```

[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[S. 1467 Introduced in Senate (IS)]

112th CONGRESS
  1st Session
                                S. 1467

  To amend the Patient Protection and Affordable Care Act to protect 
   rights of conscience with regard to requirements for coverage of 
                      specific items and services.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                             August 2, 2011

   Mr. Blunt (for himself, Mr. Rubio, and Ms. Ayotte) introduced the 
 following bill; which was read twice and referred to the Committee on 
                 Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL

 
  To amend the Patient Protection and Affordable Care Act to protect 
   rights of conscience with regard to requirements for coverage of 
                      specific items and services.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Respect for Rights of Conscience Act 
of 2011''.

SEC. 2. FINDINGS AND PURPOSES.

    (a) Findings.--Congress finds the following:
            (1) As Thomas Jefferson declared to New London Methodists 
        in 1809, ``[n]o provision in our Constitution ought to be 
        dearer to man than that which protects the rights of conscience 
        against the enterprises of the civil authority''.
            (2) Jefferson's statement expresses a conviction on respect 
        for conscience that is deeply embedded in the history and 
        traditions of our Nation and codified in numerous State and 
        Federal laws, including laws on health care.
            (3) Until enactment of the Patient Protection and 
        Affordable Care Act (Public Law 111-148, in this section 
        referred to as ``PPACA''), the Federal Government has not 
        sought to impose specific coverage or care requirements that 
        infringe on the rights of conscience of insurers, purchasers of 
        insurance, plan sponsors, beneficiaries, and other 
        stakeholders, such as individual or institutional health care 
        providers.
            (4) PPACA creates a new nationwide requirement for health 
        plans to cover ``essential health benefits'' and ``preventive 
        services'' (including a distinct set of ``preventive services 
        for women''), delegating to the Department of Health and Human 
        Services the authority to provide a list of detailed services 
        under each category, and imposes other new requirements with 
        respect to the provision of health care services.
            (5) While PPACA provides an exemption for some religious 
        groups that object to participation in Government health 
        programs generally, it does not allow purchasers, plan 
        sponsors, and other stakeholders with religious or moral 
        objections to specific items or services to decline providing 
        or obtaining coverage of such items or services, or allow 
        health care providers with such objections to decline to 
        provide them.
            (6) By creating new barriers to health insurance and 
        causing the loss of existing insurance arrangements, these 
        inflexible mandates in PPACA jeopardize the ability of 
        individuals to exercise their rights of conscience and their 
        ability to freely participate in the health insurance and 
        health care marketplace.
    (b) Purposes.--The purposes of this Act are--
            (1) to ensure that health care stakeholders retain the 
        right to provide, purchase, or enroll in health coverage that 
        is consistent with their religious beliefs and moral 
        convictions, without fear of being penalized or discriminated 
        against under PPACA; and
            (2) to ensure that no requirement in PPACA creates new 
        pressures to exclude those exercising such conscientious 
        objection from health plans or other programs under PPACA.

SEC. 3. RESPECT FOR RIGHTS OF CONSCIENCE.

    (a) In General.--Section 1302(b) of the Patient Protection and 
Affordable Care Act (Public Law 111-148; 42 U.S.C. 18022(b)) is amended 
by adding at the end the following new paragraph:
            ``(6) Respecting rights of conscience with regard to 
        specific items or services.--
                    ``(A) For health plans.--A health plan shall not be 
                considered to have failed to provide the essential 
                health benefits package described in subsection (a) (or 
                preventive health services described in section 2713 of 
                the Public Health Service Act), to fail to be a 
                qualified health plan, or to fail to fulfill any other 
                requirement under this title on the basis that it 
                declines to provide coverage of specific items or 
                services because--
                            ``(i) providing coverage (or, in the case 
                        of a sponsor of a group health plan, paying for 
                        coverage) of such specific items or services is 
                        contrary to the religious beliefs or moral 
                        convictions of the sponsor, issuer, or other 
                        entity offering the plan; or
                            ``(ii) such coverage (in the case of 
                        individual coverage) is contrary to the 
                        religious beliefs or moral convictions of the 
                        purchaser or beneficiary of the coverage.
                    ``(B) For health care providers.--Nothing in this 
                title (or any amendment made by this title) shall be 
                construed to require an individual or institutional 
                health care provider, or authorize a health plan to 
                require a provider, to provide, participate in, or 
                refer for a specific item or service contrary to the 
                provider's religious beliefs or moral convictions. 
                Notwithstanding any other provision of this title, a 
                health plan shall not be considered to have failed to 
                provide timely or other access to items or services 
                under this title (or any amendment made by this title) 
                or to fulfill any other requirement under this title 
                because it has respected the rights of conscience of 
                such a provider pursuant to this paragraph.
                    ``(C) Nondiscrimination in exercising rights of 
                conscience.--No Exchange or other official or entity 
                acting in a governmental capacity in the course of 
                implementing this title (or any amendment made by this 
                title) shall discriminate against a health plan, plan 
                sponsor, health care provider, or other person because 
                of such plan's, sponsor's, provider's, or person's 
                unwillingness to provide coverage of, participate in, 
                or refer for, specific items or services pursuant to 
                this paragraph.
                    ``(D) Construction.--Nothing in subparagraph (A) or 
                (B) shall be construed to permit a health plan or 
                provider to discriminate in a manner inconsistent with 
                subparagraphs (B) and (D) of paragraph (4).
                    ``(E) Private rights of action.--The various 
                protections of conscience in this paragraph constitute 
                the protection of individual rights and create a 
                private cause of action for those persons or entities 
                protected. Any person or entity may assert a violation 
                of this paragraph as a claim or defense in a judicial 
                proceeding.
                    ``(F) Remedies.--
                            ``(i) Federal jurisdiction.--The Federal 
                        courts shall have jurisdiction to prevent and 
                        redress actual or threatened violations of this 
                        paragraph by granting all forms of legal or 
                        equitable relief, including, but not limited 
                        to, injunctive relief, declaratory relief, 
                        damages, costs, and attorney fees.
                            ``(ii) Initiating party.--An action under 
                        this paragraph may be instituted by the 
                        Attorney General of the United States, or by 
                        any person or entity having standing to 
                        complain of a threatened or actual violation of 
                        this paragraph, including, but not limited to, 
                        any actual or prospective plan sponsor, issuer, 
                        or other entity offering a plan, any actual or 
                        prospective purchaser or beneficiary of a plan, 
                        and any individual or institutional health care 
                        provider.
                            ``(iii) Interim relief.--Pending final 
                        determination of any action under this 
                        paragraph, the court may at any time enter such 
                        restraining order or prohibitions, or take such 
                        other actions, as it deems necessary.
                    ``(G) Administration.--The Office for Civil Rights 
                of the Department of Health and Human Services is 
                designated to receive complaints of discrimination 
                based on this paragraph and coordinate the 
                investigation of such complaints.
                    ``(H) Actuarial equivalence.--Nothing in this 
                paragraph shall prohibit the Secretary from issuing 
                regulations or other guidance to ensure that health 
                plans excluding specific items or services under this 
                paragraph shall have an aggregate actuarial value at 
                least equivalent to that of plans at the same level of 
                coverage that do not exclude such items or services.''.
    (b) Effective Date.--The amendment made by subsection (a) shall be 
effective as if included in the enactment of Public Law 111-148.
                                 <all>
```