illness, or physical injury, including a life-endangering 
physical condition caused by or arising from the pregnancy 
itself, but not including psychological or emotional condi-
tions. 
‘‘(b) In this section: 
‘‘(1) The term ‘abortion’ has the meaning given 
to such term in section 1531 of title 18, United 
States Code. 
‘‘(2) The term ‘affiliate’ means any company 
that controls, is controlled by, or is under common 
control with an entity referred to in subsection (a).’’. 
(e) TABLE OF CONTENTS AMENDMENT.—The table 
of contents for title II of the Indian Health Care Improve-
ment Act (25 U.S.C. 1621 et seq.) is amended by adding 
at the end the following: 
‘‘227. Prohibition against offering an abortion.’’. 
SEC. 4. PROHIBITION ON GROUP HEALTH COVERAGE FOR 
ABORTIONS. 
(a) 
PROHIBITING
COVERAGE
UNDER
GROUP 
HEALTH PLANS AND GROUP AND INDIVIDUAL HEALTH 
INSURANCE.— 
(1) IN GENERAL.—Subpart II of part A of the 
Public Health Service Act (42 U.S.C. 300gg–11 et 
seq.) is amended by adding at the end the following 
new section: 
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‘‘SEC. 2730. PROHIBITION ON COVERAGE FOR ABORTION. 
‘‘(a) IN GENERAL.—A group health plan, and a 
health insurance issuer offering group or individual health 
insurance coverage, may not provide coverage for abortion 
(as such term is defined in section 1531 of title 18) at 
any point after fertilization, except to save the life of a 
pregnant woman whose life is endangered by a physical 
disorder, physical illness, or physical injury, including a 
life-endangering physical condition caused by or arising 
from the pregnancy itself, but not including psychological 
or emotional conditions. 
‘‘(b) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to prohibit the coverage of items 
or services that are furnished in order to— 
‘‘(1) remove a dead unborn child caused by mis-
carriage or stillbirth, or 
‘‘(2) remove an ectopic pregnancy.’’. 
(2) EFFECTIVE DATE.—The amendments made 
by this subsection shall apply to plan years begin-
ning on or after January 1 of the second year begin-
ning on or after the date of the enactment of this 
subsection. 
(b) APPLICATION
OF ABORTION PROHIBITION
TO 
PREMIUM CREDITS
AND COST-SHARING REDUCTIONS 
UNDER ACA.— 
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(1) IN GENERAL.—Section 36B(c)(3)(A) of the 
Internal Revenue Code of 1986 (26 U.S.C. 
36B(c)(3)(A)) is amended by inserting before the 
period at the end the following: ‘‘or a health plan 
that includes coverage for abortion (as such term is 
defined in section 1531 of title 18) furnished at any 
point after fertilization, except to save the life of a 
pregnant woman whose life is endangered by a phys-
ical disorder, physical illness, or physical injury, in-
cluding a life-endangering physical condition caused 
by or arising from the pregnancy itself, but not in-
cluding psychological or emotional conditions’’. 
(2) CONFORMING ACA AMENDMENTS.—Section 
1303 of Public Law 111–148 (42 U.S.C. 18023) is 
amended— 
(A) in subsection (a)(1), by striking ‘‘abor-
tion coverage’’ and inserting ‘‘coverage of abor-
tions described in subsection (b)(1)(B)(ii)’’; and 
(B) in subsection (b)— 
(i) in paragraph (1)— 
(I) in the paragraph heading, by 
striking ‘‘VOLUNTARY
CHOICE
OF 
COVERAGE OF’’ and inserting ‘‘PROHI-
BITION ON COVERAGE OF CERTAIN’’; 
(II) in subparagraph (A)— 
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(aa) in clause (i)— 
(AA) by striking ‘‘sub-
paragraph (B)(i) or’’; and 
(BB) by striking ‘‘and’’ 
at the end; 
(bb) in clause (ii)— 
(AA) by striking ‘‘sub-
paragraph (B)(i) or’’; and 
(BB) by striking the 
period at the end and insert-
ing ‘‘; and’’; and 
(cc) by adding at the end 
the following new clause: 
‘‘(iii) the issuer of a qualified health 
plan may not provide coverage of services 
described in subparagraph (B)(i).’’; and 
(III) by amending subparagraph 
(B) to read as follows: 
‘‘(B) ABORTION SERVICES.— 
‘‘(i) PROHIBITED
ABORTION
SERV-
ICES.—The services described in this 
clause are any abortions (as such term is 
defined in section 1531 of title 18) fur-
nished after fertilization that are not de-
scribed in clause (ii). 
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‘‘(ii) PERMITTED
ABORTION
SERV-
ICES.—The services described in this 
clause are only abortions that are fur-
nished to save the life of a pregnant 
woman whose life is endangered by a phys-
ical disorder, physical illness, or physical 
injury, including a life-endangering phys-
ical condition caused by or arising from 
the pregnancy itself, but not including psy-
chological or emotional conditions.’’; 
(ii) by striking paragraphs (2) and 
(3); and 
(iii) by redesignating paragraph (4) as 
paragraph (2). 
(3) APPLICATION
TO
MULTI-STATE
PLANS.— 
Section 1334(a)(6) of Public Law 111–148 (42 
U.S.C. 18054(a)(6)) is amended— 
(A) in the paragraph heading, by striking 
‘‘ASSURED
AVAILABILITY
OF
VARIED
COV-
ERAGE’’ and inserting ‘‘PROHIBITION OF CER-
TAIN ABORTION COVERAGE’’; and 
(B) by striking ‘‘there is at least one such 
plan that does not’’ and inserting ‘‘such plans 
do not’’. 
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(4) EFFECTIVE DATE.—The amendments made 
by paragraphs (1) and (2) shall apply to taxable 
years ending after January 1 of the second year be-
ginning on or after the date of the enactment of this 
subsection, but only with respect to plan years be-
ginning on or after such date, and the amendments 
made by paragraph (3) shall apply to plan years be-
ginning on or after such date. 
(c) AMENDMENT TO TITLE 5.—Section 8902 of title 
5, United States Code, is amended by adding at the end 
the following: 
‘‘(q) A contract may not be made or a plan approved 
that includes an obstetrical benefit that includes coverage 
for an abortion (as defined in section 1531 of title 18), 
except to save the life of a pregnant woman whose life 
is endangered by a physical disorder, physical illness, or 
physical injury, including a life-endangering physical con-
dition caused by or arising from the pregnancy itself, but 
not including a psychological or emotional condition.’’. 
Æ 
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