I 
118TH CONGRESS 
1ST SESSION 
H. R. 459 
To ensure the privacy of pregnancy termination or loss information under 
the HIPAA privacy regulations and the HITECH Act. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 24, 2023 
Ms. ESHOO (for herself and Ms. JACOBS) introduced the following bill; which 
was referred to the Committee on Energy and Commerce 
A BILL 
To ensure the privacy of pregnancy termination or loss infor-
mation under the HIPAA privacy regulations and the 
HITECH Act. 
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 ‘‘Secure Access For Es-
sential Reproductive Health Act of 2023’’ or the ‘‘SAFER 
Health Act of 2023’’. 
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SEC. 2. ENSURING THE PRIVACY OF PREGNANCY TERMI-
NATION OR LOSS INFORMATION UNDER THE 
HIPAA 
PRIVACY 
REGULATIONS 
AND 
THE 
HITECH ACT. 
(a) IN GENERAL.— 
(1) PROHIBITION ON DISCLOSURE.—Subject to 
paragraph (2) and nothwithstanding any provision 
in regulations promulgated pursuant to section 
264(c) of the Health Insurance Portability and Ac-
countability Act of 1996 (Public Law 104–191), a 
covered entity or business associate of such entity 
may not disclose pregnancy termination or loss in-
formation of an individual in Federal, State, local, 
or tribal proceedings, including civil, criminal, ad-
ministrative, legislative, or other proceedings, with-
out the valid authorization of the individual made in 
accordance with section 164.508 of title 45, Code of 
Federal Regulations. 
(2) EXCEPTIONS.—Paragraph (1) shall not 
apply in the case of a disclosure of pregnancy termi-
nation or loss information of an individual by a cov-
ered entity or business associate of a covered entity 
if— 
(A) such information is necessary for use 
in defense of a professional liability action or 
proceeding against the covered entity or busi-
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ness associate and such information is disclosed 
by— 
(i) the covered entity or business asso-
ciate to such covered entity’s or business 
associate’s attorney or professional liability 
insurer or insurer’s agent; or 
(ii) the authorized attorney of such 
covered entity or business associate to a 
court or body hearing such action or pro-
ceeding; or 
(B) such information is necessary to— 
(i) investigate physical harm to such 
individual by another person directly relat-
ing to the loss or termination of the preg-
nancy; and 
(ii) such individual is unable to pro-
vide consent due to death or incapacity. 
(b) HITECH.— 
(1) PRIVACY
EXCEPTION.—The Secretary of 
Health and Human Services shall revise section 
171.202 of title 45, Code of Federal Regulations, to 
clarify that an entity’s practice of not fulfilling a re-
quest to access, exchange, or use electronic health 
information in order to comply with subsection (a) 
will not be considered information blocking (as de-
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fined for purposes of such section) if such informa-
tion is pregnancy termination or loss information. 
(2) GREATER
SECURITY.—The Secretary of 
Health and Human Services shall revise section 
170.401 of title 45, Code of Federal Regulations, to 
require that as a condition of certification (as de-
scribed in such section), a health IT developer (as so 
described) shall implement practices that allow for 
the segregation of data related to pregnancy termi-
nation or loss information to ensure compliance with 
subsection (a). 
(c) MODIFICATION OF STATE PREEMPTION EXCEP-
TIONS.— 
(1) IN GENERAL.—The provisions of this sec-
tion shall preempt any State law to the extent such 
law conflicts with or prevents application of this sec-
tion. Nothing in the preceding sentence shall be con-
strued to preempt a State law to the extent that 
such law provides greater privacy protections for 
pregnancy termination or loss information than pro-
vided under this section. 
(2) MODIFICATION.—The Secretary of Health 
and Human Services shall revise section 160.203 of 
title 45, Code of Federal Regulations (or a successor 
regulation), to ensure that no exception to the gen-
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eral preemption rule stated in such section applies 
with respect to pregnancy termination or loss infor-
mation other than the exception under the second 
sentence of paragraph (1). 
(d) OUTREACH.—The Secretary of Health and 
Human Services shall conduct an outreach campaign to 
covered entities and business associates of such entities 
to ensure that such entities and associates are aware of 
the requirements of this section and any changes to regu-
lations made pursuant to this section. 
(e) PROCEDURE.—Any revisions to regulations re-
quired by application of this section shall be made by no-
tice in the Federal Register published not later than 3 
months after the date of the enactment of this section as 
an interim final rule. The Secretary of Health and Human 
Services shall, after providing opportunity for public com-
ment, finalize any such interim final rule not later than 
9 months after such interim final rule is published with 
such modifications as the Secretary determines appro-
priate. 
(f) DEFINITIONS.—In this section: 
(1) HIPAA TERMS.—The terms ‘‘business asso-
ciate’’, ‘‘covered entity’’, and ‘‘protected health infor-
mation’’ have the meaning given such terms for pur-
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poses of the regulations described in subsection 
(a)(1). 
(2) PREGNANCY TERMINATION OR LOSS INFOR-
MATION.—The term ‘‘pregnancy termination or loss 
information’’ means protected health information of 
an individual that relates to information that could 
reveal having or seeking an abortion or care for 
pregnancy loss, including without limitation, any re-
quest for or receipt of items, services, education, 
counseling, or referrals relating to the termination 
or loss of a pregnancy of such individual, including 
abortion, miscarriage, stillbirth, and ectopic preg-
nancy. 
Æ 
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