I 
118TH CONGRESS 
1ST SESSION H. R. 6459 
To amend title XI of the Social Security Act to limit demonstration projects 
related to abortion under Medicaid and CHIP. 
IN THE HOUSE OF REPRESENTATIVES 
NOVEMBER 21, 2023 
Mr. BRECHEEN (for himself, Mr. KELLY of Mississippi, Mr. ROSENDALE, Mr. 
GOOD of Virginia, Mr. LAMALFA, Mr. DUNCAN, Mrs. MILLER of Illinois, 
Mrs. HINSON, Mr. MOOLENAAR, Mr. LAMBORN, Mr. WEBER of Texas, 
and Mr. CRENSHAW) introduced the following bill; which was referred to 
the Committee on Energy and Commerce 
A BILL 
To amend title XI of the Social Security Act to limit dem-
onstration projects related to abortion under Medicaid 
and CHIP. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘No Abortion Coverage 
for Medicaid Act’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
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(1) The Hyde Amendment was first enacted in 
1976 and has prevented taxpayer funds for abor-
tions. 
(2) The most recently enacted Hyde Amend-
ment states that no appropriated dollars shall be ex-
pended for any abortion or health benefits coverage 
that includes coverage of abortion. 
(3) The Department of Health and Human 
Services sent a letter to the States on August 6, 
2022, inviting States to use Medicaid funding under 
the demonstration authority under section 1115 of 
the Social Security Act to expand access to elective 
abortions. 
(4) The Hyde Amendment applies to all Med-
icaid funds and cannot be superseded by a waiver 
under section 1115 of the Social Security Act. 
(5) Legislation to permanently prohibit Med-
icaid dollars from going to elective abortions, includ-
ing payment for abortions and services that neces-
sitate receipt for services of abortion, is consistent 
with the Hyde Amendment. 
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SEC. 3. LIMITING DEMONSTRATION PROJECTS RELATED 
TO ABORTION UNDER MEDICAID AND CHIP. 
Section 1115 of the Social Security Act (42 U.S.C. 
1315) is amended by adding at the end the following new 
subsection: 
‘‘(g) LIMITATION
ON DEMONSTRATION PROJECTS 
RELATED TO ABORTION.— 
‘‘(1) IN GENERAL.—Subject to paragraph (2), 
beginning on enactment, the Secretary may not ap-
prove an application (or extension) for any experi-
mental, pilot, or demonstration project undertaken 
under subsection (a) to promote the objectives of 
title XIX or title XXI that provides Federal finan-
cial assistance for abortion, or health benefits cov-
erage that includes abortion, including expenses for 
travel or lodging for the purpose of obtaining an 
abortion. 
‘‘(2) EXCEPTIONS.—The limitations on para-
graph (1) shall not apply to— 
‘‘(A) an abortion with respect to a preg-
nancy resulting from of an act of rape or incest; 
‘‘(B) treatment to address a physical dis-
order, physical injury, or physical illness, in-
cluding a life-endangering physical condition 
caused by or arising from the pregnancy itself, 
that would, as certified by a physician, place 
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the individual in danger of death unless such 
abortion is performed; or 
‘‘(C) treatment for miscarriage or ectopic 
pregnancy.’’. 
Æ 
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