I 

116TH CONGRESS 

1ST SESSION H. R. 20 

To prohibit taxpayer funded abortions. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 17, 2019 

Mr. SMITH of New Jersey (for himself, Mr. LIPINSKI, Mr. HARRIS, Mr. BUCK, 

Mr. FLORES, Mr. GIBBS, Mr. GUTHRIE, Mr. LAMBORN, Mr. MARCHANT, 

Mr. MEADOWS, Mr. OLSON, Mr. POSEY, Mr. SMITH of Missouri, Mr. 

STEWART, Mr. CHABOT, Mr. WENSTRUP, Mr. HUNTER, Mr. ROUZER, 

Mr. CONAWAY, Mr. ALLEN, Mr. SCALISE, Mr. KEVIN HERN of Oklahoma, Mr. LUETKEMEYER, Mr. DUNCAN, Mrs. HARTZLER, Mr. 

HUIZENGA, Mr. ABRAHAM, Mr. KINZINGER, Mr. RESCHENTHALER, Mr. 

GOHMERT, Mr. STEUBE, Mr. COLLINS of Georgia, Mr. AMASH, Mr. 

GRAVES of Missouri, Mr. NEWHOUSE, Mr. RUTHERFORD, Mr. AUSTIN

SCOTT of Georgia, Mrs. WAGNER, Mr. WALBERG, Mr. WATKINS, Mr. 

WILSON of South Carolina, Mr. RATCLIFFE, Mr. THOMPSON of Pennsylvania, Mr. COLE, Mr. TAYLOR, Mr. MOONEY of West Virginia, Mr. 

MULLIN, Mr. BUCHANAN, Mr. JONES, Mr. BERGMAN, Mr. BUDD, Ms. 

CHENEY, Mr. EMMER, Mr. HICE of Georgia, Mr. LAMALFA, Mr. MARSHALL, Mr. NORMAN, Mr. DAVID P. ROE of Tennessee, Mr. ROONEY of 

Florida, Mr. SMITH of Nebraska, Mr. SMUCKER, Mr. ARRINGTON, Mr. 

BANKS, Mr. DUFFY, Mr. ESTES, Mr. FORTENBERRY, Mr. WILLIAMS, Mr. 

BIGGS, and Mr. BILIRAKIS) 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 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 prohibit taxpayer funded abortions. 


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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; TABLE OF CONTENTS. 

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

5 ‘‘No Taxpayer Funding for Abortion and Abortion Insur6 ance Full Disclosure Act of 2019’’. 

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

8 this Act is as follows: 

Sec. 1. Short title; table of contents. 

TITLE I—PROHIBITING FEDERALLY FUNDED ABORTIONS 

Sec. 101. Prohibiting taxpayer funded abortions. 

Sec. 102. Amendment to table of chapters. 

TITLE II—APPLICATION UNDER THE AFFORDABLE CARE ACT 

Sec. 201. Clarifying application of prohibition to premium credits and costsharing reductions under ACA. 

Sec. 202. Revision of notice requirements regarding disclosure of extent of 

health plan coverage of abortion and abortion premium surcharges. 

9 TITLE I—PROHIBITING FEDER10 ALLY FUNDED ABORTIONS 

11 SEC. 101. PROHIBITING TAXPAYER FUNDED ABORTIONS. 

12 Title 1, United States Code, is amended by adding 

13 at the end the following new chapter: 

14 ‘‘CHAPTER 4—PROHIBITING TAXPAYER 

15 FUNDED ABORTIONS 

‘‘301. Prohibition on funding for abortions. 

‘‘302. Prohibition on funding for health benefits plans that cover abortion. 

‘‘303. Limitation on Federal facilities and employees. 

‘‘304. Construction relating to separate coverage. 

‘‘305. Construction relating to the use of non-Federal funds for health coverage. 

‘‘306. Non-preemption of other Federal laws. 

‘‘307. Construction relating to complications arising from abortion. 


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‘‘308. Treatment of abortions related to rape, incest, or preserving the life of 

the mother. 

‘‘309. Application to District of Columbia. 

1 ‘‘§ 301. Prohibition on funding for abortions 

2 ‘‘No funds authorized or appropriated by Federal 

3 law, and none of the funds in any trust fund to which 

4 funds are authorized or appropriated by Federal law, shall 

5 be expended for any abortion. 

6 ‘‘§ 302. Prohibition on funding for health benefits 

7 plans that cover abortion 

8 ‘‘None of the funds authorized or appropriated by 

9 Federal law, and none of the funds in any trust fund to 

10 which funds are authorized or appropriated by Federal 

11 law, shall be expended for health benefits coverage that 

12 includes coverage of abortion. 

13 ‘‘§ 303. Limitation on Federal facilities and employees 

14 ‘‘No health care service furnished— 

15 ‘‘(1) by or in a health care facility owned or op16 erated by the Federal Government; or 

17 ‘‘(2) by any physician or other individual em18 ployed by the Federal Government to provide health 

19 care services within the scope of the physician’s or 

20 individual’s employment, 

21 may include abortion. 

22 ‘‘§ 304. Construction relating to separate coverage 

23 ‘‘Nothing in this chapter shall be construed as pro24 hibiting any individual, entity, or State or locality from 


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1 purchasing separate abortion coverage or health benefits 

2 coverage that includes abortion so long as such coverage 

3 is paid for entirely using only funds not authorized or ap4 propriated by Federal law and such coverage shall not be 

5 purchased using matching funds required for a federally 

6 subsidized program, including a State’s or locality’s con7 tribution of Medicaid matching funds. 

8 ‘‘§ 305. Construction relating to the use of non-Fed9 eral funds for health coverage 

10 ‘‘Nothing in this chapter shall be construed as re11 stricting the ability of any non-Federal health benefits cov12 erage provider from offering abortion coverage, or the abil13 ity of a State or locality to contract separately with such 

14 a provider for such coverage, so long as only funds not 

15 authorized or appropriated by Federal law are used and 

16 such coverage shall not be purchased using matching 

17 funds required for a federally subsidized program, includ18 ing a State’s or locality’s contribution of Medicaid match19 ing funds. 

20 ‘‘§ 306. Non-preemption of other Federal laws 

21 ‘‘Nothing in this chapter shall repeal, amend, or have 

22 any effect on any other Federal law to the extent such 

23 law imposes any limitation on the use of funds for abortion 

24 or for health benefits coverage that includes coverage of 

25 abortion, beyond the limitations set forth in this chapter. 


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1 ‘‘§ 307. Construction relating to complications arising 

2 from abortion 

3 ‘‘Nothing in this chapter shall be construed to apply 

4 to the treatment of any infection, injury, disease, or dis5 order that has been caused by or exacerbated by the per6 formance of an abortion. This rule of construction shall 

7 be applicable without regard to whether the abortion was 

8 performed in accord with Federal or State law, and with9 out regard to whether funding for the abortion is permis10 sible under section 308. 

11 ‘‘§ 308. Treatment of abortions related to rape, incest, 

12 or preserving the life of the mother 

13 ‘‘The limitations established in sections 301, 302, 

14 and 303 shall not apply to an abortion— 

15 ‘‘(1) if the pregnancy is the result of an act of 

16 rape or incest; or 

17 ‘‘(2) in the case where a woman suffers from a 

18 physical disorder, physical injury, or physical illness 

19 that would, as certified by a physician, place the 

20 woman in danger of death unless an abortion is per21 formed, including a life-endangering physical condi22 tion caused by or arising from the pregnancy itself. 

23 ‘‘§ 309. Application to District of Columbia 

24 ‘‘In this chapter: 

25 ‘‘(1) Any reference to funds appropriated by 

26 Federal law shall be treated as including any 


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1 amounts within the budget of the District of Colum2 bia that have been approved by an Act of Congress 

3 pursuant to section 446 of the District of Columbia 

4 Home Rule Act (or any applicable successor Federal 

5 law). 

6 ‘‘(2) The term ‘Federal Government’ includes 

7 the government of the District of Columbia.’’. 

8 SEC. 102. AMENDMENT TO TABLE OF CHAPTERS. 

9 The table of chapters for title 1, United States Code, 

10 is amended by adding at the end the following new item: 

‘‘4. Prohibiting taxpayer funded abortions ............................ 301’’. 

11 TITLE II—APPLICATION UNDER 

12 THE AFFORDABLE CARE ACT 

13 SEC. 201. CLARIFYING APPLICATION OF PROHIBITION TO 

14 PREMIUM CREDITS AND COST-SHARING RE15 DUCTIONS UNDER ACA. 

16 (a) IN GENERAL.— 

17 (1) DISALLOWANCE OF REFUNDABLE CREDIT

18 AND COST-SHARING REDUCTIONS FOR COVERAGE

19 UNDER QUALIFIED HEALTH PLAN WHICH PROVIDES

20 COVERAGE FOR ABORTION.— 

21 (A) IN GENERAL.—Subparagraph (A) of 

22 section 36B(c)(3) of the Internal Revenue Code 

23 of 1986 is amended by inserting before the pe24 riod at the end the following: ‘‘or any health 

25 plan that includes coverage for abortions (other 


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1 than any abortion or treatment described in 

2 section 307 or 308 of title 1, United States 

3 Code)’’. 

4 (B) OPTION TO PURCHASE OR OFFER SEP5 ARATE COVERAGE OR PLAN.—Paragraph (3) of 

6 section 36B(c) of such Code is amended by 

7 adding at the end the following new subpara8 graph: 

9 ‘‘(C) SEPARATE ABORTION COVERAGE OR

10 PLAN ALLOWED.— 

11 ‘‘(i) OPTION TO PURCHASE SEPARATE

12 COVERAGE OR PLAN.—Nothing in subpara13 graph (A) shall be construed as prohibiting 

14 any individual from purchasing separate 

15 coverage for abortions described in such 

16 subparagraph, or a health plan that in17 cludes such abortions, so long as no credit 

18 is allowed under this section with respect 

19 to the premiums for such coverage or plan. 

20 ‘‘(ii) OPTION TO OFFER COVERAGE OR

21 PLAN.—Nothing in subparagraph (A) shall 

22 restrict any non-Federal health insurance 

23 issuer offering a health plan from offering 

24 separate coverage for abortions described 

25 in such subparagraph, or a plan that inVerDate Sep 11 2014 01:50 Jan 30, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H20.IH H20

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1 cludes such abortions, so long as premiums 

2 for such separate coverage or plan are not 

3 paid for with any amount attributable to 

4 the credit allowed under this section (or 

5 the amount of any advance payment of the 

6 credit under section 1412 of the Patient 

7 Protection and Affordable Care Act).’’. 

8 (2) DISALLOWANCE OF SMALL EMPLOYER

9 HEALTH INSURANCE EXPENSE CREDIT FOR PLAN

10 WHICH INCLUDES COVERAGE FOR ABORTION.—Sub11 section (h) of section 45R of the Internal Revenue 

12 Code of 1986 is amended— 

13 (A) by striking ‘‘Any term’’ and inserting 

14 the following: 

15 ‘‘(1) IN GENERAL.—Any term’’; and 

16 (B) by adding at the end the following new 

17 paragraph: 

18 ‘‘(2) EXCLUSION OF HEALTH PLANS INCLUDING

19 COVERAGE FOR ABORTION.— 

20 ‘‘(A) IN GENERAL.—The term ‘qualified 

21 health plan’ does not include any health plan 

22 that includes coverage for abortions (other than 

23 any abortion or treatment described in section 

24 307 or 308 of title 1, United States Code). 


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1 ‘‘(B) SEPARATE ABORTION COVERAGE OR

2 PLAN ALLOWED.— 

3 ‘‘(i) OPTION TO PURCHASE SEPARATE

4 COVERAGE OR PLAN.—Nothing in subpara5 graph (A) shall be construed as prohibiting 

6 any employer from purchasing for its em7 ployees separate coverage for abortions de8 scribed in such subparagraph, or a health 

9 plan that includes such abortions, so long 

10 as no credit is allowed under this section 

11 with respect to the employer contributions 

12 for such coverage or plan. 

13 ‘‘(ii) OPTION TO OFFER COVERAGE OR

14 PLAN.—Nothing in subparagraph (A) shall 

15 restrict any non-Federal health insurance 

16 issuer offering a health plan from offering 

17 separate coverage for abortions described 

18 in such subparagraph, or a plan that in19 cludes such abortions, so long as such sep20 arate coverage or plan is not paid for with 

21 any employer contribution eligible for the 

22 credit allowed under this section.’’. 

23 (3) CONFORMING ACA AMENDMENTS.—Section 

24 1303(b) of Public Law 111–148 (42 U.S.C. 

25 18023(b)) is amended— 


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1 (A) by striking paragraph (2); 

2 (B) by striking paragraph (3), as amended 

3 by section 202(a); and 

4 (C) by redesignating paragraph (4) as 

5 paragraph (2). 

6 (b) APPLICATION TO MULTI-STATE PLANS.—Para7 graph (6) of section 1334(a) of Public Law 111–148 (42 

8 U.S.C. 18054(a)) is amended to read as follows: 

9 ‘‘(6) COVERAGE CONSISTENT WITH FEDERAL

10 ABORTION POLICY.—In entering into contracts 

11 under this subsection, the Director shall ensure that 

12 no multi-State qualified health plan offered in an 

13 Exchange provides health benefits coverage for 

14 which the expenditure of Federal funds is prohibited 

15 under chapter 4 of title 1, United States Code.’’. 

16 (c) EFFECTIVE DATE.—The amendments made by 

17 subsection (a) shall apply to taxable years ending after 

18 December 31, 2019, but only with respect to plan years 

19 beginning after such date, and the amendment made by 

20 subsection (b) shall apply to plan years beginning after 

21 such date. 


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1 SEC. 202. REVISION OF NOTICE REQUIREMENTS REGARD2 ING DISCLOSURE OF EXTENT OF HEALTH 

3 PLAN COVERAGE OF ABORTION AND ABOR4 TION PREMIUM SURCHARGES. 

5 (a) IN GENERAL.—Paragraph (3) of section 1303(b) 

6 of Public Law 111–148 (42 U.S.C. 18023(b)) is amended 

7 to read as follows: 

8 ‘‘(3) RULES RELATING TO NOTICE.— 

9 ‘‘(A) IN GENERAL.—The extent of cov10 erage (if any) of services described in para11 graph (1)(B)(i) or (1)(B)(ii) by a qualified 

12 health plan shall be disclosed to enrollees at the 

13 time of enrollment in the plan and shall be 

14 prominently displayed in any marketing or ad15 vertising materials, comparison tools, or sum16 mary of benefits and coverage explanation made 

17 available with respect to such plan by the issuer 

18 of the plan, by an Exchange, or by the Sec19 retary, including information made available 

20 through an Internet portal or Exchange under 

21 sections 1311(c)(5) and 1311(d)(4)(C). 

22 ‘‘(B) SEPARATE DISCLOSURE OF ABOR23 TION SURCHARGES.—In the case of a qualified 

24 health plan that includes the services described 

25 in paragraph (1)(B)(i) and where the premium 

26 for the plan is disclosed, including in any marVerDate Sep 11 2014 01:50 Jan 30, 2019 Jkt 089200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H20.IH H20

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1 keting or advertising materials or any other in2 formation referred to in subparagraph (A), the 

3 surcharge described in paragraph (2)(B)(i)(II) 

4 that is attributable to such services shall also be 

5 disclosed and identified separately.’’. 

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

7 subsection (a) shall apply to materials, tools, or other in8 formation made available more than 30 days after the date 

9 of the enactment of this Act. 

Æ 


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