I 

118TH CONGRESS 

1ST SESSION H. R. 12 

To protect a person’s ability to determine whether to continue or end a 

pregnancy, and to protect a health care provider’s ability to provide 

abortion services. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 30, 2023 

Ms. CHU (for herself, Ms. ADAMS, Mr. AGUILAR, Mr. ALLRED, Mr. 

AUCHINCLOSS, Ms. BALINT, Ms. BARRAGA ́N, Mrs. BEATTY, Mr. BERA, 

Mr. BEYER, Mr. BLUMENAUER, Ms. BLUNT ROCHESTER, Ms. BONAMICI, 

Mr. BOWMAN, Ms. BROWN, Ms. BROWNLEY, Ms. BUDZINSKI, Ms. BUSH, 

Ms. CARAVEO, Mr. CARBAJAL, Mr. CA ́RDENAS, Mr. CARSON, Mr. CARTER

of Louisiana, Mr. CARTWRIGHT, Mr. CASAR, Mr. CASTEN, Ms. CASTOR

of Florida, Mr. CASTRO of Texas, Mr. CICILLINE, Ms. CLARKE of New 

York, Mr. CLEAVER, Mr. COHEN, Mr. CONNOLLY, Mr. COURTNEY, Ms. 

CRAIG, Ms. CROCKETT, Mr. CROW, Ms. DAVIDS of Kansas, Mr. DAVIS

of Illinois, Ms. DEAN of Pennsylvania, Ms. DEGETTE, Ms. DELAURO, 

Ms. DELBENE, Mr. DELUZIO, Mr. DESAULNIER, Mrs. DINGELL, Mr. 

DOGGETT, Ms. ESCOBAR, Mr. ESPAILLAT, Mr. EVANS, Mrs. FLETCHER, 

Mr. FOSTER, Ms. LOIS FRANKEL of Florida, Mr. FROST, Mr. 

GARAMENDI, Ms. GARCIA of Texas, Mr. ROBERT GARCIA of California, 

Mr. GARCI ́A of Illinois, Ms. PEREZ, Mr. GOLDMAN of New York, Mr. 

GOMEZ, Mr. GOTTHEIMER, Mr. GREEN of Texas, Mr. GRIJALVA, Mr. 

HIMES, Mr. HORSFORD, Ms. HOULAHAN, Ms. HOYLE of Oregon, Mr. 

HUFFMAN, Mr. IVEY, Mr. JACKSON of North Carolina, Ms. JACKSON

LEE, Ms. JACOBS, Ms. JAYAPAL, Mr. JEFFRIES, Ms. KAMLAGER-DOVE, 

Ms. KELLY of Illinois, Mr. KHANNA, Mr. KILDEE, Mr. KILMER, Mr. 

KRISHNAMOORTHI, Ms. KUSTER, Mr. LARSEN of Washington, Mr. LARSON of Connecticut, Mrs. LEE of Nevada, Ms. LEE of California, Ms. 

LEE of Pennsylvania, Mr. LEVIN, Mr. LIEU, Ms. LOFGREN, Mr. LYNCH, 

Mr. MAGAZINER, Ms. MANNING, Ms. MATSUI, Mrs. MCBATH, Mrs. 

MCCLELLAN, Ms. MCCOLLUM, Mr. MCGOVERN, Mr. GALLEGO, Mr. 

MEEKS, Ms. MENG, Ms. MOORE of Wisconsin, Mr. MORELLE, Mr. 

MOSKOWITZ, Mr. MOULTON, Mr. MRVAN, Mr. MULLIN, Mr. NADLER, 

Mrs. NAPOLITANO, Mr. NEAL, Mr. NICKEL, Mr. NORCROSS, Ms. NORTON, Ms. OMAR, Mr. PALLONE, Mr. PANETTA, Mr. PASCRELL, Mr. 

PAYNE, Ms. PELOSI, Mr. PETERS, Ms. PETTERSEN, Ms. PINGREE, Mr. 

POCAN, Ms. PORTER, Ms. PRESSLEY, Mr. QUIGLEY, Mr. RASKIN, Mr. 

THANEDAR, Ms. ROSS, Mr. RUPPERSBERGER, Mr. RYAN, Ms. SALINAS, 


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Ms. SA ́NCHEZ, Mr. SARBANES, Ms. SCANLON, Ms. SCHAKOWSKY, Mr. 

SCHIFF, Mr. SCHNEIDER, Ms. SCHRIER, Mr. SCOTT of Virginia, Ms. SEWELL, Mr. SHERMAN, Ms. SHERRILL, Ms. SLOTKIN, Mr. SMITH of Washington, Mr. SORENSEN, Ms. STANSBURY, Mr. STANTON, Ms. STEVENS, 

Ms. STRICKLAND, Mr. SWALWELL, Mrs. SYKES, Mr. TAKANO, Mr. 

THOMPSON of California, Mr. THOMPSON of Mississippi, Ms. TITUS, Ms. 

TLAIB, Ms. TOKUDA, Mr. TONKO, Mrs. TORRES of California, Mr. 

TORRES of New York, Mrs. TRAHAN, Mr. TRONE, Ms. UNDERWOOD, Ms. 

VELA ́ZQUEZ, Ms. WASSERMAN SCHULTZ, Mrs. WATSON COLEMAN, Ms. 

WEXTON, Ms. WILD, Ms. WILLIAMS of Georgia, Ms. WILSON of Florida, 

Mrs. HAYES, Mr. MFUME, Mr. JOHNSON of Georgia, Mr. KIM of New 

Jersey, Mr. COSTA, Ms. LEGER FERNANDEZ, Ms. CLARK of Massachusetts, Ms. ESHOO, Mr. VASQUEZ, Ms. SPANBERGER, Mr. LANDSMAN, Mr. 

KEATING, Mrs. FOUSHEE, Mr. MENENDEZ, Mr. HOYER, Mr. BOYLE of 

Pennsylvania, Mr. SOTO, Ms. OCASIO-CORTEZ, Mr. PHILLIPS, Ms. 

PLASKETT, Mr. GOLDEN of Maine, Mr. MCGARVEY, Mr. RUIZ, Ms. 

SCHOLTEN, Mrs. PELTOLA, Ms. KAPTUR, Mr. CASE, Mr. NEGUSE, Mr. 

BISHOP of Georgia, Mr. JACKSON of Illinois, Ms. WATERS, Mr. VARGAS, 

Mrs. RAMIREZ, Mr. CLYBURN, Mr. VEASEY, and Mr. CORREA) introduced 

the following bill; which was referred to the Committee on Energy and 

Commerce, and in addition to the Committee on the Judiciary, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To protect a person’s ability to determine whether to continue or end a pregnancy, and to protect a health care 

provider’s ability to provide abortion services. 

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 ‘‘Women’s Health Pro5 tection Act of 2023’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 


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1 (1) Abortion services are essential health care, 

2 and access to those services is central to people’s 

3 ability to participate equally in the economic and so4 cial life of the United States. Abortion access allows 

5 people who are pregnant to make their own decisions 

6 about their pregnancies, their families, and their 

7 lives. 

8 (2) Reproductive justice requires every indi9 vidual to have the right to make their own decisions 

10 about having children regardless of their cir11 cumstances and without interference and discrimina12 tion. Reproductive justice is a human right that can 

13 and will be achieved when all people, regardless of 

14 actual or perceived race, color, national origin, immi15 gration status, sex (including gender identity, sex 

16 stereotyping, or sexual orientation), age, or disability 

17 status have the economic, social, and political power 

18 and resources to define and make decisions about 

19 their bodies, health, sexuality, families, and commu20 nities in all areas of their lives, with dignity and 

21 self-determination. 

22 (3) Abortion care, like all health care, is a 

23 human right that should not depend on one’s ZIP 

24 Code or region, age, actual or perceived race, na25 tional origin, immigration status, sex, or disability 


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1 status. Unfortunately, this is the current reality for 

2 millions, creating a patchwork of abortion access 

3 across the United States. Protecting the right to de4 termine whether to continue or end a pregnancy, 

5 and the right of health care providers to provide 

6 abortion care, is necessary and essential to achieving 

7 this human right, and ultimately reproductive jus8 tice. 

9 (4) On June 24, 2022, in its decision in Dobbs 

10 v. Jackson Women’s Health Organization, the Su11 preme Court overruled Roe v. Wade, reversing dec12 ades of precedent recognizing a constitutional right 

13 to terminate a pregnancy before fetal viability. 

14 (5) The effects of the Dobbs decision were im15 mediate and disastrous. In the aftermath of the 

16 Dobbs decision, many States imposed near-total 

17 bans on abortion. As of March 2023, abortion is un18 available in 14 States, leaving 17.8 million women of 

19 reproductive age (15–49) and transgender and gen20 der nonconforming individuals with the capacity to 

21 become pregnant without abortion access in their 

22 home State. Within 100 days of the ruling, 66 clin23 ics across 15 States were forced to stop offering 

24 abortions. 


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1 (6) Travel time to an abortion clinic, already a 

2 burden for abortion seekers under Roe, has more 

3 than tripled since Dobbs. As distance to an abortion 

4 facility increases, so do the accompanying (and po5 tentially prohibitive) burdens of time off work or 

6 school, lost wages, transportation costs, lodging, 

7 child care costs, and other ancillary costs. 

8 (7) Even before the Dobbs decision, access to 

9 abortion services had long been obstructed across 

10 the United States in various ways, including: prohi11 bitions of, and restrictions on, insurance coverage; 

12 mandatory parental involvement laws; restrictions 

13 that shame and stigmatize people seeking abortion 

14 services; and medically unnecessary regulations that 

15 fail to further the safety of abortion services, but in16 stead cause harm people by delaying, complicating 

17 access to, and reducing the availability of, abortion 

18 services. 

19 (8) Being denied an abortion can have serious 

20 consequences for people’s physical, mental, and eco21 nomic health and well-being, and that of their fami22 lies. According to the Turnaway Study, a longitu23 dinal study published by Advancing New Standards 

24 In Reproductive Health (ANSIRH) in 2019, individ25 uals who are denied a wanted abortion are more 


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1 likely to experience economic insecurity than individ2 uals who receive a wanted abortion. After following 

3 participants for five years, the study found that peo4 ple who were denied abortion care were more likely 

5 to live in poverty, experience debt, and have lower 

6 credit scores for several years after the denial. These 

7 findings demonstrate that when people have control 

8 over when to have children and how many children 

9 to have, their children benefit through increased eco10 nomic security and better maternal bonding. 

11 (9) Abortion bans and restrictions have reper12 cussions for a broad range of health care beyond 

13 pregnancy termination, including exacerbating the 

14 existing maternal health crisis facing the United 

15 States. The United States has the highest maternal 

16 mortality rate of any industrialized nations, and 

17 Black women and birthing people face three times 

18 the risk of dying from pregnancy related causes as 

19 their white counterparts. Even prior to Dobbs, re20 search found that States that enacted abortion re21 strictions based on gestation increased their mater22 nal mortality rate by 38 percent. Research has 

23 found that a nationwide ban would increase the 

24 United States maternal mortality rate by an addi25 tional 24 percent. Furthermore, States that have 


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1 banned, are planning to ban, or have severely re2 stricted abortion care have fewer maternal health 

3 providers, more maternity care deserts, higher rates 

4 of both maternal and infant mortality, and greater 

5 racial inequity in health care. 

6 (10) Abortion bans and restrictions additionally 

7 harm people’s health by reducing access to other es8 sential health care services offered by many of the 

9 providers targeted by the restrictions, including— 

10 (A) screenings and preventive services, in11 cluding contraceptive services; 

12 (B) testing and treatment for sexually 

13 transmitted infections; 

14 (C) LGBTQ health services; and 

15 (D) referrals for primary care, intimate 

16 partner violence prevention, prenatal care, and 

17 adoption services. 

18 (11) This ripple effect has only worsened since 

19 the Dobbs decision. Clinicians and pharmacists have 

20 denied access to essential medication for conditions 

21 including gastric ulcers and autoimmune diseases be22 cause those drugs are also used for medication abor23 tion care. Patients are reporting being denied or de24 layed in their receipt of necessary and potentially 

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1 carriage management because of the newfound legal 

2 risks facing providers. 

3 (12) Reproductive justice seeks to address re4 strictions on reproductive health, including abortion, 

5 that perpetuate systems of oppression, lack of bodily 

6 autonomy, white supremacy, and anti-Black racism. 

7 This violent legacy has manifested in policies includ8 ing enslavement, rape, and experimentation on Black 

9 women; forced sterilizations, medical experimen10 tation on low-income women’s reproductive systems; 

11 and the forcible removal of Indigenous children. Ac12 cess to equitable reproductive health care, including 

13 abortion services, has always been deficient in the 

14 United States for Black, Indigenous, Latina/x, Asian 

15 American and Pacific Islander, and People of Color 

16 (BIPOC) and their families. 

17 (13) The legacy of restrictions on reproductive 

18 health, rights, and justice is not a dated vestige of 

19 a dark history. Data show the harms of abortion20 specific restrictions fall especially heavily on people 

21 with low incomes, people of color, immigrants, young 

22 people, people with disabilities, and those living in 

23 rural and other medically underserved areas. Abor24 tion bans and restrictions are compounded further 

25 by the ongoing criminalization of people who are 


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1 pregnant, including those who are incarcerated, liv2 ing with HIV, or with substance-use disorders. 

3 These populations already experience health dispari4 ties due to social, political, and environmental in5 equities, and restrictions on abortion services exacer6 bate these harms. Removing bans and restrictions on 

7 abortion services would constitute one important 

8 step on the path toward realizing reproductive jus9 tice by ensuring that the full range of reproductive 

10 health care is accessible to all who need it. 

11 (14) Abortion bans and restrictions are tools of 

12 gender oppression, as they target health care serv13 ices that are used primarily by women. These pater14 nalistic bans and restrictions rely on and reinforce 

15 harmful stereotypes about gender roles and women’s 

16 decisionmaking, undermining their ability to control 

17 their own lives and well-being. These restrictions 

18 harm the basic autonomy, dignity, and equality of 

19 women. 

20 (15) The terms ‘‘woman’’ and ‘‘women’’ are 

21 used in this bill to reflect the identity of the majority 

22 of people targeted and most directly affected by bans 

23 and restrictions on abortion services, which are root24 ed in misogyny. However, access to abortion services 

25 is critical to the health of every person capable of 


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1 becoming pregnant. This Act is intended to protect 

2 all people with the capacity for pregnancy— 

3 cisgender women, transgender men, nonbinary indi4 viduals, those who identify with a different gender, 

5 and others—who are unjustly harmed by restrictions 

6 on abortion services. 

7 (16) Pregnant individuals will continue to expe8 rience a range of pregnancy outcomes, including 

9 abortion, miscarriage, stillbirths, and infant losses 

10 regardless of how the State attempts to exert power 

11 over their reproductive decisionmaking, and will con12 tinue to need support for their health and well-being 

13 through their reproductive lifespans. 

14 (17) Evidence from the United States and 

15 around the globe bears out that criminalizing abor16 tion invariably leads to arrests, investigations, and 

17 imprisonment of people who end their pregnancies or 

18 experience pregnancy loss, leading to violations of 

19 fundamental rights to liberty, dignity, bodily auton20 omy, equality, due process, privacy, health, and free21 dom from cruel and inhumane treatment. 

22 (18) All major experts in public health and 

23 medicine such as the American Medical Association, 

24 American Public Health Association, American 

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1 tion Medicine, and the American College of Obstetri2 cians and Gynecologists, oppose the criminalization 

3 of pregnancy outcomes because the threat of being 

4 subject to investigation or punishment through the 

5 criminal legal system when seeking health care 

6 threatens pregnant people’s lives and undermines 

7 public health by deterring people from seeking care 

8 for obstetrical emergencies. 

9 (19) Antiabortion stigma that is compounded 

10 by abortion bans and restrictions also contributes to 

11 violence and harassment that put both people seek12 ing and people providing abortion care at risk. From 

13 1977 to 2021, there were 11 murders, 42 bombings, 

14 196 acts of arson, 491 assaults, and thousands of 

15 other incidents of criminal activity directed at abor16 tion seekers, providers, volunteers, and clinic staff. 

17 This violence existed under Roe and has been stead18 ily escalating for years. The presence of dangerous 

19 protestors and organized extremists acts as yet an20 other barrier to abortion care, and this threat has 

21 become even more urgent as abortion bans pro22 liferate and stigma around abortion care increases. 

23 (20) Abortion is one of the safest medical pro24 cedures in the United States. An independent, com25 prehensive review of the state of science on the safeVerDate Sep 11 2014 23:14 Mar 30, 2023 Jkt 039200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H12.IH H12

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1 ty and quality of abortion services, published by the 

2 National Academies of Sciences, Engineering, and 

3 Medicine in 2018, found that abortion in the United 

4 States is safe and effective and that the biggest 

5 threats to the quality of abortion services in the 

6 United States are State regulations that create bar7 riers to care. Such abortion-specific restrictions, as 

8 well as broader State bans, conflict with medical 

9 standards and are not supported by the rec10 ommendations and guidelines issued by leading re11 productive health care professional organizations in12 cluding the American College of Obstetricians and 

13 Gynecologists, the Society of Family Planning, the 

14 National Abortion Federation, the World Health Or15 ganization, and others. 

16 (21) For over 20 years, medication abortion 

17 care has been available in the United States as a 

18 safe, effective, Food and Drug Administration 

19 (FDA)-approved treatment to end an early preg20 nancy. Today, medication abortion care accounts for 

21 more than half of all pregnancy terminations in the 

22 United States; however, significant barriers to access 

23 remain in place, particularly in States that have im24 posed onerous restrictions that conflict with FDA’s 

25 regulation of medication abortion. Additionally, opVerDate Sep 11 2014 23:14 Mar 30, 2023 Jkt 039200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\H12.IH H12

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1 ponents of abortion are now deploying new tactics to 

2 limit access to this FDA-approved medication that 

3 would set a dangerous precedent for the Federal 

4 regulation of medication products and have national 

5 repercussions. 

6 (22) Health care providers are subject to licens7 ing laws in various jurisdictions, which are not af8 fected by this Act except as expressly provided in 

9 this Act. 

10 (23) International human rights law recognizes 

11 that access to abortion is intrinsically linked to the 

12 rights to life, health, equality and nondiscrimination, 

13 privacy, and freedom from ill treatment. United Na14 tions (UN) human rights treaty monitoring bodies 

15 have found that legal abortion services, like other re16 productive health care services, must be available, 

17 accessible, affordable, acceptable, and of good qual18 ity. UN human rights treaty bodies have condemned 

19 criminalization of abortion and medically unneces20 sary barriers to abortion services, including manda21 tory waiting periods, biased counseling requirements, 

22 and third-party authorization requirements. 

23 (24) Core human rights treaties ratified by the 

24 United States protect access to abortion. For exam25 ple, in 2018, the UN Human Rights Committee, 


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1 which oversees implementation of the International 

2 Covenant on Civil and Political Rights (ICCPR), 

3 made clear that the right to life, enshrined in Article 

4 6 of the ICCPR, at a minimum requires govern5 ments to provide safe, legal, and effective access to 

6 abortion where a person’s life and health are at risk, 

7 or when carrying a pregnancy to term would other8 wise cause substantial pain or suffering. The Com9 mittee stated that governments must not impose re10 strictions on abortion which subject women and girls 

11 to physical or mental pain or suffering, discriminate 

12 against them, arbitrarily interfere with their privacy, 

13 or place them at risk of undertaking unsafe abor14 tions. The Committee stated that governments 

15 should not apply criminal sanctions to women and 

16 girls who undergo abortion or to medical service pro17 viders who assist them in doing so. Furthermore, the 

18 Committee stated that governments should remove 

19 existing barriers that deny effective access to safe 

20 and legal abortion, refrain from introducing new 

21 barriers to abortion, and prevent the stigmatization 

22 of those seeking abortion. 

23 (25) International human rights experts have 

24 condemned the Dobbs decision and regression on 

25 abortion rights in the United States more generally 


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1 as a violation of human rights. Immediately upon re2 lease of the decision, then-UN High Commissioner 

3 for Human Rights Michelle Bachelet reiterated 

4 human rights protections for abortion and the im5 pact that the decision will have on the fundamental 

6 rights of millions within the United States, particu7 larly people with low incomes and people belonging 

8 to racial and ethnic minorities. UN independent 

9 human rights experts, including the UN Working 

10 Group on discrimination against women and girls, 

11 the UN Special Rapporteur on the right to health, 

12 and the UN Special Rapporteur on violence against 

13 women and girls, similarly denounced the decision. 

14 At the conclusion of a human rights review of the 

15 United States in August 2022, the UN Committee 

16 on the Elimination of Racial Discrimination noted 

17 deep concerns with the Dobbs decision and rec18 ommended that the United States address the dis19 parate impact that it will have on racial and ethnic 

20 minorities, Indigenous women, and those with low 

21 incomes. 

22 (26) Abortion bans and restrictions affect the 

23 cost and availability of abortion services, and the 

24 settings in which abortion services are delivered. 

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1 gage in interstate commerce to access this essential 

2 medical care. Likewise, health care providers travel 

3 across State lines and otherwise engage in interstate 

4 commerce in order to provide abortion services to 

5 patients, and more would be forced to do so absent 

6 this Act. 

7 (27) Legal limitations and requirements im8 posed upon health care providers or their patients 

9 invariably affect commerce over which the United 

10 States has jurisdiction. Health care providers engage 

11 in a form of economic and commercial activity when 

12 they provide abortion services, and there is an inter13 state market for abortion services. 

14 (28) Abortion bans and restrictions substan15 tially affect interstate commerce in numerous ways. 

16 For example, to provide abortion services, health 

17 care providers engage in interstate commerce to pur18 chase medicine, medical equipment, and other nec19 essary goods and services. To provide and assist oth20 ers in providing abortion services, health care pro21 viders engage in interstate commerce to obtain and 

22 provide training. To provide abortion services, health 

23 care providers employ and obtain commercial serv24 ices from doctors, nurses, and other personnel who 


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1 engage in interstate commerce, including by and 

2 traveling across State lines. 

3 (29) Congress has the authority to enact this 

4 Act to protect access to abortion services pursuant 

5 to— 

6 (A) its powers under the commerce clause 

7 of section 8 of article I of the Constitution of 

8 the United States; 

9 (B) its powers under section 5 of the Four10 teenth Amendment to the Constitution of the 

11 United States to enforce the provisions of sec12 tion 1 of the Fourteenth Amendment; and 

13 (C) its powers under the necessary and 

14 proper clause of section 8 of article I of the 

15 Constitution of the United States. 

16 (30) Congress has used its authority in the past 

17 to protect access to abortion services and health care 

18 providers’ ability to provide abortion services. In the 

19 early 1990s, protests and blockades at health care 

20 facilities where abortion services were provided, and 

21 associated violence, increased dramatically and 

22 reached crisis level, requiring congressional action. 

23 Congress passed the Freedom of Access to Clinic 

24 Entrances Act (Public Law 103–259; 108 Stat. 694) 


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1 to address that situation and protect physical access 

2 to abortion services. 

3 (31) Congressional action is necessary to put an 

4 end to harmful restrictions, to protect access to 

5 abortion services for everyone regardless of where 

6 they live, to protect the ability of health care pro7 viders to provide these services in a safe and acces8 sible manner, and to eliminate unwarranted burdens 

9 on commerce and the right to travel. 

10 SEC. 3. PURPOSE. 

11 The purposes of this Act are as follows: 

12 (1) To permit people to seek and obtain abor13 tion services, and to permit health care providers to 

14 provide abortion services, without harmful or unwar15 ranted limitations or requirements that single out 

16 the provision of abortion services for restrictions 

17 that are more burdensome than those restrictions 

18 imposed on medically comparable procedures, do not 

19 significantly advance reproductive health or the safe20 ty of abortion services, or make abortion services 

21 more difficult to access. 

22 (2) To promote access to abortion services and 

23 thereby protect women’s ability to participate equally 

24 in the economic and social life of the United States. 


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1 (3) To protect people’s ability to make decisions 

2 about their bodies, medical care, family, and life’s 

3 course. 

4 (4) To eliminate unwarranted burdens on com5 merce and the right to travel. Abortion bans and re6 strictions invariably affect commerce over which the 

7 United States has jurisdiction. Health care providers 

8 engage in economic and commercial activity when 

9 they provide abortion services. Moreover, there is an 

10 interstate market for abortion services and, in order 

11 to provide such services, health care providers en12 gage in interstate commerce to purchase medicine, 

13 medical equipment, and other necessary goods and 

14 services; to obtain and provide training; and to em15 ploy and obtain commercial services from health care 

16 personnel, many of whom themselves engage in 

17 interstate commerce, including by traveling across 

18 State lines. Congress has the authority to enact this 

19 Act to protect access to abortion services pursuant 

20 to— 

21 (A) its powers under the commerce clause 

22 of section 8 of article I of the Constitution of 

23 the United States; 

24 (B) its powers under section 5 of the Four25 teenth Amendment to the Constitution of the 


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1 United States to enforce the provisions of sec2 tion 1 of the Fourteenth Amendment; and 

3 (C) its powers under the necessary and 

4 proper clause of section 8 of article I of the 

5 Constitution of the United States. 

6 SEC. 4. DEFINITIONS. 

7 In this Act: 

8 (1) ABORTION SERVICES.—The term ‘‘abortion 

9 services’’ means an abortion and any medical or 

10 non-medical services related to and provided in con11 junction with an abortion (whether or not provided 

12 at the same time or on the same day as the abor13 tion). 

14 (2) GOVERNMENT.—The term ‘‘government’’ 

15 includes each branch, department, agency, instru16 mentality, and official of the United States or a 

17 State. 

18 (3) HEALTH CARE PROVIDER.—The term 

19 ‘‘health care provider’’ means any entity (including 

20 any hospital, clinic, or pharmacy) or individual (in21 cluding any physician, certified nurse-midwife, nurse 

22 practitioner, pharmacist, or physician assistant) 

23 that— 


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1 (A) is engaged or seeks to engage in the 

2 delivery of health care services, including abor3 tion services; and 

4 (B) if required by law or regulation to be 

5 licensed or certified to engage in the delivery of 

6 such services— 

7 (i) is so licensed or certified; or 

8 (ii) would be so licensed or certified 

9 but for their past, present, or potential 

10 provision of abortion services protected by 

11 section 4. 

12 (4) MEDICALLY COMPARABLE PROCEDURES.— 

13 The term ‘‘medically comparable procedures’’ means 

14 medical procedures that are similar in terms of 

15 health and safety risks to the patient, complexity, or 

16 the clinical setting that is indicated. 

17 (5) PREGNANCY.—The term ‘‘pregnancy’’ refers 

18 to the period of the human reproductive process be19 ginning with the implantation of a fertilized egg. 

20 (6) STATE.—The term ‘‘State’’ includes the 

21 District of Columbia, the Commonwealth of Puerto 

22 Rico, and each territory and possession of the 

23 United States, and any subdivision of any of the 

24 foregoing, including any unit of local government, 


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1 such as a county, city, town, village, or other general 

2 purpose political subdivision of a State. 

3 (7) VIABILITY.—The term ‘‘viability’’ means 

4 the point in a pregnancy at which, in the good-faith 

5 medical judgment of the treating health care pro6 vider, and based on the particular facts of the case 

7 before the health care provider, there is a reasonable 

8 likelihood of sustained fetal survival outside the 

9 uterus with or without artificial support. 

10 SEC. 5. PROTECTED ACTIVITIES AND SERVICES. 

11 (a) GENERAL RULES.— 

12 (1) PRE-VIABILITY.—A health care provider has 

13 a right under this Act to provide abortion services, 

14 and a patient has a corresponding right under this 

15 Act to terminate a pregnancy prior to viability with16 out being subject to any of the following limitations 

17 or requirements: 

18 (A) A prohibition on abortion prior to via19 bility, including a prohibition or restriction on 

20 a particular abortion procedure or method, or a 

21 prohibition on providing or obtaining such abor22 tions. 

23 (B) A limitation on a health care pro24 vider’s ability to prescribe or dispense drugs 

25 that could be used for reproductive health purVerDate Sep 11 2014 23:14 Mar 30, 2023 Jkt 039200 PO 00000 Frm 00022 Fmt 6652 Sfmt 6201 E:\BILLS\H12.IH H12

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1 poses based on current evidence-based regimens 

2 or the provider’s good-faith medical judgment, 

3 or a limitation on a patient’s ability to receive 

4 or use such drugs, other than a limitation gen5 erally applicable to the prescription, dispensing, 

6 or distribution of drugs. 

7 (C) A limitation on a health care provider’s 

8 ability to provide, or a patient’s ability to re9 ceive, abortion services via telemedicine, other 

10 than a limitation generally applicable to the 

11 provision of medically comparable services via 

12 telemedicine. 

13 (D) A limitation or prohibition on a pa14 tient’s ability to receive, or a provider’s ability 

15 to provide, abortion services in a State based on 

16 the State of residency of the patient, or a prohi17 bition or limitation on the ability of any indi18 vidual to assist or support a patient seeking 

19 abortion. 

20 (E) A requirement that a health care pro21 vider perform specific tests or medical proce22 dures in connection with the provision of abor23 tion services (including prior to or subsequent 

24 to the abortion), unless generally required for 


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1 the provision of medically comparable proce2 dures. 

3 (F) A requirement that a health care pro4 vider offer or provide a patient seeking abortion 

5 services medically inaccurate information. 

6 (G) A limitation or requirement concerning 

7 the physical plant, equipment, staffing, or hos8 pital transfer arrangements of facilities where 

9 abortion services are provided, or the creden10 tials or hospital privileges or status of personnel 

11 at such facilities, that is not imposed on facili12 ties or the personnel of facilities where medi13 cally comparable procedures are performed. 

14 (H) A requirement that, prior to obtaining 

15 an abortion, a patient make one or more medi16 cally unnecessary in-person visits to the pro17 vider of abortion services or to any individual or 

18 entity that does not provide abortion services. 

19 (I) A limitation on a health care provider’s 

20 ability to provide immediate abortion services 

21 when that health care provider believes, based 

22 on the good-faith medical judgment of the pro23 vider, that delay would pose a risk to the pa24 tient’s life or health. 


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1 (J) A requirement that a patient seeking 

2 abortion services at any point or points in time 

3 prior to viability disclose the patient’s reason or 

4 reasons for seeking abortion services, or a limi5 tation on providing or obtaining abortion serv6 ices at any point or points in time prior to via7 bility based on any actual, perceived, or poten8 tial reason or reasons of the patient for obtain9 ing abortion services, regardless of whether the 

10 limitation is based on a health care provider’s 

11 actual or constructive knowledge of such reason 

12 or reasons. 

13 (2) POST-VIABILITY.— 

14 (A) IN GENERAL.—A health care provider 

15 has a right under this Act to provide abortion 

16 services and a patient has a corresponding right 

17 under this Act to terminate a pregnancy after 

18 viability when, in the good-faith medical judge19 ment of the treating health care provider, it is 

20 necessary to protect the life or health of the pa21 tient. This subparagraph shall not otherwise 

22 apply after viability. 

23 (B) ADDITIONAL CIRCUMSTANCES.—A 

24 State may provide additional circumstances 


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1 under which post viability abortions are per2 mitted under this paragraph. 

3 (C) LIMITATION.—In the case where a ter4 mination of a pregnancy after viability, in the 

5 good-faith medical judgement of the treating 

6 health care provider, is necessary to protect the 

7 life or health of the patient, a State shall not 

8 impose any of the limitations or requirements 

9 described in paragraph (1). 

10 (b) OTHER LIMITATIONS OR REQUIREMENTS.—The 

11 rights described in subsection (a) shall not be limited or 

12 otherwise infringed through any other limitation or re13 quirement that— 

14 (1) expressly, effectively, implicitly, or as imple15 mented, singles out abortion, the provision of abor16 tion services, individuals who seek abortion services 

17 or who provide assistance and support to those seek18 ing abortion services, health care providers who pro19 vide abortion services, or facilities in which abortion 

20 services are provided; and 

21 (2) impedes access to abortion services. 

22 (c) FACTORS FOR CONSIDERATION.—A court may 

23 consider the following factors, among others, in deter24 mining whether a limitation or requirement impedes ac25 cess to abortion services for purposes of subsection (b)(2): 


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1 (1) Whether the limitation or requirement, in a 

2 provider’s good-faith medical judgment, interferes 

3 with a health care provider’s ability to provide care 

4 and render services, or poses a risk to the patient’s 

5 health or safety. 

6 (2) Whether the limitation or requirement is 

7 reasonably likely to delay or deter a patient in ac8 cessing abortion services. 

9 (3) Whether the limitation or requirement is 

10 reasonably likely to directly or indirectly increase the 

11 cost of providing abortion services or the cost for ob12 taining abortion services such as costs associated 

13 with travel, childcare, or time off work. 

14 (4) Whether the limitation or requirement is 

15 reasonably likely to have the effect of necessitating 

16 patient travel that would not otherwise have been re17 quired, including by making it necessary for a pa18 tient to travel out of State to obtain services. 

19 (5) Whether the limitation or requirement is 

20 reasonably likely to result in a decrease in the avail21 ability of abortion services in a given State or geo22 graphic region. 

23 (6) Whether the limitation or requirement im24 poses penalties that are not imposed on other health 

25 care providers for comparable conduct or failure to 


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1 act, or that are more severe than penalties imposed 

2 on other health care providers for comparable con3 duct or failure to act. 

4 (7) The cumulative impact of the limitation or 

5 requirement combined with other limitations or re6 quirements. 

7 (d) EXCEPTION.—To defend against a claim that a 

8 limitation or requirement violates a health care provider’s 

9 or patient’s rights under subsection (b) a party must es10 tablish, by clear and convincing evidence, that the limita11 tion or requirement is essential to significantly advance 

12 the safety of abortion services or the health of patients 

13 and that the safety or health objective cannot be accom14 plished by a different means that does not interfere with 

15 the right protected under subsection (b). 

16 SEC. 6. PROTECTION OF THE RIGHT TO TRAVEL. 

17 A person has a fundamental right under the Con18 stitution of the United States and this Act to travel to 

19 a State other than the person’s State of residence, includ20 ing to obtain reproductive health services such as prenatal, 

21 childbirth, fertility, and abortion services, and a person 

22 has a right under this Act to assist another person to ob23 tain such services or otherwise exercise the right described 

24 in this section. 


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1 SEC. 7. APPLICABILITY AND PREEMPTION. 

2 (a) IN GENERAL.— 

3 (1) SUPERSEDING INCONSISTENT LAWS.—Ex4 cept as provided under subsection (b), this Act shall 

5 supersede any inconsistent Federal or State law, and 

6 the implementation of such law, whether statutory, 

7 common law, or otherwise, and whether adopted 

8 prior to or after the date of enactment of this Act. 

9 A Federal or State government official shall not ad10 minister, implement, or enforce any law, rule, regu11 lation, standard, or other provision having the force 

12 and effect of law that conflicts with any provision of 

13 this Act, notwithstanding any other provision of 

14 Federal law, including the Religious Freedom Res15 toration Act of 1993 (42 U.S.C. 2000bb et seq.). 

16 (2) LAWS AFTER DATE OF ENACTMENT.—Fed17 eral law enacted after the date of the enactment of 

18 this Act shall be subject to this Act unless such law 

19 explicitly excludes such application by reference to 

20 this Act. 

21 (b) LIMITATIONS.—The provisions of this Act shall 

22 not supersede or apply to— 

23 (1) laws regulating physical access to clinic en24 trances; 

25 (2) laws regulating insurance or medical assist26 ance coverage of abortion services; 


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1 (3) the procedure described in section 

2 1531(b)(1) of title 18, United States Code; or 

3 (4) generally applicable State contract law. 

4 (c) PREEMPTION DEFENSE.—In any legal or admin5 istrative action against a person or entity who has exer6 cised or attempted to exercise a right protected by section 

7 4 or section 5 or against any person or entity who has 

8 taken any step to assist any such person or entity in exer9 cising such right, this Act shall also apply to, and may 

10 be raised as a defense by, such person or entity, in addi11 tion to the remedies specified in section 8. 

12 SEC. 8. RULES OF CONSTRUCTION. 

13 (a) LIBERAL CONSTRUCTION BY COURTS.—In any 

14 action before a court under this Act, the court shall lib15 erally construe the provisions of this Act to effectuate the 

16 purposes of the Act. 

17 (b) PROTECTION OF LIFE AND HEALTH.—Nothing 

18 in this Act shall be construed to authorize any government 

19 official to interfere with, diminish, or negatively affect a 

20 person’s ability to obtain or provide abortion services prior 

21 to viability, or after viability when, in the good-faith med22 ical judgment of the treating health care provider, continu23 ation of the pregnancy would pose a risk to the pregnant 

24 patient’s life or health. 


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1 (c) GOVERNMENT OFFICIALS.—Any person who, by 

2 operation of a provision of Federal or State law, is per3 mitted to implement or enforce a limitation or requirement 

4 that violates section 4 or 5 shall be considered a govern5 ment official for purposes of this Act. 

6 SEC. 9. ENFORCEMENT. 

7 (a) ATTORNEY GENERAL.—The Attorney General 

8 may commence a civil action on behalf of the United 

9 States in any district court of the United States against 

10 any State that violates, or against any government official 

11 (including a person described in section 7(c)) who imple12 ments or enforces a limitation or requirement that vio13 lates, section 4 or 5. The court shall declare unlawful the 

14 limitation or requirement if it is determined to be in viola15 tion of this Act. 

16 (b) PRIVATE RIGHT OF ACTION.— 

17 (1) IN GENERAL.—Any individual or entity ad18 versely affected by an alleged violation of this Act, 

19 including any person or health care provider, may 

20 commence a civil action against any government offi21 cial (including a person described in section 7(c)) 

22 that implements or enforces a limitation or require23 ment that violates, section 4 or 5. The court shall 

24 declare unlawful the limitation or requirement if it 

25 is determined to be in violation of this Act. 


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1 (2) HEALTH CARE PROVIDER.—A health care 

2 provider may commence an action for relief on its 

3 own behalf, on behalf of the provider’s staff, and on 

4 behalf of the provider’s patients who are or may be 

5 adversely affected by an alleged violation of this Act. 

6 (c) PRE-ENFORCEMENT CHALLENGES.—A suit 

7 under subsection (a) or (b) may be brought to prevent en8 forcement or implementation by any government of a 

9 State limitation or requirement that is inconsistent with 

10 section 4 or 5. 

11 (d) DECLARATORY AND EQUITABLE RELIEF.—In 

12 any action under this section, the court may award appro13 priate declaratory and equitable relief, including tem14 porary, preliminary, or permanent injunctive relief. 

15 (e) COSTS.—In any action under this section, the 

16 court shall award costs of litigation, as well as reasonable 

17 attorney’s fees, to any prevailing plaintiff. A plaintiff shall 

18 not be liable to a defendant for costs or attorney’s fees 

19 in any non-frivolous action under this section. 

20 (f) JURISDICTION.—The district courts of the United 

21 States shall have jurisdiction over proceedings under this 

22 Act and shall exercise the same without regard to whether 

23 the party aggrieved shall have exhausted any administra24 tive or other remedies that may be provided for by law. 


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1 (g) ABROGATION OF STATE IMMUNITY.—Neither a 

2 State that enforces or maintains, nor a government official 

3 (including a person described in section 7(c)) who is per4 mitted to implement or enforce any limitation or require5 ment that violates section 4 or 5 shall be immune under 

6 the Tenth Amendment to the Constitution of the United 

7 States, the Eleventh Amendment to the Constitution of 

8 the United States, or any other source of law, from an 

9 action in a Federal or State court of competent jurisdic10 tion challenging that limitation or requirement, unless 

11 such immunity is required by clearly established Federal 

12 law, as determined by the Supreme Court of the United 

13 States. 

14 SEC. 10. EFFECTIVE DATE. 

15 This Act shall take effect upon the date of enactment 

16 of this Act. 

17 SEC. 11. SEVERABILITY. 

18 If any provision of this Act, or the application of such 

19 provision to any person, entity, government, or cir20 cumstance, is held to be unconstitutional, the remainder 

21 of this Act, or the application of such provision to all other 

22 persons, entities, governments, or circumstances, shall not 

23 be affected thereby. 

Æ 


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