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. BAR-
RETT
of South Carolina, Mr. BARTLETT, Mr. BILIRAKIS, Mrs. 
BLACKBURN, Mr. BOEHNER, Mr. BOOZMAN, Mr. BROWN of South Caro-
lina, Mr. CANTOR, Mr. CHAFFETZ, Mr. CONAWAY, Mr. DAVIS of Ten-
nessee, 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 Cali-
fornia, 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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
VerDate Nov 24 2008 
02:14 Apr 23, 2010
Jkt 089200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H5111.IH
H5111
tjames on DSKG8SOYB1PROD with BILLS
SECTION 1. MODIFYING SPECIAL RULES RELATING TO 
COVERAGE OF ABORTION SERVICES UNDER 
THE PATIENT PROTECTION AND AFFORD-
ABLE CARE ACT TO CONFORM TO LONG- 
STANDING FEDERAL POLICY. 
(a) IN GENERAL.—Section 1303 of the Patient Pro-
tection and Affordable Care Act (Public Law 111–148), 
as amended by section 10104(c) of such Act, is amend-
ed— 
(1) by redesignating subsections (c) and (d) as 
subsections (e) and (f), respectively; 
(2) by redesignating paragraph (4) of sub-
section (b) as subsection (d) and transferring such 
subsection (d) after the subsection (c) inserted by 
paragraph (4) of this subsection with appropriate in-
dentation; 
(3) by amending subsection (b) to read as fol-
lows: 
‘‘(b) SPECIAL RULES RELATING TO COVERAGE OF 
ABORTION SERVICES.—Nothing in this Act (or any 
amendment made by this Act) shall be construed to re-
quire any health plan to provide coverage of or access to 
abortion services or to allow the Secretary or any other 
Federal or non-Federal person or entity in implementing 
this Act (or amendment) to require coverage of or access 
to such services.’’; 
VerDate Nov 24 2008 
02:14 Apr 23, 2010
Jkt 089200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H5111.IH
H5111
tjames on DSKG8SOYB1PROD with BILLS
(4) by inserting after subsection (b) the fol-
lowing new subsection: 
‘‘(c) LIMITATION ON ABORTION FUNDING.— 
‘‘(1) IN GENERAL.—No funds authorized or ap-
propriated by this Act (or an amendment made by 
this Act), including credits applied toward qualified 
health plans under section 36B of the Internal Rev-
enue Code of 1986 or cost-sharing reductions under 
section 1402 of this Act may be used to pay for any 
abortion or to cover any part of the costs of any 
health plan that includes coverage of abortion, ex-
cept in the case where a woman suffers from a phys-
ical disorder, physical injury, or physical illness that 
would, as certified by a physician, place the woman 
in danger of death unless an abortion is performed, 
including a life-endangering physical condition 
caused by or arising from the pregnancy itself, or 
unless the pregnancy is the result of an act of rape 
or incest. 
‘‘(2) OPTION
TO
PURCHASE
SEPARATE
COV-
ERAGE OR PLAN.—Nothing in this subsection shall 
be construed as prohibiting any non-Federal entity 
(including an individual or a State or local govern-
ment) from purchasing separate coverage for abor-
tions for which funding is prohibited under this sub-
VerDate Nov 24 2008 
02:14 Apr 23, 2010
Jkt 089200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H5111.IH
H5111
tjames on DSKG8SOYB1PROD with BILLS
section, or a plan that includes such abortions, so 
long as— 
‘‘(A) such coverage or plan is paid for en-
tirely using only funds not authorized or appro-
priated by this Act; and 
‘‘(B) such coverage or plan is not pur-
chased using— 
‘‘(i) individual premium payments re-
quired for a qualified health plan offered 
through an Exchange towards which a 
credit is applied under section 36B of the 
Internal Revenue Code of 1986; or 
‘‘(ii) other non-Federal funds required 
to receive a Federal payment, including a 
State’s or locality’s contribution of Med-
icaid matching funds. 
‘‘(3) OPTION TO OFFER COVERAGE OR PLAN.— 
Nothing 
in 
this 
subsection 
or 
section 
1311(d)(2)(B)(i) shall restrict any non-Federal 
health insurance issuer offering a qualified health 
plan from offering separate coverage for abortions 
for which funding is prohibited under this sub-
section, or a plan that includes such abortions, so 
long as— 
VerDate Nov 24 2008 
02:14 Apr 23, 2010
Jkt 089200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H5111.IH
H5111
tjames on DSKG8SOYB1PROD with BILLS
‘‘(A) premiums for such separate coverage 
or plan are paid for entirely with funds not au-
thorized or appropriated by this Act; 
‘‘(B) administrative costs and all services 
offered through such coverage or plan are paid 
for using only premiums collected for such cov-
erage or plan; and 
‘‘(C) any such non-Federal health insur-
ance issuer that offers a qualified health plan 
through an Exchange that includes coverage for 
abortions for which funding is prohibited under 
this subsection also offers a qualified health 
plan through the Exchange that is identical in 
every respect except that it does not cover abor-
tions for which funding is prohibited under this 
subsection.’’; 
(5) in subsection (e), as redesignated by para-
graph (1)— 
(A) in the heading, strike ‘‘REGARDING 
ABORTION’’; 
(B) in the heading of each of paragraphs 
(1) and (2), strike each place it appears ‘‘RE-
GARDING ABORTION’’; and 
VerDate Nov 24 2008 
02:14 Apr 23, 2010
Jkt 089200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H5111.IH
H5111
tjames on DSKG8SOYB1PROD with BILLS
(C) in paragraph (1), insert ‘‘conscience 
protection, abortion, or’’ after ‘‘State laws re-
garding’’; 
(6) in subsection (f), as redesignated by para-
graph (1), by striking ‘‘Nothing’’ and inserting 
‘‘Subject to subsection (g), nothing’’; and 
(7) by adding at the end the following new sub-
section: 
‘‘(g) NONDISCRIMINATION ON ABORTION.— 
‘‘(1) NONDISCRIMINATION.—A Federal agency 
or program, and any State or local government that 
receives Federal financial assistance under this Act 
(or an amendment made by this Act), may not— 
‘‘(A) subject any individual or institutional 
health care entity to discrimination; or 
‘‘(B) require any health plan created or 
regulated under this Act (or an amendment 
made by this Act) to subject any individual or 
institutional health care entity to discrimina-
tion, 
on the basis that the health care entity does not pro-
vide, pay for, provide coverage of, or refer for abor-
tions. 
‘‘(2) DEFINITION.—In this subsection, the term 
‘‘healthcare entity’’ includes an individual physician 
VerDate Nov 24 2008 
02:14 Apr 23, 2010
Jkt 089200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H5111.IH
H5111
tjames on DSKG8SOYB1PROD with BILLS