I 
117TH CONGRESS 
1ST SESSION 
H. R. 188 
To amend title XIX of the Social Security Act to allow for greater State 
flexibility with respect to excluding providers who are involved in abortions. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 5, 2021 
Mr. CLOUD (for himself, Mr. MOONEY, Mr. TIFFANY, Mr. MULLIN, Mr. 
GAETZ, Mr. ROUZER, Mr. ALLEN, Mr. BIGGS, Mr. KELLY of Mississippi, 
Mr. WALTZ, Mr. BANKS, Mr. GOSAR, Mr. WILLIAMS of Texas, Mr. 
JOYCE of Pennsylvania, Mr. LAMBORN, Mr. TIMMONS, Mr. CHABOT, Mr. 
BUDD, Mr. DUNCAN, Mr. NORMAN, Mr. LAMALFA, Mr. GALLAGHER, Mr. 
STEUBE, Mr. SMITH of New Jersey, Mr. FULCHER, Mr. BAIRD, Mr. 
LATTA, Mr. GOHMERT, Mr. KUSTOFF, Mr. ADERHOLT, Mr. WEBER of 
Texas, Mr. MCKINLEY, Mr. GROTHMAN, Mr. GRAVES of Louisiana, Mrs. 
HINSON, and Mr. WRIGHT) introduced the following bill; which was re-
ferred to the Committee on Energy and Commerce 
A BILL 
To amend title XIX of the Social Security Act to allow 
for greater State flexibility with respect to excluding 
providers who are involved in abortions. 
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 ‘‘Women’s Public 
Health and Safety Act’’. 
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SEC. 2. INCREASING STATE FLEXIBILITY IN DETERMINING 
PARTICIPATION OF PROVIDERS WHO PER-
FORM, OR PARTICIPATE IN THE PERFORM-
ANCE OF, ABORTIONS. 
Section 1902 of the Social Security Act (42 U.S.C. 
1396a) is amended— 
(1) in subsection (a)(23), by striking ‘‘sub-
section (g)’’ and inserting ‘‘subsection (g), sub-
section (tt),’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(tt) RULES WITH RESPECT TO DETERMINATION OF 
PARTICIPATION OF PROVIDERS WHO PERFORM, OR PAR-
TICIPATE IN THE PERFORMANCE OF, ABORTIONS.— 
‘‘(1) IN GENERAL.—Subject to paragraph (2), 
for purposes of this title, a State, at its option, may 
establish criteria with respect to the participation 
under the State plan (or a waiver of such plan) of 
an institution, an agency, an entity, or a person who 
performs, or participates in the performance of, 
abortions. 
‘‘(2) EXCEPTION.—Paragraph (1) shall not 
apply to an abortion— 
‘‘(A) if the pregnancy is the result of an 
act of rape or incest; or 
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‘‘(B) in the case where a woman suffers 
from a physical 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. 
‘‘(3) DEFINITIONS.—For purposes of this sub-
section, the terms ‘institution’, ‘agency’, or ‘entity’ 
mean the entire legal institution, agency, or entity, 
or any part thereof, including any institution, agen-
cy, or entity that controls, is controlled by, or is 
under common control with such institution, agency, 
or entity.’’. 
Æ 
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