I 
116TH CONGRESS 
1ST SESSION 
H. R. 20 
To prohibit taxpayer funded abortions. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 17, 2019 
Mr. SMITH of New Jersey (for himself, Mr. LIPINSKI, Mr. HARRIS, Mr. BUCK, 
Mr. FLORES, Mr. GIBBS, Mr. GUTHRIE, Mr. LAMBORN, Mr. MARCHANT, 
Mr. MEADOWS, Mr. OLSON, Mr. POSEY, Mr. SMITH of Missouri, Mr. 
STEWART, Mr. CHABOT, Mr. WENSTRUP, Mr. HUNTER, Mr. ROUZER, 
Mr. CONAWAY, Mr. ALLEN, Mr. SCALISE, Mr. KEVIN HERN of Okla-
homa, Mr. LUETKEMEYER, Mr. DUNCAN, Mrs. HARTZLER, Mr. 
HUIZENGA, Mr. ABRAHAM, Mr. KINZINGER, Mr. RESCHENTHALER, Mr. 
GOHMERT, Mr. STEUBE, Mr. COLLINS of Georgia, Mr. AMASH, Mr. 
GRAVES of Missouri, Mr. NEWHOUSE, Mr. RUTHERFORD, Mr. AUSTIN 
SCOTT of Georgia, Mrs. WAGNER, Mr. WALBERG, Mr. WATKINS, Mr. 
WILSON of South Carolina, Mr. RATCLIFFE, Mr. THOMPSON of Pennsyl-
vania, Mr. COLE, Mr. TAYLOR, Mr. MOONEY of West Virginia, Mr. 
MULLIN, Mr. BUCHANAN, Mr. JONES, Mr. BERGMAN, Mr. BUDD, Ms. 
CHENEY, Mr. EMMER, Mr. HICE of Georgia, Mr. LAMALFA, Mr. MAR-
SHALL, Mr. NORMAN, Mr. DAVID P. ROE of Tennessee, Mr. ROONEY of 
Florida, Mr. SMITH of Nebraska, Mr. SMUCKER, Mr. ARRINGTON, Mr. 
BANKS, Mr. DUFFY, Mr. ESTES, Mr. FORTENBERRY, Mr. WILLIAMS, Mr. 
BIGGS, and Mr. BILIRAKIS) introduced the following bill; which was re-
ferred to the Committee on Energy and Commerce, and in addition to 
the Committees on Ways and Means, and the Judiciary, for a period to 
be subsequently determined by the Speaker, in each case for consider-
ation of such provisions as fall within the jurisdiction of the committee 
concerned 
A BILL 
To prohibit taxpayer funded abortions. 
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Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘No Taxpayer Funding for Abortion and Abortion Insur-
ance Full Disclosure Act of 2019’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
TITLE I—PROHIBITING FEDERALLY FUNDED ABORTIONS 
Sec. 101. Prohibiting taxpayer funded abortions. 
Sec. 102. Amendment to table of chapters. 
TITLE II—APPLICATION UNDER THE AFFORDABLE CARE ACT 
Sec. 201. Clarifying application of prohibition to premium credits and cost- 
sharing reductions under ACA. 
Sec. 202. Revision of notice requirements regarding disclosure of extent of 
health plan coverage of abortion and abortion premium sur-
charges. 
TITLE I—PROHIBITING FEDER-
ALLY FUNDED ABORTIONS 
SEC. 101. PROHIBITING TAXPAYER FUNDED ABORTIONS. 
Title 1, United States Code, is amended by adding 
at the end the following new chapter: 
‘‘CHAPTER 4—PROHIBITING TAXPAYER 
FUNDED ABORTIONS 
‘‘301. Prohibition on funding for abortions. 
‘‘302. Prohibition on funding for health benefits plans that cover abortion. 
‘‘303. Limitation on Federal facilities and employees. 
‘‘304. Construction relating to separate coverage. 
‘‘305. Construction relating to the use of non-Federal funds for health coverage. 
‘‘306. Non-preemption of other Federal laws. 
‘‘307. Construction relating to complications arising from abortion. 
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‘‘308. Treatment of abortions related to rape, incest, or preserving the life of 
the mother. 
‘‘309. Application to District of Columbia. 
‘‘§ 301. Prohibition on funding for abortions 
‘‘No funds authorized or appropriated by Federal 
law, and none of the funds in any trust fund to which 
funds are authorized or appropriated by Federal law, shall 
be expended for any abortion. 
‘‘§ 302. Prohibition on funding for health benefits 
plans that cover abortion 
‘‘None of the funds authorized or appropriated by 
Federal law, and none of the funds in any trust fund to 
which funds are authorized or appropriated by Federal 
law, shall be expended for health benefits coverage that 
includes coverage of abortion. 
‘‘§ 303. Limitation on Federal facilities and employees 
‘‘No health care service furnished— 
‘‘(1) by or in a health care facility owned or op-
erated by the Federal Government; or 
‘‘(2) by any physician or other individual em-
ployed by the Federal Government to provide health 
care services within the scope of the physician’s or 
individual’s employment, 
may include abortion. 
‘‘§ 304. Construction relating to separate coverage 
‘‘Nothing in this chapter shall be construed as pro-
hibiting any individual, entity, or State or locality from 
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purchasing separate abortion coverage or health benefits 
coverage that includes abortion so long as such coverage 
is paid for entirely using only funds not authorized or ap-
propriated by Federal law and such coverage shall not be 
purchased using matching funds required for a federally 
subsidized program, including a State’s or locality’s con-
tribution of Medicaid matching funds. 
‘‘§ 305. Construction relating to the use of non-Fed-
eral funds for health coverage 
‘‘Nothing in this chapter shall be construed as re-
stricting the ability of any non-Federal health benefits cov-
erage provider from offering abortion coverage, or the abil-
ity of a State or locality to contract separately with such 
a provider for such coverage, so long as only funds not 
authorized or appropriated by Federal law are used and 
such coverage shall not be purchased using matching 
funds required for a federally subsidized program, includ-
ing a State’s or locality’s contribution of Medicaid match-
ing funds. 
‘‘§ 306. Non-preemption of other Federal laws 
‘‘Nothing in this chapter shall repeal, amend, or have 
any effect on any other Federal law to the extent such 
law imposes any limitation on the use of funds for abortion 
or for health benefits coverage that includes coverage of 
abortion, beyond the limitations set forth in this chapter. 
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‘‘§ 307. Construction relating to complications arising 
from abortion 
‘‘Nothing in this chapter shall be construed to apply 
to the treatment of any infection, injury, disease, or dis-
order that has been caused by or exacerbated by the per-
formance of an abortion. This rule of construction shall 
be applicable without regard to whether the abortion was 
performed in accord with Federal or State law, and with-
out regard to whether funding for the abortion is permis-
sible under section 308. 
‘‘§ 308. Treatment of abortions related to rape, incest, 
or preserving the life of the mother 
‘‘The limitations established in sections 301, 302, 
and 303 shall not apply to an abortion— 
‘‘(1) if the pregnancy is the result of an act of 
rape or incest; or 
‘‘(2) 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 per-
formed, including a life-endangering physical condi-
tion caused by or arising from the pregnancy itself. 
‘‘§ 309. Application to District of Columbia 
‘‘In this chapter: 
‘‘(1) Any reference to funds appropriated by 
Federal law shall be treated as including any 
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amounts within the budget of the District of Colum-
bia that have been approved by an Act of Congress 
pursuant to section 446 of the District of Columbia 
Home Rule Act (or any applicable successor Federal 
law). 
‘‘(2) The term ‘Federal Government’ includes 
the government of the District of Columbia.’’. 
SEC. 102. AMENDMENT TO TABLE OF CHAPTERS. 
The table of chapters for title 1, United States Code, 
is amended by adding at the end the following new item: 
‘‘4. Prohibiting taxpayer funded abortions ............................
301’’. 
TITLE II—APPLICATION UNDER 
THE AFFORDABLE CARE ACT 
SEC. 201. CLARIFYING APPLICATION OF PROHIBITION TO 
PREMIUM CREDITS AND COST-SHARING RE-
DUCTIONS UNDER ACA. 
(a) IN GENERAL.— 
(1) DISALLOWANCE OF REFUNDABLE CREDIT 
AND
COST-SHARING
REDUCTIONS
FOR
COVERAGE 
UNDER QUALIFIED HEALTH PLAN WHICH PROVIDES 
COVERAGE FOR ABORTION.— 
(A) IN
GENERAL.—Subparagraph (A) of 
section 36B(c)(3) of the Internal Revenue Code 
of 1986 is amended by inserting before the pe-
riod at the end the following: ‘‘or any health 
plan that includes coverage for abortions (other 
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than any abortion or treatment described in 
section 307 or 308 of title 1, United States 
Code)’’. 
(B) OPTION TO PURCHASE OR OFFER SEP-
ARATE COVERAGE OR PLAN.—Paragraph (3) of 
section 36B(c) of such Code is amended by 
adding at the end the following new subpara-
graph: 
‘‘(C) SEPARATE ABORTION COVERAGE OR 
PLAN ALLOWED.— 
‘‘(i) OPTION TO PURCHASE SEPARATE 
COVERAGE OR PLAN.—Nothing in subpara-
graph (A) shall be construed as prohibiting 
any individual from purchasing separate 
coverage for abortions described in such 
subparagraph, or a health plan that in-
cludes such abortions, so long as no credit 
is allowed under this section with respect 
to the premiums for such coverage or plan. 
‘‘(ii) OPTION TO OFFER COVERAGE OR 
PLAN.—Nothing in subparagraph (A) shall 
restrict any non-Federal health insurance 
issuer offering a health plan from offering 
separate coverage for abortions described 
in such subparagraph, or a plan that in-
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cludes such abortions, so long as premiums 
for such separate coverage or plan are not 
paid for with any amount attributable to 
the credit allowed under this section (or 
the amount of any advance payment of the 
credit under section 1412 of the Patient 
Protection and Affordable Care Act).’’. 
(2) DISALLOWANCE
OF
SMALL
EMPLOYER 
HEALTH
INSURANCE
EXPENSE
CREDIT
FOR
PLAN 
WHICH INCLUDES COVERAGE FOR ABORTION.—Sub-
section (h) of section 45R of the Internal Revenue 
Code of 1986 is amended— 
(A) by striking ‘‘Any term’’ and inserting 
the following: 
‘‘(1) IN GENERAL.—Any term’’; and 
(B) by adding at the end the following new 
paragraph: 
‘‘(2) EXCLUSION OF HEALTH PLANS INCLUDING 
COVERAGE FOR ABORTION.— 
‘‘(A) IN
GENERAL.—The term ‘qualified 
health plan’ does not include any health plan 
that includes coverage for abortions (other than 
any abortion or treatment described in section 
307 or 308 of title 1, United States Code). 
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‘‘(B) SEPARATE ABORTION COVERAGE OR 
PLAN ALLOWED.— 
‘‘(i) OPTION TO PURCHASE SEPARATE 
COVERAGE OR PLAN.—Nothing in subpara-
graph (A) shall be construed as prohibiting 
any employer from purchasing for its em-
ployees separate coverage for abortions de-
scribed in such subparagraph, or a health 
plan that includes such abortions, so long 
as no credit is allowed under this section 
with respect to the employer contributions 
for such coverage or plan. 
‘‘(ii) OPTION TO OFFER COVERAGE OR 
PLAN.—Nothing in subparagraph (A) shall 
restrict any non-Federal health insurance 
issuer offering a health plan from offering 
separate coverage for abortions described 
in such subparagraph, or a plan that in-
cludes such abortions, so long as such sep-
arate coverage or plan is not paid for with 
any employer contribution eligible for the 
credit allowed under this section.’’. 
(3) CONFORMING ACA AMENDMENTS.—Section 
1303(b) of Public Law 111–148 (42 U.S.C. 
18023(b)) is amended— 
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(A) by striking paragraph (2); 
(B) by striking paragraph (3), as amended 
by section 202(a); and 
(C) by redesignating paragraph (4) as 
paragraph (2). 
(b) APPLICATION TO MULTI-STATE PLANS.—Para-
graph (6) of section 1334(a) of Public Law 111–148 (42 
U.S.C. 18054(a)) is amended to read as follows: 
‘‘(6) COVERAGE
CONSISTENT
WITH
FEDERAL 
ABORTION
POLICY.—In entering into contracts 
under this subsection, the Director shall ensure that 
no multi-State qualified health plan offered in an 
Exchange provides health benefits coverage for 
which the expenditure of Federal funds is prohibited 
under chapter 4 of title 1, United States Code.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall apply to taxable years ending after 
December 31, 2019, but only with respect to plan years 
beginning after such date, and the amendment made by 
subsection (b) shall apply to plan years beginning after 
such date. 
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SEC. 202. REVISION OF NOTICE REQUIREMENTS REGARD-
ING DISCLOSURE OF EXTENT OF HEALTH 
PLAN COVERAGE OF ABORTION AND ABOR-
TION PREMIUM SURCHARGES. 
(a) IN GENERAL.—Paragraph (3) of section 1303(b) 
of Public Law 111–148 (42 U.S.C. 18023(b)) is amended 
to read as follows: 
‘‘(3) RULES RELATING TO NOTICE.— 
‘‘(A) IN
GENERAL.—The extent of cov-
erage (if any) of services described in para-
graph (1)(B)(i) or (1)(B)(ii) by a qualified 
health plan shall be disclosed to enrollees at the 
time of enrollment in the plan and shall be 
prominently displayed in any marketing or ad-
vertising materials, comparison tools, or sum-
mary of benefits and coverage explanation made 
available with respect to such plan by the issuer 
of the plan, by an Exchange, or by the Sec-
retary, including information made available 
through an Internet portal or Exchange under 
sections 1311(c)(5) and 1311(d)(4)(C). 
‘‘(B) SEPARATE
DISCLOSURE
OF
ABOR-
TION SURCHARGES.—In the case of a qualified 
health plan that includes the services described 
in paragraph (1)(B)(i) and where the premium 
for the plan is disclosed, including in any mar-
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keting or advertising materials or any other in-
formation referred to in subparagraph (A), the 
surcharge described in paragraph (2)(B)(i)(II) 
that is attributable to such services shall also be 
disclosed and identified separately.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply to materials, tools, or other in-
formation made available more than 30 days after the date 
of the enactment of this Act. 
Æ 
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