II 

118TH CONGRESS 

1ST SESSION S. 3485 

To amend title IV of the Social Security Act to establish requirements 

for biological fathers to pay child support for medical expenses incurred 

during pregnancy and delivery. 

IN THE SENATE OF THE UNITED STATES 

DECEMBER 13, 2023 

Mr. RUBIO introduced the following bill; which was read twice and referred 

to the Committee on Finance 

A BILL 

To amend title IV of the Social Security Act to establish 

requirements for biological fathers to pay child support 

for medical expenses incurred during pregnancy and delivery. 

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 ‘‘Supporting Healthy 

5 Pregnancy Act of 2023’’. 

2 

•S 3485 IS

1 SEC. 2. REQUIRING BIOLOGICAL FATHERS TO PAY CHILD 

2 SUPPORT FOR MEDICAL EXPENSES IN3 CURRED DURING PREGNANCY AND DELIV4 ERY. 

5 (a) IN GENERAL.—Section 454 of the Social Security 

6 Act (42 U.S.C. 654) is amended— 

7 (1) in paragraph (33), by striking ‘‘and’’ after 

8 the semicolon; 

9 (2) in paragraph (34), by striking the period 

10 and inserting ‘‘; and’’; 

11 (3) by inserting after paragraph (34), the fol12 lowing: 

13 ‘‘(35) provide that the State shall establish and 

14 enforce a child support obligation of the biological 

15 father of a child to pay for not less than 50 percent 

16 of the reasonable out-of-pocket medical expenses (in17 cluding health insurance premiums or similar 

18 charge, deductions, cost sharing or similar charges, 

19 and any other related out-of-pocket expenses) the 

20 mother of the child is responsible for that are in21 curred during, and associated with, the pregnancy 

22 and delivery of the child, provided that the mother 

23 requests the payment of such support.’’. 

24 (b) RULE OF CONSTRUCTION.— 

25 (1) IN GENERAL.—Nothing in paragraph (35) 

26 of section 454 of the Social Security Act (42 U.S.C. 

3 

•S 3485 IS

1 654), as added by subsection (a), shall be construed 

2 to imply that an expense associated with an abortion 

3 is a medical expense. 

4 (2) ABORTION DEFINED.—For purposes of this 

5 subsection, the term ‘‘abortion’’ means the use or 

6 prescription of any instrument, medicine, drug, or 

7 other substance or device to intentionally— 

8 (A) kill the unborn child of a woman 

9 known to be pregnant; or 

10 (B) prematurely terminate the pregnancy 

11 of a woman known to be pregnant, with an in12 tention other than to— 

13 (i) increase the probability of a live 

14 birth or of preserving the life or health of 

15 the child after live birth; or 

16 (ii) remove an ectopic pregnancy or a 

17 dead unborn child. 

18 (c) EFFECTIVE DATE.— 

19 (1) IN GENERAL.—Subject to paragraph (2), 

20 the amendments made by subsection (a) shall take 

21 effect on January 1 of the first calendar year that 

22 begins after the date of enactment of this Act. 

23 (2) DELAY IF STATE LEGISLATION RE24 QUIRED.—In the case of a State plan under part D 

25 of title IV of the Social Security Act which the SecVerDate Sep 11 2014 03:48 Dec 29, 2023 Jkt 049200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S3485.IS S3485
4 

•S 3485 IS

1 retary of Health and Human Services determines re2 quires State legislation (other than legislation appro3 priating funds) in order for the plan to meet the ad4 ditional requirement imposed by the amendments 

5 made by this Act, the State plan shall not be re6 garded as failing to comply with the requirements of 

7 such part solely on the basis of the failure of the 

8 plan to meet such additional requirement before the 

9 first day of the first calendar quarter beginning 

10 after the close of the first regular session of the 

11 State legislature that begins after the date of enact12 ment of this Act. For purposes of the previous sen13 tence, in the case of a State that has a 2-year legis14 lative session, each year of the session shall be 

15 deemed to be a separate regular session of the State 

16 legislature. 

Æ