I 
112TH CONGRESS 
1ST SESSION H. R. 1179 
To amend the Patient Protection and Affordable Care Act to protect rights 
of conscience with regard to requirements for coverage of specific items 
and services. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 17, 2011 
Mr. FORTENBERRY (for himself, Mr. BOREN, Mrs. MCMORRIS RODGERS, Mr. 
SCALISE, Mr. TIBERI, Mr. CONAWAY, Mr. LAMBORN, Mr. WALBERG, and 
Mr. LIPINSKI) introduced the following bill; which was referred to the 
Committee on Energy and Commerce 
A BILL 
To amend the Patient Protection and Affordable Care Act 
to protect rights of conscience with regard to require-
ments for coverage of specific items and services. 
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 ‘‘Respect for Rights of 
Conscience Act of 2011’’. 
SEC. 2. FINDINGS AND PURPOSES. 
(a) FINDINGS.—Congress finds the following: 
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(1) As Thomas Jefferson declared to New Lon-
don Methodists in 1809, ‘‘[n]o provision in our Con-
stitution ought to be dearer to man than that which 
protects the rights of conscience against the enter-
prises of the civil authority’’. 
(2) Jefferson’s statement expresses a conviction 
on respect for conscience that is deeply embedded in 
the history and traditions of our Nation and codified 
in numerous State and Federal laws, including laws 
on health care. 
(3) Until enactment of the Patient Protection 
and Affordable Care Act (Public Law 111–148, in 
this section referred to as ‘‘PPACA’’), the Federal 
Government has not sought to impose specific cov-
erage or care requirements that infringe on the 
rights of conscience of insurers, purchasers of insur-
ance, plan sponsors, beneficiaries, and other stake-
holders, such as individual or institutional health 
care providers. 
(4) PPACA creates a new nationwide require-
ment for health plans to cover ‘‘essential health ben-
efits’’ and ‘‘preventive services’’ (including a distinct 
set of ‘‘preventive services for women’’), delegating 
to the Department of Health and Human Services 
the authority to provide a list of detailed services 
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under each category, and imposes other new require-
ments with respect to the provision of health care 
services. 
(5) While PPACA provides an exemption for 
some religious groups that object to participation in 
Government health programs generally, it does not 
allow purchasers, plan sponsors, and other stake-
holders with religious or moral objections to specific 
items or services to decline providing or obtaining 
coverage of such items or services, or allow health 
care providers with such objections to decline to pro-
vide them. 
(6) By creating new barriers to health insur-
ance and causing the loss of existing insurance ar-
rangements, these inflexible mandates in PPACA 
jeopardize the ability of individuals to exercise their 
rights of conscience and their ability to freely par-
ticipate in the health insurance and health care mar-
ketplace. 
(b) PURPOSES.—The purposes of this Act are— 
(1) to ensure that health care stakeholders re-
tain the right to provide, purchase, or enroll in 
health coverage that is consistent with their religious 
beliefs and moral convictions, without fear of being 
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penalized or discriminated against under PPACA; 
and 
(2) to ensure that no requirement in PPACA 
creates new pressures to exclude those exercising 
such conscientious objection from health plans or 
other programs under PPACA. 
SEC. 3. RESPECT FOR RIGHTS OF CONSCIENCE. 
(a) IN GENERAL.—Section 1302(b) of the Patient 
Protection and Affordable Care Act (Public Law 111–148; 
42 U.S.C. 18022(b)) is amended by adding at the end the 
following new paragraph: 
‘‘(6) RESPECTING
RIGHTS
OF
CONSCIENCE 
WITH REGARD TO SPECIFIC ITEMS OR SERVICES.— 
‘‘(A) FOR HEALTH PLANS.—A health plan 
shall not be considered to have failed to provide 
the essential health benefits package described 
in subsection (a) (or preventive health services 
described in section 2713 of the Public Health 
Service Act), to fail to be a qualified health 
plan, or to fail to fulfill any other requirement 
under this title on the basis that it declines to 
provide coverage of specific items or services be-
cause— 
‘‘(i) providing coverage (or, in the 
case of a sponsor of a group health plan, 
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paying for coverage) of such specific items 
or services is contrary to the religious be-
liefs or moral convictions of the sponsor, 
issuer, or other entity offering the plan; or 
‘‘(ii) such coverage (in the case of in-
dividual coverage) is contrary to the reli-
gious beliefs or moral convictions of the 
purchaser or beneficiary of the coverage. 
‘‘(B) FOR
HEALTH
CARE
PROVIDERS.— 
Nothing in this title (or any amendment made 
by this title) shall be construed to require an 
individual or institutional health care provider, 
or authorize a health plan to require a provider, 
to provide, participate in, or refer for a specific 
item or service contrary to the provider’s reli-
gious beliefs or moral convictions. Notwith-
standing any other provision of this title, a 
health plan shall not be considered to have 
failed to provide timely or other access to items 
or services under this title (or any amendment 
made by this title) or to fulfill any other re-
quirement under this title because it has re-
spected the rights of conscience of such a pro-
vider pursuant to this paragraph. 
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‘‘(C) NONDISCRIMINATION IN EXERCISING 
RIGHTS
OF
CONSCIENCE.—No Exchange or 
other official or entity acting in a governmental 
capacity in the course of implementing this title 
(or any amendment made by this title) shall 
discriminate against a health plan, plan spon-
sor, health care provider, or other person be-
cause of such plan’s, sponsor’s, provider’s, or 
person’s unwillingness to provide coverage of, 
participate in, or refer for, specific items or 
services pursuant to this paragraph. 
‘‘(D) CONSTRUCTION.—Nothing in sub-
paragraph (A) or (B) shall be construed to per-
mit a health plan or provider to discriminate in 
a manner inconsistent with subparagraphs (B) 
and (D) of paragraph (4). 
‘‘(E) PRIVATE RIGHTS OF ACTION.—The 
various protections of conscience in this para-
graph constitute the protection of individual 
rights and create a private cause of action for 
those persons or entities protected. Any person 
or entity may assert a violation of this para-
graph as a claim or defense in a judicial pro-
ceeding. 
‘‘(F) REMEDIES.— 
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‘‘(i) FEDERAL
JURISDICTION.—The 
Federal courts shall have jurisdiction to 
prevent and redress actual or threatened 
violations of this paragraph by granting all 
forms of legal or equitable relief, including, 
but not limited to, injunctive relief, declar-
atory relief, damages, costs, and attorney 
fees. 
‘‘(ii) INITIATING
PARTY.—An action 
under this paragraph may be instituted by 
the Attorney General of the United States, 
or by any person or entity having standing 
to complain of a threatened or actual viola-
tion of this paragraph, including, but not 
limited to, any actual or prospective plan 
sponsor, issuer, or other entity offering a 
plan, any actual or prospective purchaser 
or beneficiary of a plan, and any individual 
or institutional health care provider. 
‘‘(iii) 
INTERIM
RELIEF.—Pending 
final determination of any action under 
this paragraph, the court may at any time 
enter such restraining order or prohibi-
tions, or take such other actions, as it 
deems necessary. 
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‘‘(G) ADMINISTRATION.—The Office for 
Civil Rights of the Department of Health and 
Human Services is designated to receive com-
plaints of discrimination based on this para-
graph and coordinate the investigation of such 
complaints. 
‘‘(H) ACTUARIAL EQUIVALENCE.—Nothing 
in this paragraph shall prohibit the Secretary 
from issuing regulations or other guidance to 
ensure that health plans excluding specific 
items or services under this paragraph shall 
have an aggregate actuarial value at least 
equivalent to that of plans at the same level of 
coverage that do not exclude such items or serv-
ices.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall be effective as if included in the enact-
ment of Public Law 111–148. 
Æ 
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