(b) REIMBURSEMENT FOR ABORTION CARE.— 
(1) IN GENERAL.—Each person insured by, en-
rolled in, or otherwise receiving medical care from 
health programs or plans described in subsection (c) 
shall receive coverage of abortion services. Health 
programs or plans described in section (c) shall pro-
vide coverage of abortion services. 
(2) AMOUNTS.—The Secretary of Health and 
Human Services shall issue a rule ensuring that re-
imbursement rates for such coverage are similar to 
like care and sufficient to cover the cost of care. 
(c) DEFINITION.—The term ‘‘health program or 
plan’’ means a public health insurance program or private 
health insurance plan that provides, or pays the cost of, 
medical care (as such term is defined in 42 U.S.C. § 
300gg–91). Such terms include but are not limited to the 
following, and any combination thereof: 
(1) The Medicaid program under title XIX of 
the Social Security Act (42 U.S.C. 1396 et seq.). 
(2) The Children’s Health Insurance Program 
under title XXI of the Social Security Act (42 
U.S.C. 1397 et seq.). 
(3) The Medicare program under title XVIII of 
the Social Security Act (42 U.S.C. 1395 et seq.). 
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(4) A Medicare supplemental policy as defined 
in section 1882(g)(1) of the Social Security Act (42 
U.S.C. 1395ss(g)(1)). 
(5) The Indian Health Service program under 
the Indian Health Care Improvement Act (25 U.S.C. 
1601 et seq.). 
(6) Medical care and health benefits under the 
TRICARE program (10 U.S.C. 1071 et seq.). 
(7) Benefits for veterans under chapter 17 of 
title 38, United States Code, and medical care for 
survivors and dependents of veterans (38 U.S.C. 
1781 et seq.). 
(8) Benefits under the uniform health benefits 
program for employees of the Department of De-
fense assigned to a nonappropriated fund instrumen-
tality of the Department established under section 
349 of the National Defense Authorization Act for 
Fiscal Year 1995 (Public Law 103–337; 10 U.S.C. 
1587 note). 
(9) Medical care for individuals in the care or 
custody of the Department of Homeland Security 
pursuant to any of section 235, 236, or 241 of the 
Immigration and Nationality Act (8 U.S.C. 1225, 
1226, 1231). 
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(10) Medical care for individuals in the care or 
custody of the Department of Health and Human 
Services, Office of Refugee Resettlement under sec-
tion 235 of the William Wilberforce Trafficking Vic-
tims Protection Reauthorization Act of 2008 (8 
U.S.C. 1232) or section 462 of the Homeland Secu-
rity Act of 2002 (6 U.S.C. 279). 
(11) Medical assistance to refugees under sec-
tion 412 of the Immigration and Nationality Act (8 
U.S.C. 1522). 
(12) Other coverage, such as a State health 
benefits risk pool, as the Secretary of Health and 
Human Services, in coordination with the Secretary 
of the Treasury, recognizes for purposes of section 
5000A(f)(1)(E) of the Internal Revenue Code of 
1986 (26 U.S.C. 5000A(f)(1)(E)). 
(13) The Federal Employees Health Benefit 
Plan under chapter 89 of title 5, United States 
Code. 
(14) Medical care for individuals under the care 
or custody of the Department of Justice pursuant to 
chapter 301 of title 18 (18 U.S.C. 4001 et seq.). 
(15) Medical care for Peace Corps volunteers 
under section 5(e) of the Peace Corps Act (22 
U.S.C. 2504(e)). 
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(16) Other government-sponsored programs es-
tablished after the date of the enactment of this Act. 
(17) Plans in the Federal marketplace or an in-
dividual marketplace within a State. 
(18) Eligible employer-sponsored plan as de-
fined in 26 U.S.C. 5000A(f)(2). 
(19) Grandfathered health plan as defined in 
42 U.S.C. 18011(e). 
(20) A standard health plan established 
through a State basic health program as defined in 
42 U.S.C. 18051. 
(21) Other coverage, such as a State health 
benefits risk pool, as the Secretary of Health and 
Human Services, in coordination with the Secretary 
of the Internal Revenue Services, recognizes for pur-
poses of 26 U.S.C. § 5000A(f)(E). 
(d) REPEAL.—Section 1303 of the Patient Protection 
and Affordable Care Act (42 U.S.C. 18023) is repealed. 
(e) REMOVING BARRIERS TO COVERAGE FOR IMMI-
GRANT FAMILIES.— 
(1) IN
GENERAL.—Section 1903(v)(4) of the 
Social Security Act (42 U.S.C. 1396b(v)(4)) is 
amended— 
(A) by amending subparagraph (A) to read 
as follows: 
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‘‘(A) Notwithstanding sections 401(a), 
402(b), 403, and 421 of the Personal Responsi-
bility and Work Opportunity Reconciliation Act 
of 1996, a State shall provide medical assist-
ance under this title, to individuals who are 
lawfully residing in the United States (including 
individuals described in paragraph (1), battered 
individuals described in section 431(c) of such 
Act, and individuals with an approved or pend-
ing application for deferred action or other fed-
erally authorized presence), if they otherwise 
meet the eligibility requirements for medical as-
sistance under the State plan approved under 
this title (other than the requirement of the re-
ceipt of aid or assistance under title IV, supple-
mental security income benefits under title 
XVI, or a State supplementary payment).’’; 
(B) by amending subparagraph (B) to read 
as follows: 
‘‘(B) No debt shall accrue under an affi-
davit of support against any sponsor of an indi-
vidual provided medical assistance under sub-
paragraph (A) on the basis of provision of as-
sistance to such individual and the cost of such 
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assistance shall not be considered as an unreim-
bursed cost.’’; and 
(C) in subparagraph (C)— 
(i) by striking ‘‘an election by the 
State under subparagraph (A)’’ and insert-
ing ‘‘the application of subparagraph (A)’’; 
(ii) by inserting ‘‘or be lawfully 
present’’ after ‘‘lawfully reside’’; and 
(iii) by inserting ‘‘or present’’ after 
‘‘lawfully residing’’ each place it appears. 
(2) CHIP.—Subparagraph (N) of section 
2107(e)(1) of the Social Security Act (42 U.S.C. 
1397gg(e)(1)) is amended to read as follows: 
‘‘(N) Paragraph (4) of section 1903(v) (re-
lating to lawfully present individuals).’’. 
(3) EFFECTIVE DATE.— 
(A) IN GENERAL.—Except as provided in 
subparagraph (A), the amendments made by 
this subsection shall take effect on the date of 
enactment of this Act and shall apply to serv-
ices furnished on or after the date that is 90 
days after such date of enactment. 
(B) EXCEPTION
IF
STATE
LEGISLATION 
REQUIRED.—In the case of a State plan for 
medical assistance under title XIX, or a State 
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child health plan under title XXI, of the Social 
Security Act which the Secretary of Health and 
Human Services determines requires State leg-
islation (other than legislation appropriating 
funds) in order for the plan to meet the addi-
tional requirements imposed by the amend-
ments made by this section, the respective State 
plan shall not be regarded as failing to comply 
with the requirements of such title solely on the 
basis of its failure to meet these additional re-
quirements before the first day of the first cal-
endar quarter beginning after the close of the 
first regular session of the State legislature that 
begins after the date of enactment of this Act. 
For purposes of the previous sentence, in the 
case of a State that has a 2-year legislative ses-
sion, each year of such session shall be deemed 
to be a separate regular session of the State 
legislature. 
(e) COVERAGE FOR INDIVIDUALS WITH FEDERAL 
AUTHORIZED PRESENCE, INCLUDING DEFERRED AC-
TION.— 
(1) IN GENERAL.—For purposes of eligibility 
under any of the provisions described in paragraph 
(2), all individuals granted federally authorized pres-
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ence in the United States shall be considered to be 
lawfully present in the United States. 
(2) PROVISIONS
DESCRIBED.—The provisions 
described in this paragraph are the following: 
(A) 
EXCHANGE
ELIGIBILITY.—Section 
1411 of the Patient Protection and Affordable 
Care Act (42 U.S.C. 18031). 
(B) 
REDUCED
COST-SHARING
ELIGI-
BILITY.—Section 1402 of the Patient Protec-
tion and Affordable Care Act (42 U.S.C. 
18071). 
(C) PREMIUM SUBSIDY ELIGIBILITY.—Sec-
tion 36B of the Internal Revenue Code of 1986 
(26 U.S.C. 36B). 
(D) MEDICAID AND CHIP ELIGIBILITY.— 
Titles XIX and XXI of the Social Security Act, 
including under section 1903(v) of such Act (42 
U.S.C. 1396b(v)). 
(3) TRANSITION
THROUGH
SPECIAL
ENROLL-
MENT
PERIOD.—In the case of an individual de-
scribed in paragraph (1) who, before the first day of 
the first annual open enrollment period under sub-
paragraph (B) of section 1311(c)(6) of the Patient 
Protection and Affordable Care Act (42 U.S.C. 
18031(c)(6)) beginning after the date of enactment 
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of this Act, is granted federally authorized presence 
in the United States and who, as a result of such 
subsection, qualifies for a subsidy under a provision 
described in subparagraph (B) or (C) of paragraph 
(2), the Secretary of Health and Human Services 
shall establish a special enrollment period under sub-
paragraph (C) of such section 1311(c)(6) during 
which such individual may enroll in qualified health 
plans through Exchanges under title I of the Patient 
Protection and Affordable Care Act and qualify for 
such a subsidy. For such an individual who has been 
granted federally authorized presence in the United 
States as of the date of enactment of this Act, such 
special enrollment period shall begin not later than 
90 days after such date of enactment. Nothing in 
this paragraph shall be construed as affecting the 
authority of the Secretary to establish additional 
special enrollment periods under such subparagraph 
(C). 
(f) REMOVING CITIZENSHIP AND IMMIGRATION BAR-
RIERS TO ACCESS ACA CARE.—— 
(1) IN GENERAL.— 
(A) PREMIUM TAX CREDITS.—Section 36B 
of the Internal Revenue Code of 1986 is 
amended— 
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(i) in subsection (c)(1)(B)— 
(I) by amending the heading to 
read as follows: ‘‘SPECIAL RULE 
FOR CERTAIN INDIVIDUALS IN-
ELIGIBLE FOR MEDICAID DUE 
TO STATUS’’; and 
(II) by amending clause (ii) to 
read as follows: 
‘‘(ii) the taxpayer is a noncitizen who 
is not eligible for the Medicaid program 
under title XIX of the Social Security Act 
by reason of the individual’s immigration 
status,’’; and 
(ii) by striking subsection (e). 
(B) COST-SHARING REDUCTIONS.—Section 
1402 of the Patient Protection and Affordable 
Care Act (42 U.S.C. 18071) is amended by 
striking subsection (e) and redesignating sub-
section (f) as subsection (e). 
(C) 
BASIC
HEALTH
PROGRAM
ELIGI-
BILITY.—Section 1331(e)(1)(B) of the Patient 
Protection and Affordable Care Act (42 U.S.C. 
18051(e)(1)(B)) is amended by striking ‘‘law-
fully present in the United States,’’. 
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(D) RESTRICTIONS
ON
FEDERAL
PAY-
MENTS.—Section 1412 of the Patient Protec-
tion and Affordable Care Act (42 U.S.C. 
18082) is amended by striking subsection (d) 
and redesignating subsection (e) as subsection 
(d). 
(E) REQUIREMENT TO MAINTAIN MINIMUM 
ESSENTIAL COVERAGE.—Subsection (d) of sec-
tion 5000A of the Internal Revenue Code of 
1986 is amended by striking paragraph (3) and 
by redesignating paragraph (4) as paragraph 
(3). 
(g) CONFORMING AMENDMENTS.— 
(1) ESTABLISHMENT
OF
PROGRAM.—Section 
1411(a) of the Patient Protection and Affordable 
Care Act (42 U.S.C. 18081(a)) is amended by strik-
ing paragraph (1) and redesignating paragraphs (2), 
(3), and (4) as paragraphs (1), (2), and (3), respec-
tively. 
(2) QUALIFIED INDIVIDUALS.—Section 1312(f) 
of the Patient Protection and Affordable Care Act 
(42 U.S.C. 18032(f)) is amended— 
(A) in the heading, by striking ‘‘; ACCESS 
LIMITED TO CITIZENS AND LAWFUL 
RESIDENTS’’; and 
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(B) by striking paragraph (3). 
(h) EFFECTIVE DATE.—The amendments made by 
this section shall apply to years, plan years, and taxable 
years, as applicable, beginning after December 31, 2021. 
(i) ACCESS TO COVERAGE.— 
(1) IN GENERAL.—Nothing in this Act, includ-
ing the amendments made by this Act, shall prevent 
lawfully present noncitizens who are ineligible for 
full benefits under the Medicaid program under title 
XIX of the Social Security Act from securing a cred-
it for which such lawfully present noncitizens would 
be eligible under section 36B(c)(1)(B) of the Inter-
nal Revenue Code of 1986 and under the Medicaid 
provisions for lawfully present noncitizens, as in ef-
fect on the date prior to the date of enactment of 
this Act. 
(2) DEFINITION.—For purposes of paragraph 
(1), the term ‘‘full benefits’’ means, with respect to 
an individual and State, medical assistance for all 
services covered under the State plan under title 
XIX of the Social Security Act that is not less in 
amount, duration, or scope, or is determined by the 
Secretary of Health and Human Services to be sub-
stantially equivalent to the medical assistance avail-
able 
for 
an 
individual 
described 
in 
section 
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1902(a)(10)(A)(i) of the Social Security Act (42 
U.S.C. 1396a(a)(10)(A)(i)). 
SEC. 6. RIGHTS AND PROTECTIONS. 
(a) FUNDAMENTAL RIGHT.—All persons have a fun-
damental right to make and effectuate decisions about 
abortion and miscarriage. Pursuant to this right the Gov-
ernment may not: 
(1) Deny, interfere with, or restrict the right of 
any person to obtain an abortion. 
(2) Penalize any person for providing, assisting, 
supporting, or facilitating another person’s abortion 
or miscarriage. 
(3) Penalize an individual for seeking, inducing, 
or attempting to induce, the individual’s own abor-
tion or alleged abortion. 
(b) CIVIL ACTION.—Any person aggrieved by a viola-
tion of this Act may bring a civil action for a such violation 
against a Federal, State, or local government in an appro-
priate district court of the United States. 
(c) 
CLARIFY
PRIVACY
PROTECTIONS
UNDER 
HIPAA.—The Secretary of Health and Human Services 
shall revise section 164.512 of title 42, Code of Federal 
Regulations, and any associated regulations under the 
HIPAA privacy and security law (as defined in section 
3009 of the Public Health Service Act (42 U.S.C. 300jj– 
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19)) to clarify that such regulations expressly prohibit dis-
closures of personal health information without authoriza-
tion to law enforcement officials, including immigration of-
ficials, in cases involving reproductive and sexual health, 
including in case of a miscarriage, abortion (whether self- 
managed or otherwise), or stillbirth. 
(d) PROHIBITION WITH RESPECT TO IMMIGRATION 
ENFORCEMENT ACTIONS.— 
(1) IN GENERAL.—Notwithstanding any other 
provision of law, in order to ensure that an individ-
uals’ access to abortion services is protected, this 
Act shall prohibit immigration enforcement actions 
within 2,000 feet of any health care facility. 
(2) APPLICABILITY.—The prohibition under 
paragraph (1) shall apply to— 
(A) any officer or agent of the Department 
of Homeland Security, including any officer or 
agent of the U.S. Immigration and Customs 
Enforcement or the U.S. Customs and Border 
Protection; or 
(B) any State or local employee pursuing 
immigration enforcement actions. 
(3) HEALTH
CARE
FACILITY
DEFINED.—The 
term ‘‘health care facility’’ includes— 
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(A) any institution, entity, or agency that 
provides health care services; and 
(B) any community pharmacy, hospital, 
doctor’s office, health clinic, family planning 
clinic, emergent or urgent care facility, or com-
munity health center. 
(e) ABROGATION OF STATE IMMUNITY.—Neither a 
State that enforces or maintains, nor a government official 
who is permitted to implement or enforce any limitation 
or requirement that violates this Act shall be immune 
under the Tenth Amendment to the Constitution of the 
United States, the Eleventh Amendment to the Constitu-
tion of the United States, or any other source of law, from 
an action in a Federal or State court of competent juris-
diction challenging that limitation or requirement, unless 
such immunity is required by clearly established Federal 
law, as determined by the Supreme Court of the United 
States. 
(f) SUPERSEDES.—This Act supersedes and applies 
to all Federal law, and the implementation of that law, 
whether statutory or otherwise, and whether adopted be-
fore or after the date of enactment of this Act and is not 
subject to the Religious Freedom Restoration Act of 1993 
(42 U.S.C. 2000bb et seq.). 
Æ 
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