I 

111TH CONGRESS 

1ST SESSION H. R. 643 

To encourage and assist women to carry their children to live birth by 

providing services, during and after pregnancy, that will alleviate the 

financial, social, emotional, and other difficulties that may otherwise 

lead to abortion. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 22, 2009 

Mr. FORTENBERRY (for himself and Mrs. MCMORRIS RODGERS) introduced 

the following bill; which was referred to the Committee on Energy and 

Commerce, and in addition to the Committees on Ways and Means and 

Education and Labor, 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 encourage and assist women to carry their children to 

live birth by providing services, during and after pregnancy, that will alleviate the financial, social, emotional, 

and other difficulties that may otherwise lead to abortion. 

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; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Care for Life Act of 2009’’. 


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1 (b) TABLE OF CONTENTS.—The table of contents for 

2 this Act is as follows: 

Sec. 1. Short title; table of contents. 

Sec. 2. Findings. 

TITLE I—PREGNANCY SUPPORT SERVICES 

Sec. 101. Sense of Congress. 

Sec. 102. Office of Pregnancy Support Services. 

Sec. 103. Individual health insurance coverage for pregnant women. 

TITLE II—DEPARTMENT OF EDUCATION 

Sec. 201. Fund for the Improvement of Postsecondary Education. 

TITLE III—ADOPTION TAX INCENTIVES 

Sec. 301. Expansion of adoption credit and adoption assistance programs. 

3 SEC. 2. FINDINGS. 

4 The Congress finds as follows: 

5 (1) Half of American women will experience an 

6 unintended pregnancy, and more than one-third will 

7 have an abortion by the age of 45. 

8 (2) Twenty-two percent of all pregnancies end 

9 in abortion. 

10 (3) It is estimated that more than 48,000,000 

11 abortions have been performed in the United States 

12 since 1973. 

13 (4) Two-thirds of all abortions are obtained by 

14 women who have never married. 

15 (5) Social reasons account for 93 percent of 

16 abortion decisions by United States women, whereas 

17 health concerns are the primary reason for 3 percent 

18 of abortions. 


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1 (6) According to a national study of women un2 dergoing abortion, 64 percent felt pressured by oth3 ers to have their abortions. 

4 (7) In a study of the reasons why United States 

5 women have an abortion, three-fourths report con6 cern for or responsibility to other individuals; three7 fourths cannot afford to have a child; three-fourths 

8 cite interference with work, school, or dependent 

9 care; and half report not wanting to be a single par10 ent or report problems with the father of the child. 

11 (8) Fifty percent of United States women who 

12 abort a pregnancy are younger than 25 years of age; 

13 33 percent are 20 to 24 years of age; and 17 percent 

14 are teenagers. 

15 (9) Over 70 percent of United States abortion 

16 facilities are found in minority neighborhoods. 

17 (10) Domestic private adoptions are estimated 

18 to have fallen to 58,600 in 2001 from 97,700 in 

19 1992. 

20 (11) Less than half (39 percent) of major 

21 United States companies provide adoption assistance 

22 as an employee benefit. 

23 (12) Domestic private adoptions can range in 

24 cost from $5,000 to greater than $40,000. 


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1 TITLE I—PREGNANCY SUPPORT 

2 SERVICES 

3 SEC. 101. SENSE OF CONGRESS. 

4 It is the sense of the Congress that— 

5 (1) women facing pregnancy under difficult life 

6 circumstances should not feel compelled to have an 

7 abortion; and 

8 (2) recipients of care funded through title X of 

9 the Public Health Service Act (42 U.S.C. 300 et 

10 seq.) and expectant mothers in need should be aware 

11 of the services available, during and after pregnancy, 

12 to assist them to carry their children to live birth 

13 and to care for themselves and their children fol14 lowing birth. 

15 SEC. 102. OFFICE OF PREGNANCY SUPPORT SERVICES. 

16 Part D of title III of the Public Health Service Act 

17 (42 U.S.C. 254b et seq.) is amended— 

18 (1) by redesignating section 330F as section 

19 330F–1; and 

20 (2) by inserting after section 330E the fol21 lowing: 

22 ‘‘SEC. 330F. OFFICE OF PREGNANCY SUPPORT SERVICES. 

23 ‘‘(a) OFFICE.— 

24 ‘‘(1) ESTABLISHMENT.—Not later than 180 

25 days after the date of the enactment of this section, 


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1 the Secretary shall establish within the Department 

2 of Health and Human Services an Office of Preg3 nancy Support Services. 

4 ‘‘(2) PURPOSE.—The purpose of the Office 

5 shall be to encourage and assist pregnant women to 

6 carry their children to live birth by providing serv7 ices, during and after pregnancy, that will alleviate 

8 the financial, social, emotional and other difficulties 

9 that may otherwise lead to an abortion. 

10 ‘‘(3) DEPUTY ASSISTANT SECRETARY.—The Of11 fice shall be headed by a Deputy Assistant Secretary 

12 for Pregnancy Support Services, who shall be ap13 pointed by and shall serve under the supervision and 

14 direction of the Assistant Secretary for Health. 

15 ‘‘(4) NO DUPLICATION OF EFFORT.—The Sec16 retary shall coordinate the functions of the Office 

17 with the activities of other agencies and offices of 

18 the Department of Health and Human Services so 

19 as to avoid any duplication of effort. 

20 ‘‘(b) PREGNANCY CARE INFORMATION SERVICE.— 

21 ‘‘(1) DATABASE.—The Secretary shall develop 

22 and maintain a comprehensive, publicly accessible, 

23 and user friendly database, to be known as the Preg24 nancy Care Information Service, to serve as a conVerDate Nov 24 2008 06:30 Jan 23, 2009 Jkt 079200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H643.IH H643

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1 solidated source of information on pregnancy sup2 port services. 

3 ‘‘(2) PROVIDER INFORMATION.—The database 

4 developed under paragraph (1) shall include perti5 nent information on the providers of the pregnancy 

6 support services listed in the database. 

7 ‘‘(3) DIRECTOR OF PREGNANCY CARE INFORMA8 TION SERVICES.—The Secretary shall appoint a Di9 rector of Pregnancy Care Information Services to 

10 carry out this subsection under the supervision and 

11 direction of the Deputy Assistant Secretary. 

12 ‘‘(c) ANNUAL CONFERENCE.—The Secretary shall 

13 conduct an annual nationwide best practices conference, 

14 gathering experts from State and local governments, pre15 natal and parenting care centers, and other relevant facili16 ties— 

17 ‘‘(1) to share information on best practices in 

18 pregnancy support services; and 

19 ‘‘(2) to identify and address key burdens or ad20 verse circumstances facing pregnant women. 

21 ‘‘(d) TOLL-FREE NUMBER.—The Secretary shall 

22 enter into a contract, through the use of competitive pro23 cedures, with an entity to establish and operate a toll-free 

24 number to provide women with referrals for obtaining 

25 pregnancy support services. 


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1 ‘‘(e) LIFE CARE GRANTS.— 

2 ‘‘(1) IN GENERAL.—The Secretary may award 

3 competitive grants to entities to provide pregnancy 

4 support services. 

5 ‘‘(2) ELIGIBILITY.—The Secretary may award a 

6 grant to an entity under this subsection only if the 

7 entity has been engaged in providing pregnancy sup8 port services for at least 2 years. 

9 ‘‘(3) SUPPLEMENT NOT SUPPLANT.—The Sec10 retary may award a grant to an entity under this 

11 subsection only if the entity agrees that the grant 

12 will be used to supplement, and not supplant, preg13 nancy support services. 

14 ‘‘(f) PUBLIC OUTREACH.—The Secretary shall de15 velop and implement a public outreach campaign to pro16 vide information on pregnancy support services to— 

17 ‘‘(1) vulnerable women, including those in low18 income, urban and rural areas; and 

19 ‘‘(2) facilities receiving funds through title X. 

20 ‘‘(g) PRENATAL CARE GRANTS TO INSTITUTIONS OF

21 HIGHER EDUCATION.—The Secretary may award com22 petitive grants to institutions of higher education for the 

23 exclusive purpose of providing pregnancy support services, 

24 which may include— 


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1 ‘‘(1) employing a registered nurse, nurse practi2 tioner, physician assistant, or physician with special3 ized training in prenatal care; or 

4 ‘‘(2) establishing and maintaining student out5 reach programs to provide prenatal care, parenting 

6 assistance, and student housing assistance to the in7 stitution’s pregnant and parenting students. 

8 ‘‘(h) ANNUAL REPORT.—The Secretary shall submit 

9 an annual report to the Congress on the activities carried 

10 out under this section, the funds expended on such activi11 ties, and the results achieved through such activities. 

12 ‘‘(i) DEFINITIONS.—In this section: 

13 ‘‘(1) The term ‘Deputy Assistant Secretary’ 

14 means the Deputy Assistant Secretary for Preg15 nancy Support Services appointed under subsection 

16 (a)(3). 

17 ‘‘(2) The term ‘Office’ means the Office of 

18 Pregnancy Support Services established under sub19 section (a)(1). 

20 ‘‘(3) The term ‘pregnancy support services’ 

21 means services offered by Federal, State, faith22 based, and other providers, during and after preg23 nancy, that will encourage and assist women to 

24 carry their children to live birth by alleviating finan25 cial, social, emotional, and other difficulties that 


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1 may otherwise lead to an abortion, including the fol2 lowing: 

3 ‘‘(A) Material assistance, including mater4 nity and baby clothing, diapers, baby food (in5 cluding formula), baby furniture, and car seats. 

6 ‘‘(B) Referrals for adoption, job training, 

7 housing, assistance with domestic violence, and 

8 food stamps and other governmental assistance. 

9 ‘‘(C) Crisis hotlines, including for violence 

10 or suicide prevention. 

11 ‘‘(D) Pro bono obstetric and prenatal care 

12 services for women intending to carry their chil13 dren to live birth, including services during 

14 pregnancy and following childbirth, and neo15 natal care services, including referrals for such 

16 services. 

17 ‘‘(E) Pro bono legal services to assist 

18 women who wish to carry their children to live 

19 birth and parents with newborn children. 

20 ‘‘(F) Child care services. 

21 ‘‘(G) Services to assist parents to care for, 

22 and prepare to care for, a child with Down syn23 drome or another prenatally diagnosed condi24 tion, and to facilitate the adoption of such chil25 dren as appropriate. 


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1 ‘‘(H) Life skills mentoring, including to en2 hance the following competencies: 

3 ‘‘(i) Strengthening marriage. 

4 ‘‘(ii) Communication and conflict 

5 management for building healthy mar6 riages and families. 

7 ‘‘(iii) Decisionmaking and relation8 ship-building skills prior to marriage. 

9 ‘‘(iv) High-risk behavior awareness. 

10 ‘‘(I) Life-skills counseling. 

11 ‘‘(J) Provision of any of the services identi12 fied in subparagraphs (A) through (I) through 

13 pregnancy support centers.’’. 

14 SEC. 103. INDIVIDUAL HEALTH INSURANCE COVERAGE FOR 

15 PREGNANT WOMEN. 

16 (a) LIMITATION ON IMPOSITION OF PRE-EXISTING

17 CONDITION EXCLUSIONS AND WAITING PERIODS FOR

18 WOMEN WITH PRIOR COVERAGE.—Title XXVII of the 

19 Public Health Service Act is amended by inserting after 

20 section 2753 the following new section: 


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1 ‘‘SEC. 2754. PROVIDING INDIVIDUAL HEALTH INSURANCE 

2 COVERAGE WITHOUT REGARD TO PRE3 EXISTING CONDITION EXCLUSION AND WAIT4 ING PERIODS FOR PREGNANT WOMEN WITH5 IN ONE YEAR OF CONTINUOUS PRIOR COV6 ERAGE. 

7 ‘‘In the case of a woman who has had at least 12 

8 months of creditable coverage before seeking health insur9 ance coverage in the individual market, such individual 

10 health insurance coverage, and the health insurance issuer 

11 offering such coverage, may not impose any preexisting 

12 condition exclusion (as defined in section 2701(b)(1)(A)) 

13 relating to pregnancy as a preexisting condition, any wait14 ing period, or otherwise discriminate in coverage or pre15 miums against the woman on the basis that she is preg16 nant.’’. 

17 (b) EFFECTIVE DATE.—The amendment made by 

18 subsection (a) shall take effect on January 1, 2009, and 

19 shall apply to women who become pregnant on or after 

20 such date. 

21 TITLE II—DEPARTMENT OF 

22 EDUCATION 

23 SEC. 201. FUND FOR THE IMPROVEMENT OF POSTSEC24 ONDARY EDUCATION. 

25 Section 741(a) of the Higher Education Act of 1965 

26 (20 U.S.C. 1138(a)) is amended— 


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1 (1) by striking ‘‘and’’ at the end of paragraph 

2 (12); 

3 (2) by striking the period at the end of para4 graph (13) and inserting ‘‘; and’’; and 

5 (3) by adding at the end the following: 

6 ‘‘(14) establishing and operating pregnant and 

7 parenting student services offices or agencies the ex8 clusive purpose of which shall be to provide preg9 nancy support services (as defined in section 330F 

10 of the Public Health Service Act), including serv11 ices— 

12 ‘‘(A) to assist students to carry their chil13 dren to live birth and to assist student parents 

14 to care for their children or to place them for 

15 adoption, as appropriate; and 

16 ‘‘(B) to assist pregnant and parenting stu17 dents— 

18 ‘‘(i) to locate and utilize child care, 

19 family housing, health insurance for them20 selves and their family, flexible academic 

21 scheduling such as telecommuting pro22 grams, parenting classes and programs, 

23 postpartum counseling and support groups, 

24 and adoption placement services; and 


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1 ‘‘(ii) to meet the material needs of 

2 their children, including maternity and 

3 baby clothing, diapers, baby food (includ4 ing formula), baby furniture, car seats, 

5 and similar items.’’. 

6 TITLE III—ADOPTION TAX 

7 INCENTIVES 

8 SEC. 301. EXPANSION OF ADOPTION CREDIT AND ADOP9 TION ASSISTANCE PROGRAMS. 

10 (a) INCREASE IN DOLLAR LIMITATIONS.— 

11 (1) ADOPTION CREDIT.— 

12 (A) IN GENERAL.—Paragraph (1) of sec13 tion 23(b) of the Internal Revenue Code of 

14 1986 (relating to dollar limitation) is amended 

15 by striking ‘‘$10,000’’ and inserting ‘‘$15,000’’. 

16 (B) CHILD WITH SPECIAL NEEDS.—Para17 graph (3) of section 23(a) of such Code (relat18 ing to $10,000 credit for adoption of child with 

19 special needs regardless of expenses) is amend20 ed— 

21 (i) in the text by striking ‘‘$10,000’’ 

22 and inserting ‘‘$15,000’’, and 

23 (ii) in the heading by striking 

24 ‘‘$10,000’’ and inserting ‘‘$15,000’’. 


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1 (C) INCOME LIMITATION.—Clause (i) of 

2 section 23(b)(2)(A) of such Code (relating to 

3 general rule for income limitation) is amended 

4 by striking ‘‘$150,000’’ and inserting 

5 ‘‘$200,000’’. 

6 (D) CONFORMING AMENDMENT TO INFLA7 TION ADJUSTMENT.—Subsection (h) of section 

8 23 of such Code (relating to adjustments for in9 flation) is amended— 

10 (i) in the matter preceding paragraph 

11 (1) by striking ‘‘December 31, 2002’’ and 

12 inserting ‘‘December 31, 2009,’’, and 

13 (ii) in paragraph (2) by striking ‘‘cal14 endar year 2001’’ and inserting ‘‘calendar 

15 year 2008’’. 

16 (2) ADOPTION ASSISTANCE PROGRAMS.— 

17 (A) IN GENERAL.—Paragraph (1) of sec18 tion 137(b) of the Internal Revenue Code of 

19 1986 (relating to dollar limitation) is amended 

20 by striking ‘‘$10,000’’ and inserting ‘‘$15,000’’. 

21 (B) CHILD WITH SPECIAL NEEDS.—Para22 graph (2) of section 137(a) of such Code (relat23 ing to $10,000 exclusion for adoption of child 

24 with special needs regardless of expenses) is 

25 amended— 


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1 (i) in the text by striking ‘‘$10,000’’ 

2 and inserting ‘‘$15,000’’, and 

3 (ii) in the heading by striking 

4 ‘‘$10,000’’ and inserting ‘‘$15,000’’. 

5 (C) INCOME LIMITATION.—Clause (i) of 

6 section 137(b)(2)(A) of such Code (relating to 

7 general rule for income limitation) is amended 

8 by striking ‘‘$150,000’’ and inserting 

9 ‘‘$200,000’’. 

10 (D) CONFORMING AMENDMENT TO INFLA11 TION ADJUSTMENT.—Subsection (f) of section 

12 137 of such Code (relating to adjustments for 

13 inflation) is amended— 

14 (i) in the matter preceding paragraph 

15 (1) by striking ‘‘December 31, 2002’’ and 

16 inserting ‘‘December 31, 2009,’’, and 

17 (ii) in paragraph (2) by striking ‘‘cal18 endar year 2001’’ and inserting ‘‘calendar 

19 year 2008’’. 

20 (b) CREDIT MADE REFUNDABLE.— 

21 (1) CREDIT MOVED TO SUBPART RELATING TO

22 REFUNDABLE CREDITS.—The Internal Revenue 

23 Code of 1986 is amended— 

24 (A) by redesignating section 37 as section 

25 37A, 


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1 (B) by redesignating section 23, as amend2 ed by subsection (a), as section 37, and 

3 (C) by moving section 37 (as so redesig4 nated) from subpart A of part IV of subchapter 

5 A of chapter 1 to the location immediately be6 fore section 37 (as so redesignated) in subpart 

7 C of part IV of subchapter A of chapter 1. 

8 (2) CONFORMING AMENDMENTS.— 

9 (A) Section 24(b)(3)(B) of such Code is 

10 amended by striking ‘‘sections 23 and’’ and in11 serting ‘‘section’’. 

12 (B) Section 25(e)(1)(C) of such Code is 

13 amended— 

14 (i) in clause (i) by striking ‘‘23, 

15 25D,’’ and inserting ‘‘25D’’, and 

16 (ii) in clause (ii) by striking ‘‘23,’’. 

17 (C) Section 25B(g)(2) of such Code is 

18 amended by striking ‘‘and section 23’’. 

19 (D) Section 25D(c)(2) of such Code is 

20 amended by striking ‘‘23, 24,’’ and inserting 

21 ‘‘24’’. 

22 (E) Section 26(a)(1) of such Code is 

23 amended by striking ‘‘23, 24,’’ and inserting 

24 ‘‘24’’. 


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1 (F) Section 37 of such Code, as so redesig2 nated, is amended— 

3 (i) by striking paragraph (4) of sub4 section (b), and 

5 (ii) by striking subsection (c). 

6 (G) Section 137 of such Code is amend7 ed— 

8 (i) in subsection (d) by striking ‘‘sec9 tion 23(d)’’ and inserting ‘‘section 37(d)’’, 

10 and 

11 (ii) in subsection (e) by striking ‘‘sec12 tion 23’’ and inserting ‘‘section 37’’. 

13 (H) Section 904(i) of such Code is amend14 ed by striking ‘‘23, 24,’’ and inserting ‘‘24’’. 

15 (I) Section 1016(a)(26) is amended by 

16 striking ‘‘23(g)’’ and inserting ‘‘37(g)’’. 

17 (J) Section 1400C(d) of such Code is 

18 amended by striking ‘‘23,’’. 

19 (K) The table of sections for subpart A of 

20 part IV of subchapter A of chapter 1 of such 

21 Code of 1986 is amended by striking the item 

22 relating to section 23. 

23 (L) Paragraph (2) of section 1324(b) of 

24 title 31, United States Code, is amended by in25 serting ‘‘37,’’ after ‘‘36,’’. 


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1 (M) The table of sections for subpart C of 

2 part IV of subchapter A of chapter 1 of the In3 ternal Revenue Code of 1986 is amended by 

4 striking the last item and inserting the fol5 lowing new items: 

‘‘Sec. 37. Adoption expenses. 

‘‘Sec. 37A. Overpayments of tax.’’. 

6 (c) MODIFICATIONS MADE BY EGTRRA TO ADOP7 TION CREDIT MADE PERMANENT.—Title IX of the Eco8 nomic Growth and Tax Relief Reconciliation Act of 2001 

9 shall not apply to the amendments made by section 202 

10 of such Act (relating to expansion of adoption credit and 

11 adoption assistance programs). 

12 (d) EFFECTIVE DATE.—The amendments made by 

13 this section shall apply to taxable years beginning after 

14 December 31, 2008. 

Æ 


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