

6 until such time as the conduct prohibited 

7 by this subsection has ceased. 

8 ‘‘(B) COMMENCEMENT OF ACTION.—An 

9 action under this subsection may be instituted 

10 by— 

11 ‘‘(i) any health care entity that has 

12 standing to complain of an actual or 

13 threatened violation of this subsection; or 

14 ‘‘(ii) the Attorney General of the 

15 United States. 

16 ‘‘(4) ADMINISTRATION.—The Secretary shall 

17 designate the Director of the Office for Civil Rights 

18 of the Department of Health and Human Services— 

19 ‘‘(A) to receive complaints alleging a viola20 tion of this subsection; and 

21 ‘‘(B) to pursue investigation of such com22 plaints in coordination with the Attorney Gen23 eral.’’. 

24 (b) CONFORMING AMENDMENT.—Section 1334(a)(6) 

25 of such Act is amended to read as follows: 


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1 ‘‘(6) COVERAGE CONSISTENT WITH FEDERAL

2 POLICY.—In entering into contracts under this sub3 section, the Director shall ensure that no multi-State 

4 qualified health plan offered in an Exchange pro5 vides coverage for abortions for which funding is 

6 prohibited under section 1303(c) of this Act.’’. 

Passed the House of Representatives October 13, 

2011. 

Attest: KAREN L. HAAS, 

Clerk. 


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