I 

114TH CONGRESS 

1ST SESSION H. R. 940 

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, to amend the Public Health Service Act to prohibit certain 

abortion-related discrimination in governmental activities, and for other 

purposes. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 12, 2015 

Mrs. BLACK (for herself, Mr. FORTENBERRY, Mr. FLEMING, Mrs. BLACKBURN, Mr. PITTS, Mr. JOLLY, Mr. CRAWFORD, Mr. MASSIE, Mr. MURPHY of Pennsylvania, Mr. HUELSKAMP, Mr. KING of Iowa, Mr. LIPINSKI, 

Mrs. WALORSKI, Mr. AMASH, Mr. MCKINLEY, Mr. BUCK, Mr. ROGERS

of Alabama, Mr. FITZPATRICK, Mr. FINCHER, Mr. SAM JOHNSON of 

Texas, Mr. BISHOP of Michigan, Mr. KLINE, Mr. PITTENGER, Mr. BOUSTANY, Mr. PEARCE, Mr. LATTA, Mr. ROTHFUS, Mr. SMITH of Nebraska, 

Mr. GIBBS, Mr. RIBBLE, Mr. WEBER of Texas, Mr. MULLIN, Mr. 

GRAVES of Georgia, Mr. WALBERG, Mr. OLSON, Ms. FOXX, Mr. JOYCE, 

Mr. LONG, Mr. PETERSON, Mr. MOOLENAAR, Mr. ROSKAM, Mr. HARRIS, 

Mr. CRAMER, Mr. HULTGREN, Mr. BABIN, Mr. JORDAN, Mr. DUNCAN

of Tennessee, Mr. GROTHMAN, Mr. SHUSTER, Mrs. ROBY, Mr. JOHNSON

of Ohio, Mr. MESSER, Mr. WOMACK, Mr. DESJARLAIS, Mr. SMITH of 

New Jersey, Mr. ROE of Tennessee, Mr. MOONEY of West Virginia, Mr. 

POMPEO, Mr. LUETKEMEYER, Mr. GOWDY, Mr. SESSIONS, Mr. RUSSELL, 

Mr. SALMON, Mr. CARTER of Texas, Mr. PALAZZO, Mrs. MILLER of 

Michigan, Mr. DUNCAN of South Carolina, Mr. BUCHANAN, Mr. 

LAMALFA, Mr. MARINO, Mr. VALADAO, Mr. BARLETTA, Mr. STEWART, 

Mr. FORBES, Mr. ROUZER, Mr. SHIMKUS, Mr. AUSTIN SCOTT of Georgia, 

Mr. POE of Texas, Mr. DIAZ-BALART, Mr. BYRNE, Mrs. WAGNER, Mr. 

RODNEY DAVIS of Illinois, Mr. WILSON of South Carolina, Ms. JENKINS

of Kansas, Mr. GOODLATTE, Mr. FLORES, Mr. MULVANEY, Mr. HUDSON, 

Mr. YODER, Mr. YOUNG of Iowa, Mr. YOHO, Mr. NEUGEBAUER, Mr. 

MARCHANT, Mr. MILLER of Florida, Mr. HUIZENGA of Michigan, Mr. 

ADERHOLT, Mr. LAMBORN, Mr. RYAN of Wisconsin, Mr. BISHOP of 

Utah, Mr. HARPER, Mrs. HARTZLER, Mr. BRADY of Texas, and Mr. 

KELLY of Pennsylvania) introduced the following bill; which was referred 

to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined 


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by the Speaker, in each case for consideration of such provisions as fall 

within the jurisdiction of the committee concerned 

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, to 

amend the Public Health Service Act to prohibit certain 

abortion-related discrimination in governmental activities, 

and for other purposes. 

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 ‘‘Health Care Con5 science Rights Act’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 

8 (1) As Thomas Jefferson declared to New Lon9 don Methodists in 1809, ‘‘[n]o provision in our Con10 stitution ought to be dearer to man than that which 

11 protects the rights of conscience against the enter12 prises of the civil authority’’. 

13 (2) Jefferson’s conviction on respect for con14 science is deeply embedded in the history and tradi15 tions of our Nation, and codified in numerous Fed16 eral laws approved by congressional majorities and 


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1 Presidents of both parties, including in the Public 

2 Health Service Act; the United States Leadership 

3 Against HIV/AIDS, Tuberculosis, and Malaria Act; 

4 the Religious Freedom Restoration Act; long5 standing provisions on respect for conscience rights 

6 in the Federal Employees Health Benefits Program 

7 and District of Columbia appropriations; and laws to 

8 protect individuals from being forced to participate 

9 in Federal executions or prosecutions. 

10 (3) Following enactment of the Patient Protec11 tion and Affordable Care Act (Public Law 111–148, 

12 in this section referred to as ‘‘PPACA’’), the Fed13 eral Government has sought to impose specific re14 quirements that infringe on the rights of conscience 

15 of those who offer or purchase health coverage. 

16 (4) While PPACA provides an exemption for 

17 some religious groups that object to participation in 

18 health insurance generally, and exempts millions of 

19 Americans from most of the Act’s provisions, includ20 ing the preventive services mandate, it fails to pro21 vide statutory protection for those seeking to offer 

22 and purchase health coverage who have a religious 

23 or moral objection only to specific items or services. 

24 (5) Nurses and other health care providers have 

25 increasingly been subjected to discrimination for 


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1 abiding by their conscience rather than providing, 

2 paying for, or referring for abortion. 

3 (6) Conscience rights protections for health care 

4 providers are an important part of civil rights pro5 tections in Federal law and are indispensable to the 

6 continued viability of the health care system in the 

7 United States. The increasingly significant discrimi8 nation suffered by faith-based nonprofit health care 

9 providers risks undermining access to high-quality 

10 compassionate care for some of the most vulnerable 

11 populations in our country. 

12 SEC. 3. APPLYING LONGSTANDING POLICY ON CON13 SCIENCE RIGHTS TO THE AFFORDABLE CARE 

14 ACT. 

15 (a) IN GENERAL.—Title I of the Patient Protection 

16 and Affordable Care Act (Public Law 111–148) is amend17 ed— 

18 (1) by redesignating the second section 1563 

19 (relating to conforming amendments and as redesig20 nated by section 10107(b)(1) of the Patient Protec21 tion and Affordable Care Act) as section 1564; 

22 (2) by redesignating the third section 1563 (re23 lating to the Sense of the Senate promoting fiscal 

24 responsibility) as section 1565; and 


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1 (3) by adding at the end the following new sec2 tion: 

3 ‘‘SEC. 1566. RESPECTING CONSCIENCE RIGHTS IN HEALTH 

4 COVERAGE. 

5 ‘‘(a) IN GENERAL.—Notwithstanding any other pro6 vision of this title, no provision of this title (and no amend7 ment made by any such provision) shall— 

8 ‘‘(1) require an individual to purchase indi9 vidual health insurance coverage that includes cov10 erage of an abortion or other item or service to 

11 which such individual has a moral or religious objec12 tion, or prevent an issuer from offering or issuing, 

13 to such individual, individual health insurance cov14 erage that excludes such item or service; 

15 ‘‘(2) require a sponsor (or, in the case of health 

16 insurance coverage offered to students through an 

17 institution of higher education, the institution of 

18 higher education offering such coverage) to sponsor, 

19 purchase, or provide any health benefits coverage or 

20 group health plan that includes coverage of an abor21 tion or other item or service to which such sponsor 

22 or institution, respectively, has a moral or religious 

23 objection, or prevent an issuer from offering or 

24 issuing to such sponsor or institution, respectively, 


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1 health insurance coverage that excludes such item or 

2 service; 

3 ‘‘(3) require an issuer of health insurance cov4 erage or the sponsor of a group health plan to in5 clude, in any such coverage or plan, coverage of an 

6 abortion or other item or service to which such 

7 issuer or sponsor has a moral or religious objection; 

8 or 

9 ‘‘(4) authorize the imposition of a tax, penalty, 

10 fee, fine, or other sanction, or the imposition of cov11 erage of the item or service to which there is a moral 

12 or religious objection, in relation to health insurance 

13 coverage or a group health plan that excludes an 

14 item or service pursuant to this section. 

15 ‘‘(b) RESTRICTION ON CONTRARY GOVERNMENTAL

16 ACTION.—No provision in this title (or amendment made 

17 by such provision) or law, regulation, guideline or other 

18 governmental action that implements such provision or 

19 amendment, or derives its authority therefrom, shall be 

20 given legal effect to the extent that it violates this section. 

21 ‘‘(c) NO EFFECT ON OTHER LAWS.—Nothing in this 

22 section shall be construed to preempt, modify, or otherwise 

23 have any effect on— 

24 ‘‘(1) the Civil Rights Act of 1964; 


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1 ‘‘(2) the Americans with Disabilities Act of 

2 1990; 

3 ‘‘(3) the Pregnancy Discrimination Act of 1978; 

4 ‘‘(4) the Mental Health Parity Act of 1996; or 

5 ‘‘(5) any other State or Federal law, other than 

6 a provision in this title (or an amendment made by 

7 such provision) or a law, regulation, guideline or 

8 other governmental action that implements such pro9 vision or amendment or derives its authority there10 from. 

11 ‘‘(d) AGGREGATE ACTUARIAL VALUE.—Nothing in 

12 this section shall be construed to prohibit the Secretary 

13 from issuing regulations or other guidance to ensure that 

14 health insurance coverage or group health plans excluding 

15 abortion or other items or services under this section shall 

16 have an aggregate actuarial value at least equivalent to 

17 that of health insurance coverage or group health plans 

18 at the same level of coverage that do not exclude such 

19 items or services. 

20 ‘‘(e) CONTINUED APPLICATION OF NONDISCRIMINA21 TION RULES.—Nothing in this section shall be construed 

22 to permit a health insurance issuer, group health plan, or 

23 other health care provider to act in a manner inconsistent 

24 with subparagraph (B) or (D) of section 1302(b)(4).’’. 


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1 (b) CLERICAL AMENDMENT.—The table of contents 

2 of the Patient Protection and Affordable Care Act (Public 

3 Law 111–148) is amended— 

4 (1) by striking the following items: 

‘‘1563. Conforming amendments. 

‘‘1563. Sense of the Senate promoting fiscal responsibility.’’; 

5 and 

6 (2) by inserting after the item relating to the 

7 section 1563 relating to small business procurement 

8 the following items: 

‘‘1564. Conforming amendments. 

‘‘1565. Sense of the Senate promoting fiscal responsibility. 

‘‘1566. Respecting conscience rights in health coverage.’’. 

9 SEC. 4. ABORTION NONDISCRIMINATION FOR HEALTH 

10 CARE PROVIDERS. 

11 Section 245 of the Public Health Service Act (42 

12 U.S.C. 238n) is amended— 

13 (1) in the section heading, by striking ‘‘AND

14 LICENSING OF PHYSICIANS’’ and inserting ‘‘, LI15 CENSING, AND PRACTICE OF PHYSICIANS AND

16 OTHER HEALTH CARE ENTITIES’’; 

17 (2) in subsection (a), by amending paragraph 

18 (1) to read as follows: 

19 ‘‘(1) the entity refuses— 

20 ‘‘(A) to undergo training in the perform21 ance of induced abortions; 

22 ‘‘(B) to require or provide such training; 


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1 ‘‘(C) to perform, participate in, provide 

2 coverage of, or pay for induced abortions; or 

3 ‘‘(D) to provide referrals for such training 

4 or such abortions;’’; 

5 (3) in subsection (b)(1), by striking ‘‘stand6 ards’’ and inserting ‘‘standard’’; 

7 (4) in subsection (c), by amending paragraphs 

8 (1) and (2) to read as follows: 

9 ‘‘(1) The term ‘financial assistance’, with re10 spect to a government program, means governmental 

11 payments to cover the cost of health care services or 

12 benefits, or other Federal payments, grants, or loans 

13 to promote or otherwise facilitate health-related ac14 tivities. 

15 ‘‘(2) The term ‘health care entity’ includes an 

16 individual physician or other health professional, a 

17 postgraduate physician training program, a partici18 pant in a program of training in the health profes19 sions, a hospital, a provider-sponsored organization 

20 as defined in section 1855(d) of the Social Security 

21 Act, a health maintenance organization, an account22 able care organization, an issuer of health insurance 

23 coverage, any other kind of health care facility, orga24 nization, or plan, and an entity that provides or au25 thorizes referrals for health care services.’’; 


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1 (5) by adding at the end of subsection (c) the 

2 following new paragraph: 

3 ‘‘(4) The term ‘State or local government that 

4 receives Federal financial assistance’ includes any 

5 agency or other governmental unit of a State or 

6 local government if such government receives Fed7 eral financial assistance.’’; 

8 (6) by redesignating subsection (c) as sub9 section (d); and 

10 (7) by inserting after subsection (b) the fol11 lowing new subsection: 

12 ‘‘(c) ADMINISTRATION.—The Secretary shall des13 ignate the Director of the Office for Civil Rights of the 

14 Department of Health and Human Services— 

15 ‘‘(1) to receive complaints alleging a violation of 

16 this section, section 1566 of the Patient Protection 

17 and Affordable Care Act, or any of subsections (b) 

18 through (e) of section 401 of the Health Programs 

19 Extension Act of 1973; and 

20 ‘‘(2) to pursue the investigation of such com21 plaints, in coordination with the Attorney General.’’. 


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1 SEC. 5. REMEDIES FOR VIOLATIONS OF FEDERAL CON2 SCIENCE LAWS. 

3 Title II of the Public Health Service Act (42 U.S.C. 

4 202 et seq.) is amended by inserting after section 245 the 

5 following: 

6 ‘‘SEC. 245A. CIVIL ACTION FOR CERTAIN VIOLATIONS. 

7 ‘‘(a) IN GENERAL.—A qualified party may, in a civil 

8 action, obtain appropriate relief with regard to a des9 ignated violation. 

10 ‘‘(b) DEFINITIONS.—In this section— 

11 ‘‘(1) the term ‘qualified party’ means— 

12 ‘‘(A) the Attorney General; or 

13 ‘‘(B) any person or entity adversely af14 fected by the designated violation; and 

15 ‘‘(2) the term ‘designated violation’ means an 

16 actual or threatened violation of section 245 of this 

17 Act, section 1566 of the Patient Protection and Af18 fordable Care Act, or any of subsections (b) through 

19 (e) of section 401 of the Health Programs Extension 

20 Act of 1973. 

21 ‘‘(c) ADMINISTRATIVE REMEDIES NOT REQUIRED.— 

22 An action under this section may be commenced, and relief 

23 may be granted, without regard to whether the party com24 mencing the action has sought or exhausted available ad25 ministrative remedies. 


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1 ‘‘(d) DEFENDANTS IN ACTIONS UNDER THIS SEC2 TION MAY INCLUDE GOVERNMENTAL ENTITIES AS WELL

3 AS OTHERS.— 

4 ‘‘(1) IN GENERAL.—An action under this sec5 tion may be maintained against, among others, a 

6 party that is a Federal or State governmental entity. 

7 Relief in an action under this section may include 

8 money damages even if the defendant is such a gov9 ernmental entity. 

10 ‘‘(2) DEFINITION.—For the purposes of this 

11 subsection, the term ‘State governmental entity’ 

12 means a State, a local government within a State, 

13 or any agency or other governmental unit or author14 ity of a State or of such a local government. 

15 ‘‘(e) NATURE OF RELIEF.—The court shall grant— 

16 ‘‘(1) all necessary equitable and legal relief, in17 cluding, where appropriate, declaratory relief and 

18 compensatory damages, to prevent the occurrence, 

19 continuance, or repetition of the designated violation 

20 and to compensate for losses resulting from the des21 ignated violation; and 

22 ‘‘(2) to a prevailing plaintiff, reasonable attor23 neys’ fees and litigation expenses as part of the 

24 costs.’’. 

Æ 


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