I 

111TH CONGRESS 

2D SESSION H. R. 5111 

To amend the Patient Protection and Affordable Care Act to modify special 

rules relating to coverage of abortion services under such Act. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 22, 2010 

Mr. PITTS (for himself, Mr. ADERHOLT, Mr. AKIN, Mr. BACHUS, Mr. BARRETT of South Carolina, Mr. BARTLETT, Mr. BILIRAKIS, Mrs. 

BLACKBURN, Mr. BOEHNER, Mr. BOOZMAN, Mr. BROWN of South Carolina, Mr. CANTOR, Mr. CHAFFETZ, Mr. CONAWAY, Mr. DAVIS of Tennessee, Mr. FLEMING, Mr. FORTENBERRY, Ms. FOXX, Mr. FRANKS of 

Arizona, Mr. GARRETT of New Jersey, Mr. GINGREY of Georgia, Mr. 

GOHMERT, Mr. GRIFFITH, Mr. HENSARLING, Mr. HOEKSTRA, Mr. 

HOLDEN, Mr. INGLIS, Mr. ISSA, Mr. JORDAN of Ohio, Mr. LAMBORN, 

Mr. LATTA, Mr. LIPINSKI, Mr. MANZULLO, Mr. MARCHANT, Mr. 

MCHENRY, Mr. MCINTYRE, Mr. NEUGEBAUER, Mr. PENCE, Mr. ROE of 

Tennessee, Mr. RYAN of Wisconsin, Mr. SMITH of New Jersey, Mr. 

SCALISE, Mrs. SCHMIDT, Mr. TAYLOR, Mr. TIAHRT, Mr. WILSON of 

South Carolina, Mr. BRADY of Texas, Mr. DANIEL E. LUNGREN of California, Mr. CHILDERS, Mr. MARSHALL, and Mr. SESSIONS) introduced 

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

Commerce 

A BILL 

To amend the Patient Protection and Affordable Care Act 

to modify special rules relating to coverage of abortion 

services under such Act. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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1 SECTION 1. MODIFYING SPECIAL RULES RELATING TO 

2 COVERAGE OF ABORTION SERVICES UNDER 

3 THE PATIENT PROTECTION AND AFFORD4 ABLE CARE ACT TO CONFORM TO LONG5 STANDING FEDERAL POLICY. 

6 (a) IN GENERAL.—Section 1303 of the Patient Pro7 tection and Affordable Care Act (Public Law 111–148), 

8 as amended by section 10104(c) of such Act, is amend9 ed— 

10 (1) by redesignating subsections (c) and (d) as 

11 subsections (e) and (f), respectively; 

12 (2) by redesignating paragraph (4) of sub13 section (b) as subsection (d) and transferring such 

14 subsection (d) after the subsection (c) inserted by 

15 paragraph (4) of this subsection with appropriate in16 dentation; 

17 (3) by amending subsection (b) to read as fol18 lows: 

19 ‘‘(b) SPECIAL RULES RELATING TO COVERAGE OF

20 ABORTION SERVICES.—Nothing in this Act (or any 

21 amendment made by this Act) shall be construed to re22 quire any health plan to provide coverage of or access to 

23 abortion services or to allow the Secretary or any other 

24 Federal or non-Federal person or entity in implementing 

25 this Act (or amendment) to require coverage of or access 

26 to such services.’’; 


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1 (4) by inserting after subsection (b) the fol2 lowing new subsection: 

3 ‘‘(c) LIMITATION ON ABORTION FUNDING.— 

4 ‘‘(1) IN GENERAL.—No funds authorized or ap5 propriated by this Act (or an amendment made by 

6 this Act), including credits applied toward qualified 

7 health plans under section 36B of the Internal Rev8 enue Code of 1986 or cost-sharing reductions under 

9 section 1402 of this Act may be used to pay for any 

10 abortion or to cover any part of the costs of any 

11 health plan that includes coverage of abortion, ex12 cept in the case where a woman suffers from a phys13 ical disorder, physical injury, or physical illness that 

14 would, as certified by a physician, place the woman 

15 in danger of death unless an abortion is performed, 

16 including a life-endangering physical condition 

17 caused by or arising from the pregnancy itself, or 

18 unless the pregnancy is the result of an act of rape 

19 or incest. 

20 ‘‘(2) OPTION TO PURCHASE SEPARATE COV21 ERAGE OR PLAN.—Nothing in this subsection shall 

22 be construed as prohibiting any non-Federal entity 

23 (including an individual or a State or local govern24 ment) from purchasing separate coverage for abor25 tions for which funding is prohibited under this subVerDate Nov 24 2008 02:14 Apr 23, 2010 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H5111.IH H5111

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1 section, or a plan that includes such abortions, so 

2 long as— 

3 ‘‘(A) such coverage or plan is paid for en4 tirely using only funds not authorized or appro5 priated by this Act; and 

6 ‘‘(B) such coverage or plan is not pur7 chased using— 

8 ‘‘(i) individual premium payments re9 quired for a qualified health plan offered 

10 through an Exchange towards which a 

11 credit is applied under section 36B of the 

12 Internal Revenue Code of 1986; or 

13 ‘‘(ii) other non-Federal funds required 

14 to receive a Federal payment, including a 

15 State’s or locality’s contribution of Med16 icaid matching funds. 

17 ‘‘(3) OPTION TO OFFER COVERAGE OR PLAN.— 

18 Nothing in this subsection or section 

19 1311(d)(2)(B)(i) shall restrict any non-Federal 

20 health insurance issuer offering a qualified health 

21 plan from offering separate coverage for abortions 

22 for which funding is prohibited under this sub23 section, or a plan that includes such abortions, so 

24 long as— 


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1 ‘‘(A) premiums for such separate coverage 

2 or plan are paid for entirely with funds not au3 thorized or appropriated by this Act; 

4 ‘‘(B) administrative costs and all services 

5 offered through such coverage or plan are paid 

6 for using only premiums collected for such cov7 erage or plan; and 

8 ‘‘(C) any such non-Federal health insur9 ance issuer that offers a qualified health plan 

10 through an Exchange that includes coverage for 

11 abortions for which funding is prohibited under 

12 this subsection also offers a qualified health 

13 plan through the Exchange that is identical in 

14 every respect except that it does not cover abor15 tions for which funding is prohibited under this 

16 subsection.’’; 

17 (5) in subsection (e), as redesignated by para18 graph (1)— 

19 (A) in the heading, strike ‘‘REGARDING

20 ABORTION’’; 

21 (B) in the heading of each of paragraphs 

22 (1) and (2), strike each place it appears ‘‘RE23 GARDING ABORTION’’; and 


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1 (C) in paragraph (1), insert ‘‘conscience 

2 protection, abortion, or’’ after ‘‘State laws re3 garding’’; 

4 (6) in subsection (f), as redesignated by para5 graph (1), by striking ‘‘Nothing’’ and inserting 

6 ‘‘Subject to subsection (g), nothing’’; and 

7 (7) by adding at the end the following new sub8 section: 

9 ‘‘(g) NONDISCRIMINATION ON ABORTION.— 

10 ‘‘(1) NONDISCRIMINATION.—A Federal agency 

11 or program, and any State or local government that 

12 receives Federal financial assistance under this Act 

13 (or an amendment made by this Act), may not— 

14 ‘‘(A) subject any individual or institutional 

15 health care entity to discrimination; or 

16 ‘‘(B) require any health plan created or 

17 regulated under this Act (or an amendment 

18 made by this Act) to subject any individual or 

19 institutional health care entity to discrimina20 tion, 

21 on the basis that the health care entity does not pro22 vide, pay for, provide coverage of, or refer for abor23 tions. 

24 ‘‘(2) DEFINITION.—In this subsection, the term 

25 ‘‘healthcare entity’’ includes an individual physician 


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1 or other health care professional, a hospital, a pro2 vider-sponsored organization, a health maintenance 

3 organization, a health insurance plan, or any other 

4 kind of health care facility, organization, or plan. 

5 ‘‘(3) ADMINISTRATION.—The Office for Civil 

6 Rights of the Department of Health and Human 

7 Services is designated to receive complaints of dis8 crimination based on this subsection, and coordinate 

9 the investigation of such complaints.’’. 

10 (b) CONFORMING AMENDMENT.—Section 1334(a)(6) 

11 of such Act is amended to read as follows: 

12 ‘‘(6) COVERAGE CONSISTENT WITH FEDERAL

13 POLICY.—In entering into contracts under this sub14 section, the Director shall ensure that no multi-State 

15 qualified health plan offered in an Exchange pro16 vides coverage for abortions for which funding is 

17 prohibited under subsection 1303(c) of this Act.’’. 

Æ 


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