I 

118TH CONGRESS 

1ST SESSION H. R. 6103 

To allow Americans to receive paid leave time to process and address their 

own health needs and the health needs of their partners during the 

period following a pregnancy loss, an unsuccessful round of intrauterine 

insemination or of an assisted reproductive technology procedure, a failed 

adoption arrangement, a failed surrogacy arrangement, or a diagnosis 

or event that impacts pregnancy or fertility, to support related research 

and education, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

OCTOBER 26, 2023 

Ms. PRESSLEY (for herself, Ms. NORTON, Mr. BOWMAN, Ms. LEE of California, Mr. JOHNSON of Georgia, Ms. CROCKETT, Mr. JACKSON of Illinois, Mr. THANEDAR, Mr. CARSON, Ms. SALINAS, Mr. BOYLE of Pennsylvania, Ms. CHU, Ms. BUSH, Ms. PINGREE, Mr. IVEY, and Ms. WILLIAMS

of Georgia) introduced the following bill; which was referred to the Committee on Education and the Workforce, and in addition to the Committees on House Administration, Oversight and Accountability, and 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 allow Americans to receive paid leave time to process 

and address their own health needs and the health needs 

of their partners during the period following a pregnancy 

loss, an unsuccessful round of intrauterine insemination 

or of an assisted reproductive technology procedure, a 

failed adoption arrangement, a failed surrogacy arrangement, or a diagnosis or event that impacts pregnancy 


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or fertility, to support related research and education, 

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 ‘‘Support Through Loss 

5 Act’’. 

6 SEC. 2. PURPOSES. 

7 The purposes of this Act are— 

8 (1) to allow individuals in the United States to 

9 receive supplementary paid leave time to process and 

10 address their own health needs and the health needs 

11 of their partners during the period following a preg12 nancy loss, an unsuccessful round of intrauterine in13 semination or of an assisted reproductive technology 

14 procedure, a failed adoption arrangement, a failed 

15 surrogacy arrangement, or a diagnosis or event that 

16 impacts pregnancy or fertility; and 

17 (2) to support related research or education. 

18 TITLE I—PAID LEAVE 

19 FOLLOWING A PREGNANCY LOSS 

20 SEC. 101. DEFINITIONS. 

21 In this title: 

22 (1) ASSISTED REPRODUCTIVE TECHNOLOGY

23 PROCEDURE.—The term ‘‘assisted reproductive tech24 nology procedure’’ has the meaning given the term 


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1 ‘‘assisted reproductive technology’’ in section 8 of 

2 the Fertility Clinic Success Rate and Certification 

3 Act of 1992 (42 U.S.C. 263a–7). 

4 (2) COMMERCE.—The terms ‘‘commerce’’ and 

5 ‘‘industry or activity affecting commerce’’ mean any 

6 activity, business, or industry in commerce or in 

7 which a labor dispute would hinder or obstruct com8 merce or the free flow of commerce, and include 

9 ‘‘commerce’’ and any ‘‘industry affecting com10 merce’’, as defined in paragraphs (1) and (3) of sec11 tion 501 of the Labor Management Relations Act, 

12 1947 (29 U.S.C. 142 (1) and (3)). 

13 (3) DOMESTIC PARTNER.—The term ‘‘domestic 

14 partner’’, used with respect to an unmarried em15 ployee, includes— 

16 (A) the person recognized as the domestic 

17 partner of the employee under any domestic 

18 partnership or civil union law of a State or po19 litical subdivision of a State; and 

20 (B) an unmarried, adult person who is in 

21 a committed, personal relationship with the em22 ployee, who is not a domestic partner as de23 scribed in subparagraph (A) to or in such a re24 lationship with any other person, and who is 


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1 designated to the employee’s employer by such 

2 employee as that employee’s domestic partner. 

3 (4) EMPLOYEE.—The term ‘‘employee’’ means 

4 an individual who is— 

5 (A)(i) an employee, as defined in section 

6 3(e) of the Fair Labor Standards Act of 1938 

7 (29 U.S.C. 203(e)), who is not covered under 

8 any other provision of this paragraph, except 

9 that a reference in such section to an employer 

10 shall be considered to be a reference to an em11 ployer described in clauses (i)(I) and (ii) of 

12 paragraph (5)(A); or 

13 (ii) an employee of the Government Ac14 countability Office; 

15 (B) a State employee described in section 

16 304(a) of the Government Employee Rights Act 

17 of 1991 (42 U.S.C. 2000e–16c(a)); 

18 (C) a covered employee, as defined in sec19 tion 101 of the Congressional Accountability 

20 Act of 1995 (2 U.S.C. 1301), other than an ap21 plicant for employment; 

22 (D) a covered employee, as defined in sec23 tion 411(c) of title 3, United States Code; or 

24 (E) a Federal officer or employee covered 

25 under subchapter V of chapter 63 of title 5, 


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1 United States Code (without regard to the limi2 tation in section 6381(1)(B) of that title), who 

3 is not covered under subparagraph (D). 

4 (5) EMPLOYER.— 

5 (A) IN GENERAL.—The term ‘‘employer’’ 

6 means a person who is— 

7 (i)(I) a covered employer who is not 

8 described in any other subclause of this 

9 clause; 

10 (II) an entity employing a State em11 ployee described in section 304(a) of the 

12 Government Employee Rights Act of 1991; 

13 (III) an employing office, as defined 

14 in section 101 of the Congressional Ac15 countability Act of 1995; 

16 (IV) an employing office, as defined in 

17 section 411(c) of title 3, United States 

18 Code; or 

19 (V) an employing agency covered 

20 under subchapter V of chapter 63 of title 

21 5, United States Code; and 

22 (ii) engaged in commerce (including 

23 government), or an industry or activity af24 fecting commerce (including government). 

25 (B) COVERED EMPLOYER.— 


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1 (i) IN GENERAL.—In subparagraph 

2 (A)(i)(I), the term ‘‘covered employer’’— 

3 (I) means any person engaged in 

4 commerce or in any industry or activ5 ity affecting commerce who employs 5 

6 or more employees for each working 

7 day during each of 20 or more cal8 endar workweeks in the current or 

9 preceding year; 

10 (II) includes— 

11 (aa) any person who acts, 

12 directly or indirectly, in the inter13 est of an employer covered by 

14 this clause to any of the employ15 ees of such employer; and 

16 (bb) any successor in inter17 est of an employer; 

18 (III) includes any public agency; 

19 and 

20 (IV) includes the Government 

21 Accountability Office. 

22 (ii) PUBLIC AGENCY.—For purposes 

23 of clause (i)(III), a public agency shall be 

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1 merce or in an industry or activity affect2 ing commerce. 

3 (iii) DEFINITIONS.—For purposes of 

4 this subparagraph: 

5 (I) EMPLOYEE.—The term ‘‘em6 ployee’’ has the meaning given such 

7 term in section 3(e) of the Fair Labor 

8 Standards Act of 1938 (29 U.S.C. 

9 203(e)). 

10 (II) PERSON.—The term ‘‘per11 son’’ has the meaning given such term 

12 in section 3(a) of the Fair Labor 

13 Standards Act of 1938 (29 U.S.C. 

14 203(a)). 

15 (III) PUBLIC AGENCY.—The 

16 term ‘‘public agency’’ has the meaning 

17 given such term in section 3(x) of the 

18 Fair Labor Standards Act of 1938 

19 (29 U.S.C. 203(x)). 

20 (C) PREDECESSORS.—Any reference in 

21 this paragraph to an employer shall include a 

22 reference to any predecessor of such employer. 

23 (6) EMPLOYMENT BENEFITS.—The term ‘‘em24 ployment benefits’’ means all benefits provided or 

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1 ing group life insurance, health insurance, disability 

2 insurance, sick leave, annual leave, educational bene3 fits, and pensions, regardless of whether such bene4 fits are provided by a practice or written policy of 

5 an employer or through an ‘‘employee benefit plan’’, 

6 as defined in section 3(3) of the Employee Retire7 ment Income Security Act of 1974 (29 U.S.C. 

8 1002(3)). 

9 (7) PAID LEAVE TIME.—The term ‘‘paid leave 

10 time’’ means an increment of compensated leave that 

11 can be granted to an employee for use during an ab12 sence from employment for any reason described in 

13 section 102(b). 

14 (8) SECRETARY.—The term ‘‘Secretary’’ means 

15 the Secretary of Labor. 

16 (9) SPOUSE.—The term ‘‘spouse’’, with respect 

17 to an employee, has the meaning given such term by 

18 the marriage laws of the State in which the mar19 riage was celebrated. 

20 (10) STATE.—The term ‘‘State’’ has the mean21 ing given the term in section 3 of the Fair Labor 

22 Standards Act of 1938 (29 U.S.C. 203). 

23 (11) UNPAID LEAVE TIME.—The term ‘‘unpaid 

24 leave time’’ means the leave granted and used in the 

25 same manner and under the same conditions as paid 


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1 leave time for the purposes of this title, except that 

2 no compensation shall be paid. 

3 SEC. 102. PAID LEAVE TIME. 

4 (a) GRANTING LEAVE TIME.— 

5 (1) IN GENERAL.—An employer shall grant to 

6 each employee employed by the employer, not less 

7 than 56 hours of paid leave time on the employee’s 

8 first workday of each calendar year. The employee 

9 may use the paid leave time as needed during that 

10 calendar year for reasons described in subsection 

11 (b). 

12 (2) CARRYOVER.—Paid leave time granted 

13 under paragraph (1) shall not carry over from 1 

14 year to the next. 

15 (3) EMPLOYERS WITH EXISTING POLICIES.— 

16 Any employer with a paid leave policy who makes 

17 available an amount of paid leave that is sufficient 

18 to meet the requirements of this section and that is 

19 made available for all stated reasons and under all 

20 stated conditions that are the same as the reasons 

21 and conditions outlined in subsection (b) shall not be 

22 required to grant an employee additional paid leave 

23 time under this section. 

24 (4) CONSTRUCTION.—Nothing in this section 

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1 imbursement to an employee from an employer upon 

2 the employee’s termination, resignation, retirement, 

3 or other separation from employment for granted 

4 paid leave time that has not been used. 

5 (5) PROHIBITION.—An employer may not re6 quire, as a condition of providing paid leave time 

7 under this title, that the employee involved search 

8 for or find a replacement employee to cover the 

9 hours during which the employee is using paid leave 

10 time. 

11 (b) USES.—Paid leave time granted under subsection 

12 (a)(1) may be used by an employee for any of the fol13 lowing: 

14 (1) An absence resulting from— 

15 (A) a pregnancy loss; 

16 (B) an unsuccessful round of intrauterine 

17 insemination or of an assisted reproductive 

18 technology procedure; 

19 (C) a failed adoption match or an adoption 

20 that is not finalized because it is contested by 

21 another party; 

22 (D) a failed surrogacy arrangement; or 

23 (E) a diagnosis or event that impacts preg24 nancy or fertility. 


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1 (2) An absence to care for a spouse or domestic 

2 partner who experiences a circumstance described in 

3 paragraph (1). 

4 (c) PROCEDURES.—Paid leave time granted under 

5 subsection (a)(1) shall be provided upon the oral or writ6 ten request of an employee. Such request shall— 

7 (1) include the expected duration of the period 

8 of such time; and 

9 (2) be provided as soon as practicable after the 

10 employee is aware of the need for such period. 

11 SEC. 103. NOTICE REQUIREMENT. 

12 (a) IN GENERAL.—Each employer shall notify each 

13 employee and include in any employee handbook the infor14 mation described in paragraphs (1) through (3). Each em15 ployer shall post and keep posted a notice, to be prepared 

16 or approved in accordance with procedures specified in 

17 regulations prescribed under section 110, setting forth ex18 cerpts from, or summaries of, the pertinent provisions of 

19 this title, including— 

20 (1) information describing paid leave time avail21 able to employees under this title; 

22 (2) information pertaining to the filing of an 

23 action under this title; and 

24 (3) information that describes— 


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1 (A) the protections that an employee has 

2 in exercising rights under this title; and 

3 (B) how the employee can contact the Sec4 retary (or other appropriate authority as de5 scribed in section 105) if any of the rights are 

6 violated. 

7 (b) LOCATION.—The notice described under sub8 section (a) shall be posted— 

9 (1) in conspicuous places on the premises of the 

10 employer, where notices to employees (including ap11 plicants) are customarily posted; or 

12 (2) in employee handbooks. 

13 (c) VIOLATION; PENALTY.—Any employer who will14 fully violates the posting requirements of this section shall 

15 be subject to a civil fine in an amount not to exceed $100 

16 for each separate offense. 

17 SEC. 104. PROHIBITED ACTS. 

18 (a) INTERFERENCE WITH RIGHTS.— 

19 (1) EXERCISE OF RIGHTS.—It shall be unlawful 

20 for any employer to interfere with, restrain, or deny 

21 the exercise of, or the attempt to exercise, any right 

22 provided under this title, including— 

23 (A) discharging or discriminating against 

24 (including retaliating against) any individual, 

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1 tempting to exercise, any right provided under 

2 this title; 

3 (B) using the taking of paid leave time or 

4 unpaid leave time under this title as a negative 

5 factor in an employment action, such as hiring, 

6 promotion, reducing hours or number of shifts, 

7 or a disciplinary action; or 

8 (C) counting the paid leave time or unpaid 

9 leave time under a no-fault attendance policy or 

10 any other absence control policy. 

11 (2) DISCRIMINATION.—It shall be unlawful for 

12 any employer to discharge or in any other manner 

13 discriminate against (including retaliating against) 

14 any individual, including a job applicant, for oppos15 ing any practice made unlawful by this title. 

16 (b) INTERFERENCE WITH PROCEEDINGS OR INQUIR17 IES.—It shall be unlawful for any person to discharge or 

18 in any other manner discriminate against (including retali19 ating against) any individual, including a job applicant, 

20 because such individual— 

21 (1) has filed an action, or has instituted or 

22 caused to be instituted any proceeding, under or re23 lated to this title; 


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1 (2) has given, or is about to give, any informa2 tion in connection with any inquiry or proceeding re3 lating to any right provided under this title; or 

4 (3) has testified, or is about to testify, in any 

5 inquiry or proceeding relating to any right provided 

6 under this title. 

7 (c) CONSTRUCTION.—Nothing in this section shall be 

8 construed to state or imply that the scope of the activities 

9 prohibited by section 105 of the Family and Medical Leave 

10 Act of 1993 (29 U.S.C. 2615) or the Civil Rights Act of 

11 1964 (42 U.S.C. 2000a et seq.) is less than the scope of 

12 the activities prohibited by this section or is otherwise al13 tered by the activities prohibited by this section. 

14 SEC. 105. ENFORCEMENT AUTHORITY. 

15 (a) IN GENERAL.— 

16 (1) DEFINITION.—In this subsection— 

17 (A) the term ‘‘employee’’ means an em18 ployee described in subparagraph (A) or (B) of 

19 section 101(4); and 

20 (B) the term ‘‘employer’’ means an em21 ployer described in subclause (I) or (II) of sec22 tion 101(5)(A)(i). 

23 (2) INVESTIGATIVE AUTHORITY.— 

24 (A) IN GENERAL.—To ensure compliance 

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1 tion or order issued under this title, the Sec2 retary shall have, subject to subparagraph (C), 

3 the investigative authority provided under sec4 tion 11(a) of the Fair Labor Standards Act of 

5 1938 (29 U.S.C. 211(a)), with respect to em6 ployers, employees, and other individuals af7 fected. 

8 (B) OBLIGATION TO KEEP AND PRESERVE

9 RECORDS.—An employer shall make, keep, and 

10 preserve records pertaining to compliance with 

11 this title in accordance with section 11(c) of the 

12 Fair Labor Standards Act of 1938 (29 U.S.C. 

13 211(c)) and in accordance with regulations pre14 scribed by the Secretary. 

15 (C) REQUIRED SUBMISSIONS GENERALLY

16 LIMITED TO AN ANNUAL BASIS.—The Secretary 

17 shall not require, under the authority of this 

18 paragraph, an employer to submit to the Sec19 retary any books or records more than once 

20 during any 12-month period, unless the Sec21 retary has reasonable cause to believe there 

22 may exist a violation of this title or any regula23 tion or order issued pursuant to this title, or is 

24 investigating a charge pursuant to paragraph 

25 (4). 


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1 (D) SUBPOENA AUTHORITY.—For the pur2 poses of any investigation provided for in this 

3 paragraph, the Secretary shall have the sub4 poena authority provided for under section 9 of 

5 the Fair Labor Standards Act of 1938 (29 

6 U.S.C. 209). 

7 (3) CIVIL ACTION BY EMPLOYEES OR INDIVID8 UALS.— 

9 (A) RIGHT OF ACTION.—An action to re10 cover the damages or equitable relief prescribed 

11 in subparagraph (B) may be maintained 

12 against any employer in any Federal or State 

13 court of competent jurisdiction by an employee 

14 or individual or a representative for and on be15 half of— 

16 (i) the employee or individual; or 

17 (ii) the employee or individual and 

18 others similarly situated. 

19 (B) LIABILITY.—Any employer who vio20 lates section 104 (including a violation relating 

21 to rights provided under section 102) shall be 

22 liable to any employee or individual affected— 

23 (i) for damages equal to— 

24 (I) the amount of— 


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1 (aa) any wages, salary, em2 ployment benefits, or other com3 pensation denied or lost by rea4 son of the violation; or 

5 (bb) in a case in which 

6 wages, salary, employment bene7 fits, or other compensation have 

8 not been denied or lost, any ac9 tual monetary losses sustained as 

10 a direct result of the violation up 

11 to a sum equal to 56 hours of 

12 wages or salary for the employee 

13 or individual; 

14 (II) the interest on the amount 

15 described in subclause (I) calculated 

16 at the prevailing rate; and 

17 (III) an additional amount as liq18 uidated damages; and 

19 (ii) for such equitable relief as may be 

20 appropriate, including employment, rein21 statement, and promotion. 

22 (C) FEES AND COSTS.—The court in an 

23 action under this paragraph shall, in addition to 

24 any judgment awarded to the plaintiff, allow a 

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1 ness fees, and other costs of the action to be 

2 paid by the defendant. 

3 (4) ACTION BY THE SECRETARY.— 

4 (A) ADMINISTRATIVE ACTION.—The Sec5 retary shall receive, investigate, and attempt to 

6 resolve complaints of violations of section 104 

7 (including a violation relating to rights provided 

8 under section 102) in the same manner that the 

9 Secretary receives, investigates, and attempts to 

10 resolve complaints of violations of sections 6 

11 and 7 of the Fair Labor Standards Act of 1938 

12 (29 U.S.C. 206 and 207). 

13 (B) CIVIL ACTION.—The Secretary may 

14 bring an action in any court of competent juris15 diction to recover the damages described in 

16 paragraph (3)(B)(i). 

17 (C) SUMS RECOVERED.—Any sums recov18 ered by the Secretary pursuant to subparagraph 

19 (B) shall be held in a special deposit account 

20 and shall be paid, on order of the Secretary, di21 rectly to each employee or individual affected. 

22 Any such sums not paid to an employee or indi23 vidual affected because of inability to do so 

24 within a period of 3 years shall be deposited 


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1 into the Treasury of the United States as mis2 cellaneous receipts. 

3 (5) LIMITATION.— 

4 (A) IN GENERAL.—Except as provided in 

5 subparagraph (B), an action may be brought 

6 under paragraph (3), (4), or (6) not later than 

7 2 years after the date of the last event consti8 tuting the alleged violation for which the action 

9 is brought. 

10 (B) WILLFUL VIOLATION.—In the case of 

11 an action brought for a willful violation of sec12 tion 104 (including a willful violation relating to 

13 rights provided under section 102), such action 

14 may be brought not later than 3 years after the 

15 date of the last event constituting the alleged 

16 violation for which such action is brought. 

17 (C) COMMENCEMENT.—In determining 

18 when an action is commenced under paragraph 

19 (3), (4), or (6) for the purposes of this para20 graph, it shall be considered to be commenced 

21 on the date when the complaint is filed. 

22 (6) ACTION FOR INJUNCTION BY SECRETARY.— 

23 The district courts of the United States shall have 

24 jurisdiction, for cause shown, in an action brought 

25 by the Secretary— 


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1 (A) to restrain violations of section 104 

2 (including a violation relating to rights provided 

3 under section 102), including the restraint of 

4 any withholding of payment of wages, salary, 

5 employment benefits, or other compensation, 

6 plus interest, found by the court to be due to 

7 employees or individuals eligible under this title; 

8 or 

9 (B) to award such other equitable relief as 

10 may be appropriate, including employment, re11 instatement, and promotion. 

12 (7) SOLICITOR OF LABOR.—The Solicitor of 

13 Labor may appear for and represent the Secretary 

14 on any litigation brought under paragraph (4) or 

15 (6). 

16 (8) GOVERNMENT ACCOUNTABILITY OFFICE.— 

17 Notwithstanding any other provision of this sub18 section, in the case of the Government Account19 ability Office, the authority of the Secretary of 

20 Labor under this subsection shall be exercised by the 

21 Comptroller General of the United States. 

22 (b) EMPLOYEES COVERED BY CONGRESSIONAL AC23 COUNTABILITY ACT OF 1995.—The powers, remedies, and 

24 procedures provided in the Congressional Accountability 

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1 fined in section 101 of that Act (2 U.S.C. 1301)), or any 

2 person, alleging a violation of section 202(a)(1) of that 

3 Act (2 U.S.C. 1312(a)(1)) shall be the powers, remedies, 

4 and procedures this title provides to that Board, or any 

5 person, alleging an unlawful employment practice in viola6 tion of this title against an employee described in section 

7 101(4)(C). 

8 (c) EMPLOYEES COVERED BY CHAPTER 5 OF TITLE

9 3, UNITED STATES CODE.—The powers, remedies, and 

10 procedures provided in chapter 5 of title 3, United States 

11 Code, to the President, the Merit Systems Protection 

12 Board, or any person, alleging a violation of section 

13 412(a)(1) of that title, shall be the powers, remedies, and 

14 procedures this title provides to the President, that Board, 

15 or any person, respectively, alleging an unlawful employ16 ment practice in violation of this title against an employee 

17 described in section 101(4)(D). 

18 (d) EMPLOYEES COVERED BY CHAPTER 63 OF TITLE

19 5, UNITED STATES CODE.—The powers, remedies, and 

20 procedures provided in title 5, United States Code, to an 

21 employing agency, provided in chapter 12 of that title to 

22 the Merit Systems Protection Board, or provided in that 

23 title to any person, alleging a violation of chapter 63 of 

24 that title, shall be the powers, remedies, and procedures 

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1 son, respectively, alleging an unlawful employment prac2 tice in violation of this title against an employee described 

3 in section 101(4)(E). 

4 (e) REMEDIES FOR STATE EMPLOYEES.— 

5 (1) WAIVER OF SOVEREIGN IMMUNITY.—A 

6 State’s receipt or use of Federal financial assistance 

7 for any program or activity of a State shall con8 stitute a waiver of sovereign immunity, under the 

9 11th Amendment to the Constitution or otherwise, 

10 to a suit brought by an employee of that program 

11 or activity under this title for equitable, legal, or 

12 other relief authorized under this title. 

13 (2) OFFICIAL CAPACITY.—An official of a State 

14 may be sued in the official capacity of the official by 

15 any employee who has complied with the procedures 

16 under subsection (a)(3), for injunctive relief that is 

17 authorized under this title. In such a suit the court 

18 may award to the prevailing party those costs au19 thorized by section 722 of the Revised Statutes (42 

20 U.S.C. 1988). 

21 (3) APPLICABILITY.—With respect to a par22 ticular program or activity, paragraph (1) applies to 

23 conduct occurring on or after the day, after the date 

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1 ceives or uses Federal financial assistance for that 

2 program or activity. 

3 (4) DEFINITION OF PROGRAM OR ACTIVITY.—In 

4 this subsection, the term ‘‘program or activity’’ has 

5 the meaning given the term in section 606 of the 

6 Civil Rights Act of 1964 (42 U.S.C. 2000d–4a). 

7 SEC. 106. EDUCATION AND OUTREACH. 

8 (a) IN GENERAL.—The Secretary may conduct a 

9 public awareness campaign to educate and inform the pub10 lic of the requirements for paid leave time required by this 

11 title. 

12 (b) AUTHORIZATION OF APPROPRIATIONS.—There is 

13 authorized to be appropriated to the Secretary such sums 

14 as may be necessary to carry out such campaign. 

15 SEC. 107. EFFECT ON OTHER LAWS. 

16 (a) FEDERAL AND STATE ANTIDISCRIMINATION

17 LAWS.—Nothing in this title shall be construed to modify 

18 or affect any Federal or State law prohibiting discrimina19 tion on the basis of race, religion, color, national origin, 

20 sex, age, or disability. 

21 (b) FEDERAL, STATE, AND LOCAL LAWS.—Nothing 

22 in this title shall be construed to supersede (including pre23 empting) any provision of any Federal, State, or local law 

24 that provides greater paid or unpaid family or medical 

25 leave rights than the rights established under this title. 


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1 SEC. 108. EFFECT ON EXISTING EMPLOYMENT BENEFITS. 

2 (a) MORE PROTECTIVE.—Nothing in this title shall 

3 be construed to diminish the obligation of an employer to 

4 comply with any contract, collective bargaining agreement, 

5 or any employment benefit program or plan that provides 

6 greater paid leave or other leave rights to employees or 

7 individuals than the rights established under this title. 

8 (b) LESS PROTECTIVE.—The rights established for 

9 employees under this title shall not be diminished by any 

10 contract, collective bargaining agreement, or any employ11 ment benefit program or plan. 

12 SEC. 109. ENCOURAGEMENT OF MORE GENEROUS LEAVE 

13 POLICIES. 

14 Nothing in this title shall be construed to discourage 

15 employers from adopting or retaining leave policies more 

16 generous than policies that comply with the requirements 

17 of this title. 

18 SEC. 110. REGULATIONS. 

19 (a) IN GENERAL.— 

20 (1) AUTHORITY.—Except as provided in para21 graph (2), not later than 180 days after the date of 

22 enactment of this title, the Secretary shall prescribe 

23 such regulations as are necessary to carry out this 

24 title with respect to employees described in subpara25 graph (A) or (B) of section 101(4) and other indiVerDate Sep 11 2014 17:35 Oct 28, 2023 Jkt 049200 PO 00000 Frm 00024 Fmt 6652 Sfmt 6201 E:\BILLS\H6103.IH H6103

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1 viduals affected by employers described in subclause 

2 (I) or (II) of section 101(5)(A)(i). 

3 (2) GOVERNMENT ACCOUNTABILITY OFFICE.— 

4 The Comptroller General of the United States shall 

5 prescribe the regulations with respect to employees 

6 of the Government Accountability Office and the Li7 brary of Congress, respectively, and other individuals 

8 affected by the Comptroller General of the United 

9 States. 

10 (b) EMPLOYEES COVERED BY CONGRESSIONAL AC11 COUNTABILITY ACT OF 1995.— 

12 (1) AUTHORITY.—Not later than 90 days after 

13 the Secretary prescribes regulations under sub14 section (a), the Board of Directors of the Office of 

15 Compliance shall prescribe (in accordance with sec16 tion 304 of the Congressional Accountability Act of 

17 1995 (2 U.S.C. 1384)) such regulations as are nec18 essary to carry out this title with respect to employ19 ees described in section 101(4)(C) and other individ20 uals affected by employers described in section 

21 101(5)(A)(i)(III). 

22 (2) AGENCY REGULATIONS.—The regulations 

23 prescribed under paragraph (1) shall be the same as 

24 substantive regulations promulgated by the Sec25 retary to carry out this title except insofar as the 


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1 Board may determine, for good cause shown and 

2 stated together with the regulations prescribed 

3 under paragraph (1), that a modification of such 

4 regulations would be more effective for the imple5 mentation of the rights and protections involved 

6 under this section. 

7 (c) EMPLOYEES COVERED BY CHAPTER 5 OF TITLE

8 3, UNITED STATES CODE.— 

9 (1) AUTHORITY.—Not later than 90 days after 

10 the Secretary prescribes regulations under sub11 section (a), the President (or the designee of the 

12 President) shall prescribe such regulations as are 

13 necessary to carry out this title with respect to em14 ployees described in section 101(4)(D) and other in15 dividuals affected by employers described in section 

16 101(5)(A)(i)(IV). 

17 (2) AGENCY REGULATIONS.—The regulations 

18 prescribed under paragraph (1) shall be the same as 

19 substantive regulations promulgated by the Sec20 retary to carry out this title except insofar as the 

21 President (or designee) may determine, for good 

22 cause shown and stated together with the regula23 tions prescribed under paragraph (1), that a modi24 fication of such regulations would be more effective 


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1 for the implementation of the rights and protections 

2 involved under this section. 

3 (d) EMPLOYEES COVERED BY CHAPTER 63 OF TITLE

4 5, UNITED STATES CODE.— 

5 (1) AUTHORITY.—Not later than 90 days after 

6 the Secretary prescribes regulations under sub7 section (a), the Director of the Office of Personnel 

8 Management shall prescribe such regulations as are 

9 necessary to carry out this title with respect to em10 ployees described in section 101(4)(E) and other in11 dividuals affected by employers described in section 

12 101(5)(A)(i)(V). 

13 (2) AGENCY REGULATIONS.—The regulations 

14 prescribed under paragraph (1) shall be the same as 

15 substantive regulations promulgated by the Sec16 retary to carry out this title except insofar as the 

17 Director may determine, for good cause shown and 

18 stated together with the regulations prescribed 

19 under paragraph (1), that a modification of such 

20 regulations would be more effective for the imple21 mentation of the rights and protections involved 

22 under this section. 


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1 SEC. 111. EFFECTIVE DATES. 

2 (a) EFFECTIVE DATE.—This title, other than section 

3 110, shall take effect 6 months after the date of issuance 

4 of regulations under section 110(a)(1). 

5 (b) COLLECTIVE BARGAINING AGREEMENTS.—In the 

6 case of a collective bargaining agreement in effect on the 

7 effective date prescribed by subsection (a), this title shall 

8 take effect on the earlier of— 

9 (1) the date of the termination of such agree10 ment; or 

11 (2) the date that occurs 18 months after the 

12 date of issuance of regulations under section 

13 110(a)(1). 

14 TITLE II—RESEARCH AND 

15 EDUCATION 

16 SEC. 201. PREGNANCY LOSS PUBLIC EDUCATION PRO17 GRAM. 

18 (a) IN GENERAL.—The Secretary of Health and 

19 Human Services, acting through the Director of the Cen20 ters for Disease Control and Prevention, shall develop and 

21 disseminate to the public information regarding pregnancy 

22 loss, including information on— 

23 (1) awareness of pregnancy loss, and the inci24 dence and prevalence of pregnancy loss among preg25 nant people; and 


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1 (2) the accessibility of the range of evidence2 based treatment options, as medically appropriate, 

3 for pregnancy loss, including miscarriage and recur4 rent miscarriage, including comprehensive mental 

5 health supports, necessary procedures and medica6 tions, and culturally responsive supports including 

7 pregnancy-loss doula care. 

8 (b) DISSEMINATION OF INFORMATION.—In carrying 

9 out subsection (a), the Secretary may disseminate infor10 mation to the public directly or through arrangements 

11 with agencies carrying out intra-agency initiatives, non12 profit organizations, consumer groups, community organi13 zations, institutions of higher education (as defined in sec14 tion 101 of the Higher Education Act of 1965 (20 U.S.C. 

15 1001)), or Federal, State, or local public-private partner16 ships. 

17 (c) AUTHORIZATION OF APPROPRIATIONS.—There is 

18 authorized to be appropriated to carry out this section 

19 such sums as may be necessary for each of fiscal years 

20 2023 through 2026. 

21 SEC. 202. RESEARCH WITH RESPECT TO PREGNANCY LOSS. 

22 (a) IN GENERAL.—The Director of the National In23 stitutes of Health (in this section referred to as the ‘‘Di24 rector of NIH’’) shall expand and coordinate programs for 

25 conducting and supporting evidence-based research with 


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1 respect to causes of and current and novel treatment op2 tions and procedures for pregnancy loss. 

3 (b) ADMINISTRATION AND COORDINATION.—The Di4 rector of NIH, acting through the Director of the Office 

5 of Research on Women’s Health, shall carry out evidence6 based research conducted pursuant to subsection (a), in 

7 coordination with the appropriate institutes, offices, and 

8 centers of the National Institutes of Health, including the 

9 National Institute of Child Health and Human Develop10 ment, the National Institute of Environmental Health 

11 Sciences, the National Institute of Mental Health, and the 

12 Office on Women’s Health of the Department of Health 

13 and Human Services. 

14 (c) AUTHORIZATION OF APPROPRIATIONS.—There is 

15 authorized to be appropriated to carry out this section 

16 $45,000,000 for each of fiscal years 2023 through 2026. 

17 SEC. 203. EDUCATION AND DISSEMINATION OF INFORMA18 TION TO PERINATAL HEALTH CARE WORK19 ERS WITH RESPECT TO PREGNANCY LOSS. 

20 (a) IN GENERAL.—The Secretary of Health and 

21 Human Services, acting through the Administrator of the 

22 Health Resources and Services Administration and the Di23 rector of the Agency for Healthcare Research and Quality 

24 shall, in consultation with and in accordance with guide25 lines from relevant medical societies, develop and dissemiVerDate Sep 11 2014 17:35 Oct 28, 2023 Jkt 049200 PO 00000 Frm 00030 Fmt 6652 Sfmt 6201 E:\BILLS\H6103.IH H6103

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1 nate to perinatal health care workers, including midwives, 

2 physician assistants, nurse practitioners, clinical nurse 

3 specialists, and non-clinical perinatal health care workers, 

4 information on pregnancy loss for the purpose of ensuring 

5 that such perinatal health care workers remain informed 

6 about current information (as of the date of dissemina7 tion) regarding pregnancy loss, including miscarriage and 

8 recurrent miscarriage, and prioritizing both the physical 

9 and mental health care of the patient. 

10 (b) PERINATAL HEALTH CARE WORKER.—For pur11 poses of this section, the term ‘‘perinatal health care work12 er’’ includes any doula, community health worker, peer 

13 supporter, breastfeeding and lactation educator or coun14 selor, nutritionist or dietitian, childbirth educator, social 

15 worker, home visitor, language interpreter, or navigator. 

16 SEC. 204. DATA COLLECTION REGARDING PREGNANCY 

17 LOSS. 

18 The Secretary of Health and Human Services shall, 

19 in an manner that protects personal privacy, collect and 

20 assess data regarding pregnancy loss, including informa21 tion (disaggregated by race, ethnicity, health insurance 

22 status, disability, income level, and geography) on the 

23 prevalence of, the incidence of, and knowledge about preg24 nancy loss. 

Æ 


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