I 

113TH CONGRESS 

1ST SESSION H. R. 3471 

To protect a woman’s right to determine whether and when to bear a child 

or end a pregnancy by limiting restrictions on the provision of abortion 

services. 

IN THE HOUSE OF REPRESENTATIVES 

NOVEMBER 13, 2013 

Ms. CHU (for herself, Ms. FUDGE, Ms. FRANKEL of Florida, Ms. BROWNLEY

of California, Ms. TITUS, Mrs. NEGRETE MCLEOD, Ms. BASS, Mrs. 

BEATTY, Mr. BERA of California, Mr. BLUMENAUER, Ms. BROWN of 

Florida, Mrs. CHRISTENSEN, Mr. CICILLINE, Mr. CLAY, Mr. DANNY K. 

DAVIS of Illinois, Ms. DELAURO, Ms. DELBENE, Mr. ELLISON, Mr. 

FARR, Mr. GRIJALVA, Mr. GUTIE ́RREZ, Ms. HAHN, Mr. HOLT, Ms. JACKSON LEE, Ms. EDDIE BERNICE JOHNSON of Texas, Mr. JOHNSON of 

Georgia, Mrs. KIRKPATRICK, Ms. LEE of California, Mr. LEWIS, Mr. 

LOWENTHAL, Mrs. CAROLYN B. MALONEY of New York, Ms. MCCOLLUM, Ms. MOORE, Mr. MORAN, Ms. NORTON, Mr. RANGEL, Ms. LINDA

T. SA ́NCHEZ of California, Ms. SCHAKOWSKY, Ms. SLAUGHTER, Ms. 

SPEIER, Mr. TAKANO, Mr. WELCH, Ms. CASTOR of Florida, Ms. 

MICHELLE LUJAN GRISHAM of New Mexico, Ms. TSONGAS, Mr. BRALEY

of Iowa, Mr. SMITH of Washington, Ms. KUSTER, Mr. KILDEE, Mr. 

LOEBSACK, Ms. ESTY, Mr. SHERMAN, Mr. PAYNE, Ms. MENG, Mr. 

POCAN, Mr. HUFFMAN, Ms. WATERS, Ms. KELLY of Illinois, Ms. 

EDWARDS, and Mr. KEATING) introduced the following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To protect a woman’s right to determine whether and when 

to bear a child or end a pregnancy by limiting restrictions on the provision of abortion services. 

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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 ‘‘Women’s Health Pro5 tection Act of 2013’’. 

6 SEC. 2. FINDINGS AND PURPOSE. 

7 (a) FINDINGS.—Congress finds the following: 

8 (1) Access to safe, legal abortion services is es9 sential to women’s health and central to women’s 

10 ability to participate equally in the economic and so11 cial life of the United States. 

12 (2) Access to safe, legal abortion services has 

13 been hindered in the United States in various ways, 

14 including blockades of health care facilities and asso15 ciated violence; restrictions on insurance coverage; 

16 restrictions on minors’ ability to obtain services; and 

17 requirements and restrictions that single out abor18 tion providers and those seeking their services, and 

19 which do not further women’s health or the safety 

20 of abortion, but harm women by reducing the avail21 ability of services. 

22 (3) In the early 1990s, protests and blockades 

23 at health care facilities where abortions were per24 formed, and associated violence, increased dramati25 cally and reached crisis level, requiring Congresmstockstill on DSK4VPTVN1PROD with BILLS

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1 sional action. Congress passed the Freedom of Ac2 cess to Clinic Entrances Act (Public Law 103–259) 

3 to address that situation and ensure that women 

4 could physically access abortion services. 

5 (4) Since 2010, there has been an equally dra6 matic increase in the number of laws and regulations 

7 singling out abortion that threaten women’s health 

8 and their ability to access safe abortion services by 

9 interfering with health care professionals’ ability to 

10 provide such services. Congressional action is now 

11 necessary to put an end to these restrictions. In ad12 dition, there has been a dramatic increase in the 

13 passage of laws that blatantly violate the constitu14 tional protections afforded women, such as bans on 

15 abortions prior to viability. 

16 (5) Legal abortion is one of the safest medical 

17 procedures in the United States. That safety is 

18 furthered by regulations that are based on science 

19 and are generally applicable to the medical profes20 sion or to medically comparable procedures. 

21 (6) Many State and local governments are im22 posing restrictions on the provision of abortion that 

23 are neither science-based nor generally applicable to 

24 the medical profession or to medically comparable 

25 procedures. Though described by their proponents as 

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1 health and safety regulations, many of these abor2 tion-specific restrictions do not advance the safety of 

3 abortion services and do nothing to protect women’s 

4 health. Also, these restrictions interfere with wom5 en’s personal and private medical decisions, make 

6 access to abortion more difficult and costly, and 

7 even make it impossible for some women to obtain 

8 those services. 

9 (7) These restrictions harm women’s health by 

10 reducing access not only to abortion services but also 

11 to the other essential health care services offered by 

12 the providers targeted by the restrictions, including 

13 contraceptive services, which reduce unintended 

14 pregnancies and thus abortions, and screenings for 

15 cervical cancer and sexually transmitted infections. 

16 These harms fall especially heavily on low-income 

17 women, women of color, and women living in rural 

18 and other medically underserved areas. 

19 (8) The cumulative effect of these numerous re20 strictions has been widely varying access to abortion 

21 services such that a woman’s ability to exercise her 

22 constitutional rights is dependent on the State in 

23 which she lives. Federal legislation putting a stop to 

24 harmful restrictions throughout the United States is 

25 necessary to ensure that women in all States have 

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1 access to safe abortion services, an essential con2 stitutional right repeatedly affirmed by the United 

3 States Supreme Court. 

4 (9) Congress has the authority to protect wom5 en’s ability to access abortion services pursuant to 

6 its powers under the Commerce Clause and its pow7 ers under section 5 of the Fourteenth Amendment to 

8 the Constitution to enforce the provisions of section 

9 1 of the Fourteenth Amendment. 

10 (b) PURPOSE.—It is the purpose of this Act to pro11 tect women’s health by ensuring that abortion services will 

12 continue to be available and that abortion providers are 

13 not singled out for medically unwarranted restrictions that 

14 harm women by preventing them from accessing safe abor15 tion services. It is not the purpose of this Act to address 

16 all threats to access to abortion (for example, this Act does 

17 not apply to clinic violence, restrictions on insurance cov18 erage of abortion, or requirements for parental consent or 

19 notification before a minor may obtain an abortion) which 

20 Congress should address through separate legislation as 

21 appropriate. 

22 SEC. 3. DEFINITIONS. 

23 In this Act: 

24 (1) ABORTION.—The term ‘‘abortion’’ means 

25 any medical treatment, including the prescription of 

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1 medication, intended to cause the termination of a 

2 pregnancy except for the purpose of increasing the 

3 probability of a live birth, to remove an ectopic preg4 nancy, or to remove a dead fetus. 

5 (2) ABORTION PROVIDER.—The term ‘‘abortion 

6 provider’’ means a health care professional who per7 forms abortions. 

8 (3) GOVERNMENT.—The term ‘‘government’’ 

9 includes a branch, department, agency, instrumen10 tality, or individual acting under color of law of the 

11 United States, a State, or a subdivision of a State. 

12 (4) HEALTH CARE PROFESSIONAL.—The term 

13 ‘‘health care professional’’ means a licensed medical 

14 professional (including physicians, certified nurse15 midwives, nurse practitioners, and physician assist16 ants) who is competent to perform abortions based 

17 on clinical training. 

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

19 to the period of the human reproductive process be20 ginning with the implantation of a fertilized egg. 

21 (6) STATE.—The term ‘‘State’’ includes each of 

22 the 50 States, the District of Columbia, the Com23 monwealth of Puerto Rico, and each territory or pos24 session of the United States. 

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1 (7) VIABILITY.—the term ‘‘viability’’ means the 

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

3 medical judgment of the treating health care profes4 sional, based on the particular facts of the case be5 fore her or him, there is a reasonable likelihood of 

6 sustained fetal survival outside the uterus with or 

7 without artificial support. 

8 SEC. 4. PROHIBITED MEASURES AND ACTIONS. 

9 (a) GENERAL PROHIBITIONS.—The following limita10 tions or requirements are unlawful and shall not be im11 posed or applied by any government because they single 

12 out the provision of abortion services for restrictions that 

13 are more burdensome than those restrictions imposed on 

14 medically comparable procedures, they do not significantly 

15 advance women’s health or the safety of abortion services, 

16 and they make abortion services more difficult to access: 

17 (1) A requirement that a medical professional 

18 perform specific tests or follow specific medical pro19 cedures in connection with the provision of an abor20 tion, unless generally required for the provision of 

21 medically comparable procedures. 

22 (2) A limitation on an abortion provider’s abil23 ity to delegate tasks, other than a limitation gen24 erally applicable to providers of medically com25 parable procedures. 

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1 (3) A limitation on an abortion provider’s abil2 ity to prescribe or dispense drugs based on her or 

3 his good-faith medical judgment, other than a limi4 tation generally applicable to the medical profession. 

5 (4) A limitation on an abortion provider’s abil6 ity to provide abortion services via telemedicine, 

7 other than a limitation generally applicable to the 

8 provision of medical services via telemedicine. 

9 (5) A requirement or limitation concerning the 

10 physical plant, equipment, staffing, or hospital 

11 transfer arrangements of facilities where abortions 

12 are performed, or the credentials or hospital privi13 leges or status of personnel at such facilities, that is 

14 not imposed on facilities or the personnel of facilities 

15 where medically comparable procedures are per16 formed. 

17 (6) A requirement that, prior to obtaining an 

18 abortion, a woman make one or more medically un19 necessary visits to the provider of abortion services 

20 or to any individual or entity that does not provide 

21 abortion services. 

22 (7) A requirement or limitation that prohibits 

23 or restricts medical training for abortion procedures, 

24 other than a requirement or limitation generally apmstockstill on DSK4VPTVN1PROD with BILLS

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1 plicable to medical training for medically comparable 

2 procedures. 

3 (b) OTHER PROHIBITED MEASURES OR ACTIONS.— 

4 (1) IN GENERAL.—A measure or action that re5 stricts the provision of abortion services or the facili6 ties that provide abortion services that is similar to 

7 any of the prohibited limitations or requirements de8 scribed in subsection (a) shall be unlawful if such 

9 measure or action singles out abortion services or 

10 make abortions services more difficult to access and 

11 does not significantly advance women’s health or the 

12 safety of abortion services. 

13 (2) PRIMA FACIE CASE.—To make a prima 

14 facie showing that a measure or action is unlawful 

15 under paragraph (1) a plaintiff shall demonstrate 

16 that the measure or action involved— 

17 (A) singles out the provision of abortion 

18 services or facilities in which abortion services 

19 are performed; or 

20 (B) impedes women’s access to abortion 

21 services based on one or more of the factors de22 scribed in paragraph (3). 

23 (3) FACTORS.—Factors for a court to consider 

24 in determining whether a measure or action impedes 

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1 access to abortion services for purposes of paragraph 

2 (2)(B) include the following: 

3 (A) Whether the measure or action inter4 feres with an abortion provider’s ability to pro5 vide care and render services in accordance with 

6 her or his good-faith medical judgment. 

7 (B) Whether the measure or action is rea8 sonably likely to delay some women in accessing 

9 abortion services. 

10 (C) Whether the measure or action is rea11 sonably likely to directly or indirectly increase 

12 the cost of providing abortion services or the 

13 cost for obtaining abortion services (including 

14 costs associated with travel, childcare, or time 

15 off work). 

16 (D) Whether the measure or action re17 quires, or is reasonably likely to have the effect 

18 of necessitating, a trip to the offices of the 

19 abortion provider that would not otherwise be 

20 required. 

21 (E) Whether the measure or action is rea22 sonably likely to result in a decrease in the 

23 availability of abortion services in the State. 

24 (F) Whether the measure or action im25 poses criminal or civil penalties that are not immstockstill on DSK4VPTVN1PROD with BILLS

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1 posed on other health care professionals for 

2 comparable conduct or failure to act or that are 

3 harsher than penalties imposed on other health 

4 care professionals for comparable conduct or 

5 failure to act. 

6 (G) The cumulative impact of the measure 

7 or action combined with other new or existing 

8 requirements or restrictions. 

9 (4) DEFENSE.—A measure or action shall be 

10 unlawful under this subsection upon making a prima 

11 facie case (as provided for under paragraph (2)), un12 less the defendant establishes, by clear and con13 vincing evidence, that— 

14 (A) the measure or action significantly ad15 vances the safety of abortion services or the 

16 health of women; and 

17 (B) the safety of abortion services or the 

18 health of women cannot be advanced by a less 

19 restrictive alternative measure or action. 

20 (c) OTHER PROHIBITIONS.—The following restric21 tions on the performance of abortion are unlawful and 

22 shall not be imposed or applied by any government: 

23 (1) A prohibition or ban on abortion prior to 

24 fetal viability. 

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1 (2) A prohibition on abortion after fetal viabil2 ity when, in the good-faith medical judgment of the 

3 treating physician, continuation of the pregnancy 

4 would pose a risk to the pregnant woman’s life or 

5 health. 

6 (3) A restriction that limits a pregnant wom7 an’s ability to obtain an immediate abortion when a 

8 health care professional believes, based on her or his 

9 good-faith medical judgment, that delay would pose 

10 a risk to the woman’s health. 

11 (4) A measure or action that prohibits or re12 stricts a woman from obtaining an abortion prior to 

13 fetal viability based on her reasons or perceived rea14 sons or that requires a woman to state her reasons 

15 before obtaining an abortion prior to fetal viability. 

16 (d) LIMITATION.—The provisions of this Act shall 

17 not apply to laws regulating physical access to clinic en18 trances, requirements for parental consent or notification 

19 before a minor may obtain an abortion, insurance coverage 

20 of abortion, or the procedure described in section 

21 1531(b)(1) of title 18, United States Code. 

22 (e) EFFECTIVE DATE.—This Act shall apply to gov23 ernment restrictions on the provision of abortion services, 

24 whether statutory or otherwise, whether they are enacted 

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1 or imposed prior to or after the date of enactment of this 

2 Act. 

3 SEC. 5. LIBERAL CONSTRUCTION. 

4 (a) LIBERAL CONSTRUCTION.—In interpreting the 

5 provisions of this Act, a court shall liberally construe such 

6 provisions to effectuate the purposes of the Act. 

7 (b) RULE OF CONSTRUCTION.—Nothing in this Act 

8 shall be construed to authorize any government to inter9 fere with a woman’s ability to terminate her pregnancy, 

10 to diminish or in any way negatively affect a woman’s con11 stitutional right to terminate her pregnancy, or to displace 

12 any other remedy for violations of the constitutional right 

13 to terminate a pregnancy. 

14 SEC. 6. ENFORCEMENT. 

15 (a) ATTORNEY GENERAL.—The Attorney General 

16 may commence a civil action for prospective injunctive re17 lief on behalf of the United States against any government 

18 official that is charged with implementing or enforcing any 

19 restriction that is challenged as unlawful under this Act. 

20 (b) PRIVATE RIGHT OF ACTION.— 

21 (1) IN GENERAL.—Any individual or entity ag22 grieved by an alleged violation of this Act may com23 mence a civil action for prospective injunctive relief 

24 against the government official that is charged with 

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1 implementing or enforcing the restriction that is 

2 challenged as unlawful under this Act. 

3 (2) FACILITY OR PROFESSIONAL.—A health 

4 care facility or medical professional may commence 

5 an action for prospective injunctive relief on behalf 

6 of the facility’s or professional’s patients who are or 

7 may be adversely affected by an alleged violation of 

8 this Act. 

9 (c) EQUITABLE RELIEF.—In any action under this 

10 section, the court may award appropriate equitable relief, 

11 including temporary, preliminary, or permanent injunctive 

12 relief. 

13 (d) COSTS.—In any action under this section, the 

14 court shall award the costs of litigation, including reason15 able attorney and expert witness fees, to any prevailing 

16 or substantially prevailing plaintiff. 

17 (e) JURISDICTION.—The district courts of the United 

18 States shall have jurisdiction over proceedings commenced 

19 pursuant to this section and shall exercise the same with20 out regard to whether the party aggrieved shall have ex21 hausted any administrative or other remedies that may be 

22 provided for by law. 

23 SEC. 7. PREEMPTION. 

24 No State or subdivision thereof shall enact or enforce 

25 any law, rule, regulation, standard, or other provision havmstockstill on DSK4VPTVN1PROD with BILLS

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1 ing the force and effect of law that conflicts with any pro2 vision of this Act. 

3 SEC. 8. SEVERABILITY. 

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

5 provision to any person or circumstance, is held to be un6 constitutional, the remainder of this Act, or the applica7 tion of such provision to all other persons or cir8 cumstances, shall not be affected thereby. 

Æ 

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