IB 

Union Calendar No. 133 

112TH CONGRESS 

1ST SESSION H. R. 358 

[Report No. 112–40, Part I] 

To amend the Patient Protection and Affordable Care Act to modify special 

rules relating to coverage of abortion services under such Act. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 20, 2011 

Mr. PITTS (for himself, Mr. LIPINSKI, Mrs. SCHMIDT, Mr. ROSS of Arkansas, 

Mr. SMITH of New Jersey, Mr. UPTON, Mrs. BLACK, Mr. PENCE, Mr. 

FLEMING, Mrs. MCMORRIS RODGERS, Mr. ADERHOLT, Mr. AKIN, Mr. 

AUSTRIA, Mrs. BACHMANN, Mr. BACHUS, Mr. BARTON of Texas, Mr. 

BILIRAKIS, Mrs. BLACKBURN, Mr. BRADY of Texas, Mr. BROUN of Georgia, Mr. BUCHANAN, Mr. BURGESS, Mr. CANSECO, Mrs. MILLER of 

Michigan, Ms. JENKINS, Mr. CARTER, Mr. CHAFFETZ, Mr. COFFMAN of 

Colorado, Mr. CONAWAY, Mr. COSTELLO, Mr. CRAWFORD, Mr. CRITZ, 

Mrs. ELLMERS, Mr. FORTENBERRY, Mr. GARRETT, Mr. GIBBS, Mr. 

GINGREY of Georgia, Mr. GOHMERT, Mr. GRAVES of Missouri, Mr. 

GUTHRIE, Mr. HALL, Mr. HARRIS, Mrs. HARTZLER, Mr. JOHNSON of Illinois, Mr. JONES, Mr. JORDAN, Mr. KINGSTON, Mr. KINZINGER of Illinois, Mr. KLINE, Mr. LAMBORN, Mr. LANCE, Mr. LATTA, Mr. LEE of 

New York, Mr. DANIEL E. LUNGREN of California, Mr. MANZULLO, Mr. 

MARCHANT, Mr. MCCAUL, Mr. MCCLINTOCK, Mr. MCCOTTER, Mr. 

MCKINLEY, Mr. MURPHY of Pennsylvania, Mr. NEUGEBAUER, Mr. 

OLSON, Mr. PAUL, Mr. POE of Texas, Mr. ROE of Tennessee, Mr. ROGERS of Michigan, Mr. ROGERS of Kentucky, Mr. ROSS of Florida, Mr. 

RYAN of Wisconsin, Mr. SCALISE, Mr. SESSIONS, Mr. SHIMKUS, Mr. 

SHULER, Mr. SMITH of Texas, Mr. STUTZMAN, Mr. SULLIVAN, Mr. 

TERRY, Mr. THOMPSON of Pennsylvania, Mr. WHITFIELD, Mr. FLAKE, 

Mr. POMPEO, Mr. KELLY, Mr. LONG, Mr. ROSKAM, Mr. MILLER of Florida, Mr. HUIZENGA of Michigan, Mr. DAVIS of Kentucky, and Mr. SHUSTER) introduced the following bill; which was referred to the Committee 

on Energy and Commerce 

MARCH 17, 2011 

Reported with an amendment and referred to the Committee on Ways and 


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Means for a period ending not later than April 15, 2011, for consideration of such provisions of the bill and amendment as fall within the jurisdiction of that committee pursuant to clause 1(t), rule X 

[Strike out all after the enacting clause and insert the part printed in italic] 

APRIL 15, 2011 

Referral to the Committee on Ways and Means extended for a period ending 

not later than May 20, 2011 

MAY 20, 2011 

Referral to the Committee on Ways and Means extended for a period ending 

not later than September 9, 2011 

SEPTEMBER 9, 2011 

Referral to the Committee on Ways and Means extended for a period ending 

not later than September 12, 2011 

SEPTEMBER 12, 2011 

Additional sponsors: Mr. WALBERG, Mr. ROGERS of Alabama, Mr. YOUNG of 

Florida, Mr. CASSIDY, Mr. LUETKEMEYER, Mr. NUNNELEE, Mr. PETRI, 

Mr. FLORES, Mr. HARPER, Mr. HUELSKAMP, Mr. LATHAM, Mrs. 

MYRICK, Ms. FOXX, Mr. MARINO, Mr. TURNER, Mr. RIBBLE, Mr. CALVERT, Mr. YODER, Mr. BARTLETT, Mr. FINCHER, Mr. GARY G. MILLER

of California, Mr. LATOURETTE, Mr. TIBERI, Mr. PLATTS, Mr. BERG, 

Mr. LANKFORD, Mr. ALEXANDER, Mr. RAHALL, Mr. STEARNS, Mr. 

PAULSEN, Mr. CHABOT, Mr. FORBES, Mr. CAMP, Mr. HUNTER, Mr. 

PEARCE, Mr. MULVANEY, Mr. WILSON of South Carolina, Mr. DUNCAN

of South Carolina, Mr. HERGER, Mr. SCOTT of South Carolina, Mr. 

JOHNSON of Ohio, Mr. BISHOP of Utah, Mr. FRANKS of Arizona, Mr. 

ROONEY, Mr. POSEY, Mr. GOWDY, Mr. LANDRY, Mr. REHBERG, Mr. SAM

JOHNSON of Texas, Mr. RIGELL, Mr. LEWIS of California, Mr. DUFFY, 

Mr. AMASH, Mr. ROKITA, Mr. GOSAR, and Mr. ROYCE

SEPTEMBER 12, 2011 

The Committee on Ways and Means discharged; committed to the Committee 

of the Whole House on the State of the Union and ordered to be printed 

[For text of introduced bill, see copy of bill as introduced on January 20, 2011] 

A BILL 

To amend the Patient Protection and Affordable Care Act 

to modify special rules relating to coverage of abortion 

services under such Act. 


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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. 

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

5 SEC. 2. MODIFYING SPECIAL RULES RELATING TO COV6 ERAGE OF ABORTION SERVICES UNDER THE 

7 PATIENT PROTECTION AND AFFORDABLE 

8 CARE ACT TO CONFORM TO LONG-STANDING 

9 FEDERAL POLICY. 

10 (a) IN GENERAL.—Section 1303 of the Patient Protec11 tion and Affordable Care Act (Public Law 111–148), as 

12 amended by section 10104(c) of such Act, is amended— 

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

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

15 (2) by redesignating paragraph (4) of subsection 

16 (b) as subsection (d) and transferring such subsection 

17 (d) after the subsection (c) inserted by paragraph (4) 

18 of this subsection with appropriate indentation (and 

19 conforming the style of the heading to a subsection 

20 heading); 

21 (3) by amending subsection (b) to read as fol22 lows: 

23 ‘‘(b) SPECIAL RULES RELATING TO TRAINING IN AND

24 COVERAGE OF ABORTION SERVICES.—Nothing in this Act 

25 (or any amendment made by this Act) shall be construed 


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1 to require any health plan to provide coverage of or access 

2 to abortion services or to allow the Secretary or any other 

3 Federal or non-Federal person or entity in implementing 

4 this Act (or amendment) to require coverage of, access to, 

5 or training in abortion services.’’; 

6 (4) by inserting after subsection (b) the following 

7 new subsection: 

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

9 ‘‘(1) IN GENERAL.—No funds authorized or ap10 propriated by this Act (or an amendment made by 

11 this Act), including credits applied toward qualified 

12 health plans under section 36B of the Internal Rev13 enue Code of 1986 or cost-sharing reductions under 

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

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

16 health plan that includes coverage of abortion, ex17 cept— 

18 ‘‘(A) if the pregnancy is the result of an act 

19 of rape or incest; or 

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

21 suffers from a physical disorder, physical injury, 

22 or physical illness that would, as certified by a 

23 physician, place the female in danger of death 

24 unless an abortion is performed, including a lifeVerDate Mar 15 2010 01:52 Sep 13, 2011 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6203 E:\BILLS\H358.RH H358

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1 endangering physical condition caused by or 

2 arising from the pregnancy itself. 

3 ‘‘(2) OPTION TO PURCHASE SEPARATE COVERAGE

4 OR PLAN.—Nothing in this subsection shall be con5 strued as prohibiting any non-Federal entity (includ6 ing an individual or a State or local government) 

7 from purchasing separate coverage for abortions for 

8 which funding is prohibited under this subsection, or 

9 a qualified health plan that includes such abortions, 

10 so long as— 

11 ‘‘(A) such coverage or plan is paid for en12 tirely using only funds not authorized or appro13 priated by this Act; and 

14 ‘‘(B) such coverage or plan is not purchased 

15 using— 

16 ‘‘(i) individual premium payments re17 quired for a qualified health plan offered 

18 through an Exchange towards which a cred19 it is applied under section 36B of the Inter20 nal Revenue Code of 1986; or 

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

22 to receive a Federal payment, including a 

23 State’s or locality’s contribution of Med24 icaid matching funds. 


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

2 Nothing in this subsection or section 1311(d)(2)(B)(i) 

3 shall restrict any non-Federal health insurance issuer 

4 offering a qualified health plan from offering separate 

5 coverage for abortions for which funding is prohibited 

6 under this subsection, or a qualified health plan that 

7 includes such abortions, so long as— 

8 ‘‘(A) premiums for such separate coverage 

9 or plan are paid for entirely with funds not au10 thorized or appropriated by this Act; 

11 ‘‘(B) administrative costs and all services 

12 offered through such coverage or plan are paid 

13 for using only premiums collected for such cov14 erage or plan; and 

15 ‘‘(C) any such non-Federal health insurance 

16 issuer that offers a qualified health plan through 

17 an Exchange that includes coverage for abortions 

18 for which funding is prohibited under this sub19 section also offers a qualified health plan through 

20 the Exchange that is identical in every respect 

21 except that it does not cover abortions for which 

22 funding is prohibited under this subsection.’’; 

23 (5) in subsection (e), as redesignated by para24 graph (1)— 


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1 (A) in the heading, by striking ‘‘REGARD2 ING ABORTION’’; 

3 (B) in the heading of each of paragraphs 

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

5 ‘‘REGARDING ABORTION’’; 

6 (C) in paragraph (1), by striking ‘‘regard7 ing the prohibition of (or requirement of) cov8 erage, funding, or’’ and inserting ‘‘protecting 

9 conscience rights, restricting or prohibiting abor10 tion or coverage or funding of abortion, or estab11 lishing’’; and 

12 (D) in paragraph (2)(A), by striking ‘‘Noth13 ing’’ and inserting ‘‘Subject to subsection (g), 

14 nothing’’; 

15 (6) in subsection (f), as redesignated by para16 graph (1), by striking ‘‘Nothing’’ and inserting ‘‘Sub17 ject to subsection (g), nothing’’; and 

18 (7) by adding at the end the following new sub19 section: 

20 ‘‘(g) NONDISCRIMINATION ON ABORTION.— 

21 ‘‘(1) NONDISCRIMINATION.—A Federal agency or 

22 program, and any State or local government that re23 ceives Federal financial assistance under this Act (or 

24 an amendment made by this Act), may not subject 

25 any institutional or individual health care entity to 


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1 discrimination, or require any health plan created or 

2 regulated under this Act (or an amendment made by 

3 this Act) to subject any institutional or individual 

4 health care entity to discrimination, on the basis that 

5 the health care entity refuses to— 

6 ‘‘(A) undergo training in the performance 

7 of induced abortions; 

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

9 ‘‘(C) perform, participate in, provide cov10 erage of, or pay for induced abortions; or 

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

12 such abortions. 

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

14 ‘health care entity’ includes an individual physician 

15 or other health care professional, a hospital, a pro16 vider-sponsored organization, a health maintenance 

17 organization, a health insurance plan, or any other 

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

19 ‘‘(3) REMEDIES.— 

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

21 United States shall have jurisdiction to prevent 

22 and redress actual or threatened violations of 

23 this section by issuing any form of legal or equi24 table relief, including— 


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1 ‘‘(i) injunctions prohibiting conduct 

2 that violates this subsection; and 

3 ‘‘(ii) orders preventing the disburse4 ment of all or a portion of Federal financial 

5 assistance to a State or local government, or 

6 to a specific offending agency or program of 

7 a State or local government, until such time 

8 as the conduct prohibited by this subsection 

9 has ceased. 

10 ‘‘(B) COMMENCEMENT OF ACTION.—An ac11 tion under this subsection may be instituted 

12 by— 

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

14 standing to complain of an actual or threat15 ened violation of this subsection; or 

16 ‘‘(ii) the Attorney General of the 

17 United States. 

18 ‘‘(4) ADMINISTRATION.—The Secretary shall des19 ignate the Director of the Office for Civil Rights of the 

20 Department of Health and Human Services— 

21 ‘‘(A) to receive complaints alleging a viola22 tion of this subsection; and 

23 ‘‘(B) to pursue investigation of such com24 plaints in coordination with the Attorney Gen25 eral.’’. 


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1 (b) CONFORMING AMENDMENT.—Section 1334(a)(6) of 

2 such Act is amended to read as follows: 

3 ‘‘(6) COVERAGE CONSISTENT WITH FEDERAL

4 POLICY.—In entering into contracts under this sub5 section, the Director shall ensure that no multi-State 

6 qualified health plan offered in an Exchange provides 

7 coverage for abortions for which funding is prohibited 

8 under section 1303(c) of this Act.’’. 


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Union Calendar No. 133 

112TH CONGRESS 

1ST SESSION H. R. 358 

[Report No. 112–40, Part I] 

A BILL 

To amend the Patient Protection and Affordable 

erage of abortion services under such Act. Care Act to modify special rules relating to covSEPTEMBER 12, 2011 

The Committee on Ways and Means discharged; comState of the Union and ordered to be printed mitted to the Committee of the Whole House on the 


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