I 
118TH CONGRESS 
1ST SESSION H. R. 1126 
To make improvements in prenatal and maternal care, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 21, 2023 
Mrs. FISCHBACH introduced the following bill; which was referred to the 
Committee on Energy and Commerce 
A BILL 
To make improvements in prenatal and maternal care, and 
for other purposes. 
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 ‘‘Health, Opportunity, 
Protecting life, Education Act’’ or the ‘‘HOPE Act’’. 
SEC. 2. TABLE OF CONTENTS. 
The table of contents for this Act is as follows: 
Sec. 1. Short title. 
Sec. 2. Table of contents. 
TITLE I—ALTERNATIVES TO ABORTION 
Sec. 101. Improving access to prenatal telehealth care. 
Sec. 102. Positive alternatives for women. 
Sec. 103. Educated decisions on maternal health. 
Sec. 104. Life.Gov: awareness for expecting mothers. 
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Sec. 105. Parental notification. 
Sec. 106. Moratorium on Federal funding to Planned Parenthood Federation of 
America, Inc. 
Sec. 107. Funding. 
TITLE II—GENERAL PROVISIONS 
Sec. 201. Rule of construction. 
TITLE I—ALTERNATIVES TO 
ABORTION 
SEC. 101. IMPROVING ACCESS TO PRENATAL TELEHEALTH 
CARE. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall award grants or cooperative agree-
ments to eligible entities to purchase equipment necessary 
for carrying out at-home telehealth visits for screening, 
monitoring, and management of prenatal and postnatal 
care for the purpose of improving maternal and infant 
health outcomes, and reducing maternal mortality, by im-
proving access to care in rural areas, frontier counties, 
medically underserved areas, or jurisdictions of Indian 
Tribes and Tribal organizations. 
(b) USE OF FUNDS.—A recipient of a grant under 
this section shall use the grant as described in subsection 
(a), which may include purchasing or providing equipment 
necessary for carrying out at-home telehealth visits (such 
as remote physiologic devices and related services, includ-
ing pulse oximeters, blood pressure cuffs, scales, and blood 
glucose monitors) to screen, monitor, and manage prenatal 
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and postnatal care at home by means of telehealth visits 
and services for the purpose described in subsection (a). 
(c) REPORT TO CONGRESS.—Not later than Sep-
tember 30, 2028, the Secretary shall submit to the Con-
gress a report on activities supported through grants 
under this section, including— 
(1) a description of the activities conducted 
pursuant to such grants; and 
(2) an analysis of the effects of such grants on 
improving prenatal and postnatal care in areas and 
jurisdictions described in subsection (a). 
(d) DEFINITIONS.—In this section: 
(1) The term ‘‘eligible entity’’ means an entity 
providing prenatal care, labor care, birthing, and 
postpartum care services in a rural area, a frontier 
county, a medically underserved area, or the juris-
diction of an Indian Tribe or Tribal organization. 
(2) The term ‘‘frontier county’’ has the mean-
ing 
given 
such 
term 
in 
section 
1886(d)(3)(E)(iii)(III) of the Social Security Act 
(42 U.S.C. 1395ww(d)(3)(E)(iii)(III)). 
(3) The terms ‘‘Indian Tribe’’ and ‘‘Tribal or-
ganization’’ have the meanings given to such terms 
in section 4 of the Indian Self-Determination and 
Education Assistance Act (25 U.S.C. 5304). 
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(4) The term ‘‘medically underserved area’’ 
means a health professional shortage area des-
ignated under section 332 of the Public Health Serv-
ice Act (42 U.S.C. 254e). 
(5) The term ‘‘rural area’’ has the meaning 
given to such term in section 330J(e) of the Public 
Health Service Act (42 U.S.C. 254c–15(e)). 
(6) The term ‘‘Secretary’’ means the Secretary 
of Health and Human Services. 
(e) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there are authorized to be appropriated 
such sums as may be necessary for fiscal years 2024 
through 2029. 
SEC. 102. POSITIVE ALTERNATIVES FOR WOMEN. 
(a) PROGRAM AUTHORITY.— 
(1) PURPOSE.—The purpose of grants under 
this section shall be to support, encourage, and as-
sist women— 
(A) to carry their pregnancies to term; and 
(B) to care for their babies after birth. 
(2) GRANTS.—For the purpose described in 
paragraph (1), the Secretary shall award grants to 
eligible entities described in subsection (b) to provide 
information on, referral to, and direct services as de-
scribed in subsection (c). 
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(b) ELIGIBILITY.— 
(1) ELIGIBLE ENTITIES.—To be eligible for a 
grant under this section, an entity shall— 
(A) be a nonprofit organization; 
(B) support, encourage, and assist women 
as described in subsection (a)(1); 
(C) agree to be subject to such monitoring 
and review as the Secretary may require under 
subsection (g); 
(D) agree to not charge women for services 
provided through the grant; 
(E) provide each pregnant woman coun-
seled through the grant with accurate informa-
tion on the developmental characteristics of ba-
bies and of unborn children, including offering 
printed information; and 
(F) have a privacy policy and procedures 
in place to ensure that— 
(i) the name, address, telephone num-
ber, or any other information that might 
identify any woman seeking services sup-
ported through the grant is not made pub-
lic or shared with any other entity without 
the written consent of the woman; and 
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(ii) the grantee adheres to require-
ments comparable to those applicable 
under the HIPAA privacy regulation (as 
defined in section 1180(b)(3) of the Social 
Security Act (42 U.S.C. 1320d–9)) to cov-
ered entities (as defined for purposes of 
such regulation). 
(2) INELIGIBLE ENTITIES.—An entity shall be 
ineligible to receive a grant under this section if the 
entity or any affiliate, subsidiary, successor, or clinic 
thereof— 
(A) performs, induces, refers for, or coun-
sels in favor of abortions; or 
(B) provides financial support to any other 
entity that conducts any activity described in 
subparagraph (A). 
(3) FINANCIAL RECORDS.—As a condition on 
receipt of a grant under this section, an eligible enti-
ty shall agree to maintain and make available to the 
Secretary records, including financial records, that 
demonstrate that the entity satisfies the require-
ments of paragraph (1) and is not ineligible by oper-
ation of paragraph (2). 
(c) COVERED SERVICES.— 
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(1) REQUIRED
INFORMATION
AND
REFER-
RAL.—For the purpose described in subsection 
(a)(1), an eligible entity receiving a grant under this 
section shall use the grant to provide information 
on, and referral to, each of the following services: 
(A) Medical care. 
(B) Nutritional services. 
(C) Housing assistance. 
(D) Adoption services. 
(E) Education and employment assistance, 
including services that support the continuation 
and completion of high school. 
(F) Child care assistance. 
(G) Parenting education and support serv-
ices. 
(H) Voluntary substance abuse counseling 
and treatment. 
(2) PERMISSIBLE DIRECT PROVISION OF SERV-
ICES.—For the purpose described in subsection 
(a)(1), in addition to using a grant under this sec-
tion as described in paragraph (1), an eligible entity 
receiving a grant under this section may use the 
grant for the direct provision of one or more services 
listed in paragraph (1). 
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(d) PROHIBITED USES
OF FUNDS.—None of the 
funds made available under this section shall be used— 
(1) for health benefits coverage that includes 
coverage of abortion; 
(2) for providing or assisting a woman to obtain 
adoption services from a provider of adoption serv-
ices that is not licensed; and 
(3) for any of the activities described in sub-
section (b)(2). 
(e) APPROVAL OF INFORMATION AS MEDICALLY AC-
CURATE.—As a condition on the receipt of a grant under 
this section, an eligible entity shall refrain from providing 
any information pursuant to the grant on the health risks 
associated with abortions other than information that has 
been approved by the Secretary as medically accurate. 
(f) CONSIDERATION.—In selecting the recipients of 
grants under this section, the Secretary shall consider 
each applicant’s demonstrated capacity in providing serv-
ices to assist a pregnant woman in carrying her pregnancy 
to term. 
(g) MONITORING
AND
REVIEW.—The Secretary 
shall— 
(1) monitor and review each program funded 
through a grant under this section to ensure that 
the grantee carefully adheres to— 
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(A) the purpose described in subsection 
(a)(1); and 
(B) the requirements of this section; and 
(2) cease to fund a program under this section 
if the grantee fails to adhere to such purpose and re-
quirements. 
(h) DEFINITIONS.—In this section: 
(1) ABORTION.—The term ‘‘abortion’’ means 
the use or prescription of any instrument, medicine, 
drug, or any other substance or device to inten-
tionally— 
(A) kill the unborn child of a woman 
known to be pregnant; or 
(B) terminate the pregnancy of a woman 
known to be pregnant, with an intention other 
than— 
(i) after viability, to produce a live 
birth and preserve the life and health of 
the child born alive; 
(ii) to remove a dead unborn child; or 
(iii) to treat an ectopic pregnancy. 
(2) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
(i) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there are authorized to be appropriated 
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such sums as may be necessary for fiscal years 2024 
through 2029. 
SEC. 103. EDUCATED DECISIONS ON MATERNAL HEALTH. 
(a) IN GENERAL.— 
(1) REQUIREMENT
OF
COMPLIANCE
BY
PRO-
VIDERS.—Any abortion provider, acting in or affect-
ing interstate or foreign commerce, who knowingly 
performs, or attempts to perform, any abortion shall 
comply with the requirements of this section. 
(2) REVIEW OF MEDICAL RISKS AND UNBORN 
HEALTH STATUS.—An abortion provider who intends 
to perform, or attempt to perform, an abortion may 
not perform any part of the abortion procedure with-
out first obtaining a signed Informed Consent Au-
thorization form in accordance with this subsection. 
(3) 
INFORMED
CONSENT
AUTHORIZATION 
FORM.— 
(A) IN GENERAL.—The Informed Consent 
Authorization form required under this sub-
section shall— 
(i) be presented in person by the abor-
tion provider 24 hours prior to performing, 
or attempting to perform, the abortion to 
the woman seeking the abortion; and 
(ii) consist of— 
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(I) a statement, in easily under-
standable common language, by the 
abortion provider indicating— 
(aa) the probable gestational 
age, in completed days, of the 
child; 
(bb) all medical risks associ-
ated with the specific abortion 
procedure; and 
(cc) the major developmental 
characteristics of unborn children 
at such gestational age, including 
the presence of a heartbeat, the 
ability to react to painful stimuli, 
and the development of organs, 
fingers, and facial features; 
(II) a statement, in easily under-
standable common language, that the 
requirements of this subsection are 
binding upon the abortion provider 
and all other medical personnel, that 
such abortion providers and medical 
personnel are subject to criminal and 
civil penalties for violations of these 
requirements, and that a woman on 
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whom an abortion has been performed 
may take civil action if these require-
ments are not followed; and 
(III) an affirmation that each in-
dividual signing the Informed Consent 
Authorization form has filled out the 
form to the best of his or her knowl-
edge and understands the information 
contained in the form. 
(B) SIGNATORIES
REQUIRED.—The In-
formed Consent Authorization form required 
under this subsection shall be signed in person 
by the woman seeking the abortion, the abor-
tion provider performing or attempting to per-
form the abortion, and a witness. 
(C) RETENTION OF CONSENT FORM.—The 
abortion provider performing or attempting to 
perform an abortion shall retain the signed In-
formed Consent Authorization form required 
under this subsection in the patient’s medical 
file. 
(D) REQUIREMENT
FOR
DATA
RETEN-
TION.—Paragraph (j)(2) of section 164.530 of 
title 45, Code of Federal Regulations, shall 
apply to the Informed Consent Authorization 
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form required to be placed in a patient’s med-
ical file pursuant to subparagraph (C) in the 
same manner and to the same extent as such 
paragraph applies to documentation required by 
paragraph (j)(1) of such section. 
(E) COPY OF FORM.—A copy of the signed 
Informed Consent Authorization required under 
this subsection shall be provided to the woman 
seeking an abortion. 
(4) EXCEPTIONS.—The requirements of this 
subsection shall not apply if, in reasonable medical 
judgment, compliance with paragraph (2) would pose 
a greater risk of— 
(A) the death of the pregnant woman; or 
(B) the substantial and irreversible phys-
ical impairment of a major bodily function, not 
including psychological or emotional conditions, 
of the pregnant woman. 
(b) PENALTY FOR FAILURE TO COMPLY.— 
(1) CIVIL PENALTY.— 
(A) ENFORCEMENT
BY
ATTORNEY
GEN-
ERAL.—The Attorney General shall commence 
a civil action in an appropriate district court of 
the United States under this subsection against 
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any abortion provider who knowingly commits a 
violation of subsection (a). 
(B) PENALTY.—In a civil action under 
subparagraph (A), the court may, to vindicate 
the public interest, assess a civil penalty against 
the abortion provider in an amount— 
(i) not less than $100,000 and not 
more than $150,000, for each such viola-
tion that is adjudicated in the first pro-
ceeding against such abortion provider 
under this subsection; or 
(ii) not less than $150,001 and not 
more than $250,000, for each such viola-
tion that is adjudicated in a subsequent 
proceeding against such abortion provider 
under this subsection. 
(C) NOTIFICATION.—Upon the assessment 
of a civil penalty under subparagraph (B), the 
Attorney General shall notify the appropriate 
State medical licensing authority. 
(D) 
NO
PENALTIES
FOR
PREGNANT 
WOMEN.—A pregnant woman shall not be sub-
ject to any penalty under this section. 
(2) PRIVATE RIGHT OF ACTION.— 
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(A) IN GENERAL.—A woman or a parent 
of a minor upon whom an abortion has been 
performed in violation of subsection (a) may 
commence a civil action against the abortion 
provider for appropriate relief. 
(B) APPROPRIATE
RELIEF.—Appropriate 
relief in a civil action under this paragraph in-
cludes— 
(i) objectively verifiable money dam-
ages for all injuries, psychological and 
physical, occasioned by the violation; 
(ii) statutory damages equal to 3 
times the cost of the abortion; and 
(iii) punitive damages. 
(C) ATTORNEY’S FEES FOR PLAINTIFF.— 
The court shall award a reasonable attorney’s 
fee as part of the costs to a prevailing plaintiff 
in a civil action under this paragraph. 
(D) ATTORNEY’S
FEES
FOR
DEFEND-
ANT.—If a defendant in a civil action under 
this paragraph prevails and the court finds that 
the plaintiff’s suit was frivolous, the court shall 
award a reasonable attorney’s fee in favor of 
the defendant against the plaintiff. 
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(E) AWARDS
AGAINST
WOMAN.—In any 
civil action under this paragraph, no damages 
or other monetary relief, and no attorney’s fees 
except as provided under subparagraph (D), 
may be assessed against the woman upon whom 
the abortion was performed or attempted. 
(c) PREEMPTION.—Nothing in this title or the 
amendments made by this title shall be construed to pre-
empt any provision of State law to the extent that such 
State law establishes, implements, or continues in effect 
disclosure requirements regarding abortion or penalties 
for failure to comply with such requirements that are more 
extensive than those provided under the amendment made 
by this title. 
(d) RULE OF CONSTRUCTION.—Nothing in this title 
shall be construed to prohibit an abortion provider from 
presenting the information required under subsection (a) 
to a pregnant woman at the same time as acquiring in-
formed consent for an abortion from such woman in ac-
cordance with State law, provided that the presentation 
of such information occurs at least 24 hours before the 
abortion. 
(e) DEFINITIONS.—In this section: 
(1) ABORTION.—The term ‘‘abortion’’ means 
the use or prescription of any instrument, medicine, 
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drug, or any other substance or device to inten-
tionally— 
(A) kill the unborn child of a woman 
known to be pregnant; or 
(B) terminate the pregnancy of a woman 
known to be pregnant, with an intention other 
than— 
(i) after viability, to produce a live 
birth and preserve the life and health of 
the child born alive; 
(ii) to remove a dead unborn child; or 
(iii) to treat an ectopic pregnancy. 
(2) ABORTION PROVIDER.—The term ‘‘abortion 
provider’’ means a person— 
(A) licensed to practice medicine and sur-
gery or osteopathic medicine and surgery; or 
(B) otherwise legally authorized to perform 
an abortion. 
(3) ATTEMPT.—The term ‘‘attempt’’, with re-
spect to an abortion, means conduct that, under the 
circumstances as the actor believes them to be, con-
stitutes a substantial step in a course of conduct 
planned to culminate in performing an abortion. 
(4) MINOR.—The term ‘‘minor’’ means an indi-
vidual who has not attained the age of 18 years. 
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(5) PERFORM.—The term ‘‘perform’’, with re-
spect to an abortion, includes inducing an abortion 
through a medical or chemical intervention including 
writing a prescription for a drug or device intended 
to result in an abortion. 
(6) REASONABLE
MEDICAL
JUDGMENT.—The 
term ‘‘reasonable medical judgment’’ means a med-
ical judgment that would be made by a reasonably 
prudent abortion provider, knowledgeable about the 
case and the treatment possibilities with respect to 
the medical conditions involved. 
(7) UNBORN CHILD.—The term ‘‘unborn child’’ 
means an individual organism of the species homo 
sapiens, beginning at fertilization, until the point of 
being born alive as defined in section 8(b) of title 1, 
United States Code. 
(8) WOMAN.—The term ‘‘woman’’ means a fe-
male human being whether or not she has reached 
the age of majority. 
SEC. 104. LIFE.GOV: AWARENESS FOR EXPECTING MOTH-
ERS. 
The Public Health Service Act (42 U.S.C. 201 et 
seq.) is amended by adding at the end the following: 
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‘‘TITLE XXXIV—AWARENESS FOR 
EXPECTING MOTHERS 
‘‘SEC. 3401. WEBSITE AND PORTAL. 
‘‘(a) WEBSITE.—Not later than 1 year after the date 
of enactment of this section, the Secretary shall publish 
a user-friendly public website, life.gov, to provide a com-
prehensive list of Federal, State, local governmental, and 
private resources available to pregnant women including— 
‘‘(1) resources to mental health counseling, 
pregnancy counseling, and other prepartum and 
postpartum services; 
‘‘(2) comprehensive information on alternatives 
to abortion; 
‘‘(3) information about abortion risks, including 
complications and failures; and 
‘‘(4) links to information on child development 
from moment of conception. 
‘‘(b) PORTAL.—Not later than 1 year after the date 
of enactment of this section, the Secretary shall publish 
a portal on the public website of the Department of Health 
and Human Services that— 
‘‘(1) through a series of questions, will furnish 
specific tailored information to the user on what 
pregnancy-related information they are looking for, 
such as— 
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‘‘(A) Federal, State, local governmental, 
and private resources that may be available to 
the woman within her ZIP Code, including the 
resources specified in subsection (c); and 
‘‘(B) risks related to abortion at all stages 
of fetal gestation; and 
‘‘(2) provides for the submission of feedback on 
how user-friendly and helpful the portal was in pro-
viding the tailored information the user was seeking. 
‘‘(c) RESOURCES.—The Federal, State, local govern-
mental, and private resources specified in this subsection 
are the following: 
‘‘(1) Mentorship opportunities, including preg-
nancy help and case management resources. 
‘‘(2) Health and well-being services, including 
women’s medical services such as obstetrical and 
gynecological support services for women, abortion 
pill reversal, breastfeeding, general health services, 
primary care, and dental care. 
‘‘(3) Financial assistance, work opportunities, 
nutrition assistance, childcare, and education oppor-
tunities. 
‘‘(4) Material or legal support, including trans-
portation, food, nutrition, clothing, household goods, 
baby supplies, housing, shelters, maternity homes, 
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tax preparation, legal support for child support, 
family leave, breastfeeding protections, and custody 
issues. 
‘‘(5) Recovery and mental health services, in-
cluding services with respect to addiction or suicide 
intervention, intimate partner violence, sexual as-
sault, rape, sex trafficking, and counseling for 
women and families surrounding unexpected loss of 
a child. 
‘‘(6) Prenatal diagnostic services, including dis-
ability support organizations, medical interventions 
for a baby, perinatal hospice resources, pregnancy 
and infant loss support, and literature on pregnancy 
wellness. 
‘‘(7) Healing and support services for abortion 
survivors and their families. 
‘‘(8) Services providing care for children, in-
cluding family planning education, adoption, foster 
care, and short-term care resources. 
‘‘(d) ADMINISTRATION.—The Secretary may not del-
egate implementation or administration of the portal es-
tablished under subsection (b) below the level of the Office 
of the Secretary. 
‘‘(e) FOLLOW-UP.—The Secretary shall develop a 
plan under which— 
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‘‘(1) the Secretary includes in the portal estab-
lished under subsection (b), a mechanism for users 
of the portal to take an assessment through the por-
tal and provide consent to use the user’s contact in-
formation; 
‘‘(2) the Secretary conducts outreach via phone 
or email to follow up with users of the portal estab-
lished under subsection (b) on additional resources 
that would be helpful for the users to review; and 
‘‘(3) upon the request of a user of the portal for 
specific information, after learning of the additional 
resources through the portal, agents of the Depart-
ment of Health and Human Services make every ef-
fort to furnish specific information to such user in 
coordination with Federal, State, local governmental, 
and private health care providers and resources. 
‘‘(f) RESOURCE LIST AGGREGATION.— 
‘‘(1) IN GENERAL.—Pursuant to criteria devel-
oped in subsection (e)(2), each State shall provide 
recommendations of State, local governmental, and 
private resources under subsection (b)(1)(A) to in-
clude in the portal. 
‘‘(2) CRITERIA
FOR
MAKING
RECOMMENDA-
TIONS.—The Secretary shall develop, and make pub-
lic, criteria to provide to the States to determine 
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(1) at least 24 hours of actual notice to a par-
ent of the minor before performing or inducing the 
abortion; or 
(2) at least 48 hours of constructive notice to 
a parent of the minor before performing or inducing 
the abortion. 
(b) EXCEPTIONS.—The notification requirement of 
subsection (a) does not apply if— 
(1) the abortion is performed or induced in a 
State that has, in force, a law requiring parental in-
volvement in a minor’s abortion decision and the 
physician complies with the requirements of that 
law; 
(2) the physician is presented with documenta-
tion showing with a reasonable degree of certainty 
that a court in the minor’s State of residence has 
waived any parental notification required by the laws 
of that State, or has otherwise authorized that the 
minor be allowed to procure an abortion; 
(3) the minor declares in a signed written state-
ment that she is the victim of sexual abuse, neglect, 
or physical abuse by a parent, and, before an abor-
tion is performed on the minor, the physician noti-
fies the authorities specified to receive reports of 
child abuse or neglect by the law of the State in 
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