I 

116TH CONGRESS 

1ST SESSION H. R. 2014 

To amend the Public Health Service Act to prohibit governmental discrimination against providers of health services that are not involved in abortion. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 1, 2019 

Mr. HARRIS (for himself, Mr. FORTENBERRY, Mr. PALMER, Mr. MEADOWS, 

Mr. ADERHOLT, Mr. WEBER of Texas, Mr. GAETZ, Mr. DUNCAN, Mr. 

SCALISE, Mr. WALKER, Mr. SMITH of New Jersey, Mr. LONG, Mr. DAVID

P. ROE of Tennessee, Mr. WESTERMAN, Mrs. HARTZLER, Mr. 

GROTHMAN, Mr. BYRNE, Mr. COLLINS of Georgia, Mr. NORMAN, Mr. 

ABRAHAM, Mrs. WALORSKI, Mr. FLORES, Mr. LATTA, Mr. AMASH, Mr. 

MOONEY of West Virginia, Mr. ALLEN, Mr. BANKS, Mr. HUIZENGA, Mr. 

GIANFORTE, Mr. WILSON of South Carolina, Mr. ROY, Mr. BACON, Mr. 

RODNEY DAVIS of Illinois, Mr. GALLAGHER, Mr. DUFFY, Mr. GIBBS, Mr. 

NEWHOUSE, Mr. WALBERG, Mr. CHABOT, Mr. BABIN, Mr. JOYCE of 

Pennsylvania, Mr. JOHNSON of Louisiana, Mr. BARR, Mr. HICE of Georgia, Mr. RATCLIFFE, Mr. JORDAN, Mr. WITTMAN, Mr. GRAVES of Missouri, Mr. HILL of Arkansas, Mr. WILLIAMS, Mr. LUETKEMEYER, Mr. 

OLSON, Mr. HUDSON, Mr. MITCHELL, Mr. BUCSHON, Mr. BUDD, Mr. 

KELLY of Pennsylvania, Mr. LAMALFA, Mr. COLLINS of New York, Mr. 

POSEY, Mr. GRIFFITH, Mr. JOHN W. ROSE of Tennessee, Mr. STEWART, 

Mr. LAMBORN, Mr. BERGMAN, Mr. MARCHANT, Mr. AUSTIN SCOTT of 

Georgia, Mr. KING of Iowa, Mr. JOHNSON of Ohio, Mr. 

RESCHENTHALER, Mr. HIGGINS of Louisiana, Mr. GUTHRIE, Mr. BRADY, 

Mr. COLE, Mr. SMITH of Nebraska, Mr. WATKINS, Mr. CLOUD, Mr. 

STEUBE, Mr. YOHO, Mr. RUTHERFORD, and Mr. PALAZZO) introduced 

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

Commerce 

A BILL 

To amend the Public Health Service Act to prohibit governVerDate Sep 11 2014 19:18 Apr 15, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6652 E:\BILLS\H2014.IH H2014

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mental discrimination against providers of health services 

that are not involved in 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. 

4 This Act may be cited as the ‘‘Conscience Protection 

5 Act of 2019’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds as follows: 

8 (1) Thomas Jefferson stated a conviction com9 mon to our Nation’s founders when he declared in 

10 1809 that ‘‘[n]o provision in our Constitution ought 

11 to be dearer to man than that which protects the 

12 rights of conscience against the enterprises of the 

13 civil authority’’. 

14 (2) In 1973, the Supreme Court concluded that 

15 the government must leave the abortion decision ‘‘to 

16 the medical judgment of the pregnant woman’s at17 tending physician’’, recognizing that a physician may 

18 choose not to participate in abortion. Roe v. Wade, 

19 410 U.S. 113, 164 (1973). The Court cited with ap20 proval a policy that ‘‘neither physician, hospital, nor 

21 hospital personnel shall be required to perform any 

22 act violative of personally-held moral principles’’, 

23 410 U.S. at 143 n. 38, and cited State laws upholdVerDate Sep 11 2014 19:18 Apr 15, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2014.IH H2014

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1 ing this principle. Doe v. Bolton, 410 U.S. 179, 

2 197–8 (1973). 

3 (3) Congress’ enactments to protect this right 

4 of conscience in health care include the Church 

5 amendment of 1973 (42 U.S.C. 300a–7), the Coats/ 

6 Snowe amendment of 1996 (42 U.S.C. 238n), and 

7 the Weldon amendment approved by Congresses and 

8 Presidents of both parties every year since 2004. 

9 (4) None of these laws explicitly provides a 

10 ‘‘private right of action’’ so victims of discrimination 

11 can defend their conscience rights in court, and ad12 ministrative enforcement by the Department of 

13 Health and Human Services Office for Civil Rights 

14 has been lax, at times allowing cases to languish for 

15 years without resolution. 

16 (5) Defying the Federal Weldon amendment, 

17 California’s Department of Managed Health Care 

18 has mandated coverage for all elective abortions in 

19 all health plans under its jurisdiction. Other States 

20 such as New York and Washington have taken or 

21 considered similar action, and some States may go 

22 farther to require all physicians and hospitals to pro23 vide or facilitate abortions. On June 21, 2016, the 

24 Obama Administration concluded a nearly two-year 

25 investigation of this matter by determining that 


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1 California’s decision to require insurance plans 

2 under the California Department for Managed 

3 Health Care authority to cover all legal abortion 

4 services did not violate the Weldon amendment. 

5 Until the new Administration is able to reverse this 

6 finding, individuals will have to choose between ig7 noring their conscience or forgoing health care cov8 erage. 

9 (6) The vast majority of medical professionals 

10 do not perform abortions, with 86 percent of ob/gyns 

11 unwilling to provide them in a recent study (Obstet12 rics & Gynecology, Sept. 2011) and the great major13 ity of hospitals choosing to do so in rare cases or not 

14 at all. 

15 (7) A health care provider’s decision not to par16 ticipate in an abortion, like Congress’ decision not to 

17 fund most abortions, erects no new barrier to those 

18 seeking to perform or undergo abortions but leaves 

19 each party free to act as he or she wishes. 

20 (8) Such protection poses no conflict with other 

21 Federal laws, such as the law requiring emergency 

22 stabilizing treatment for a pregnant woman and her 

23 unborn child when either is in distress (Emergency 

24 Medical Treatment and Active Labor Act). As the 

25 previous Administration has said, these areas of law 


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1 have operated side by side for many years and both 

2 should be fully enforced (76 Fed. Reg. 9968–77 

3 (2011) at 9973). 

4 (9) Reaffirming longstanding Federal policy on 

5 conscience rights and providing a right of action in 

6 cases where it is violated allows longstanding and 

7 widely supported Federal laws to work as intended. 

8 SEC. 3. PROHIBITING GOVERNMENTAL DISCRIMINATION 

9 AGAINST PROVIDERS OF HEALTH SERVICES 

10 THAT ARE NOT INVOLVED IN ABORTION. 

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

12 202 et seq.) is amended by inserting after section 245 the 

13 following: 

14 ‘‘SEC. 245A. PROHIBITING GOVERNMENTAL DISCRIMINA15 TION AGAINST PROVIDERS OF HEALTH SERV16 ICES THAT ARE NOT INVOLVED IN ABORTION. 

17 ‘‘(a) IN GENERAL.—Notwithstanding any other law, 

18 the Federal Government, and any State or local govern19 ment that receives Federal financial assistance, may not 

20 penalize, retaliate against, or otherwise discriminate 

21 against a health care provider on the basis that the pro22 vider does not— 

23 ‘‘(1) perform, refer for, pay for, or otherwise 

24 participate in abortion; 

25 ‘‘(2) provide or sponsor abortion coverage; or 


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1 ‘‘(3) facilitate or make arrangements for any of 

2 the activities specified in this subsection. 

3 ‘‘(b) RULE OF CONSTRUCTION.—Nothing in this sec4 tion shall be construed— 

5 ‘‘(1) to prevent any health care provider from 

6 voluntarily electing to participate in abortions or 

7 abortion referrals; 

8 ‘‘(2) to prevent any health care provider from 

9 voluntarily electing to provide or sponsor abortion 

10 coverage or health benefits coverage that includes 

11 abortion; 

12 ‘‘(3) to prevent an accrediting agency, the Fed13 eral Government, or a State or local government 

14 from establishing standards of medical competency 

15 applicable only to those who have knowingly, volun16 tarily, and specifically elected to perform abortions, 

17 or from enforcing contractual obligations applicable 

18 only to those who, as part of such contract, know19 ingly, voluntarily, and specifically elect to provide 

20 abortions; 

21 ‘‘(4) to affect, or be affected by, section 1867 

22 of the Social Security Act (42 U.S.C. 1395dd, com23 monly referred to as the ‘Emergency Medical Treat24 ment and Active Labor Act’); or 


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1 ‘‘(5) to supersede any law enacted by any State 

2 for the purpose of regulating insurance, except as 

3 specified in subsection (a). 

4 ‘‘(c) ADMINISTRATION.—The Secretary shall des5 ignate the Director of the Office for Civil Rights of the 

6 Department of Health and Human Services— 

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

8 this section, section 245 of this Act, or any of sub9 sections (b) through (e) of section 401 of the Health 

10 Programs Extension Act of 1973; and 

11 ‘‘(2) to pursue the investigation of such com12 plaints in coordination with the Attorney General. 

13 ‘‘(d) DEFINITIONS.—For purposes of this section: 

14 ‘‘(1) FEDERAL FINANCIAL ASSISTANCE.—The 

15 term ‘Federal financial assistance’ means Federal 

16 payments to cover the cost of health care services or 

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

18 to promote or otherwise facilitate health-related ac19 tivities. 

20 ‘‘(2) HEALTH CARE PROVIDER.—The term 

21 ‘health care provider’ means— 

22 ‘‘(A) an individual physician, nurse, or 

23 other health care professional; 

24 ‘‘(B) a hospital, health system, or other 

25 health care facility or organization (including a 


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1 party to a proposed merger or other collabo2 rative arrangement relating to health services, 

3 and an entity resulting therefrom); 

4 ‘‘(C) a provider-sponsored organization, an 

5 accountable care organization, or a health 

6 maintenance organization; 

7 ‘‘(D) a social services provider that pro8 vides or authorizes referrals for health care 

9 services; 

10 ‘‘(E) a program of training in the health 

11 professions or an applicant to or participant in 

12 such a program; 

13 ‘‘(F) an issuer of health insurance cov14 erage; or 

15 ‘‘(G) a group health plan or student health 

16 plan, or a sponsor or administrator thereof. 

17 ‘‘(3) STATE OR LOCAL GOVERNMENT THAT RE18 CEIVES FEDERAL FINANCIAL ASSISTANCE.—The 

19 term ‘State or local government that receives Fed20 eral financial assistance’ includes every agency and 

21 other governmental unit and subdivision of a State 

22 or local government, if such State or local govern23 ment, or any agency or governmental unit or sub24 division thereof, receives Federal financial assist25 ance. 


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1 ‘‘SEC. 245B. CIVIL ACTION FOR CERTAIN VIOLATIONS. 

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

3 action, obtain appropriate relief with regard to a des4 ignated violation. 

5 ‘‘(b) DEFINITIONS.—For purposes of this section: 

6 ‘‘(1) QUALIFIED PARTY.—The term ‘qualified 

7 party’ means— 

8 ‘‘(A) the Attorney General of the United 

9 States; or 

10 ‘‘(B) any person or entity adversely af11 fected by the designated violation. 

12 ‘‘(2) DESIGNATED VIOLATION.—The term ‘des13 ignated violation’ means an actual or threatened vio14 lation of— 

15 ‘‘(A) section 245 or 245A of this Act; or 

16 ‘‘(B) any of subsections (b) through (e) of 

17 section 401 of the Health Programs Extension 

18 Act of 1973 regarding an objection to abortion. 

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

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

21 may be granted, without regard to whether the party com22 mencing the action has sought or exhausted available ad23 ministrative remedies. 

24 ‘‘(d) DEFENDANTS IN ACTIONS UNDER THIS SEC25 TION MAY INCLUDE GOVERNMENTAL ENTITIES AS WELL

26 AS OTHERS.— 


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1 ‘‘(1) IN GENERAL.—An action under this sec2 tion may be maintained against, among others, a 

3 party that is a Federal or State governmental entity. 

4 Relief in an action under this section may include 

5 money damages even if the defendant is such a gov6 ernmental entity. 

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

8 subsection, the term ‘State governmental entity’ 

9 means a State, a local government within a State, 

10 and any agency or other governmental unit or sub11 division of a State or of such a local government. 

12 ‘‘(e) NATURE OF RELIEF.—In an action under this 

13 section, the court shall grant— 

14 ‘‘(1) all necessary equitable and legal relief, in15 cluding, where appropriate, declaratory relief and 

16 compensatory damages, to prevent the occurrence, 

17 continuance, or repetition of the designated violation 

18 and to compensate for losses resulting from the des19 ignated violation; and 

20 ‘‘(2) to a prevailing plaintiff, reasonable attor21 neys’ fees and litigation expenses as part of the 

22 costs.’’. 

Æ 


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