No Taxpayer Funding for Abortion and Abortion Insurance Full Disclosure Act of 2021
Bill: H.R.18 | Sponsor: Rep. Smith, Christopher H. (R-NJ)
Policy area: Health

Summary:
No Taxpayer Funding for Abortion and Abortion Insurance Full Disclosure Act of 2021
This bill modifies provisions relating to federal funding for, and health insurance coverage of, abortions.
Specifically, the bill prohibits the use of federal funds for abortions or for health coverage that includes abortions. Such restrictions extend to the use of funds in the budget of the District of Columbia. Additionally, abortions may not be provided in a federal health care facility or by a federal employee.
Historically, language has been included in annual appropriations bills for the Department of Health and Human Services (HHS) that prohibits the use of federal funds for abortions—such language is commonly referred to as the Hyde Amendment. Similar language is also frequently included in appropriations bills for other federal agencies and the District of Columbia. The bill makes these restrictions permanent and extends the restrictions to all federal funds (rather than specific agencies).
The bill's restrictions regarding the use of federal funds do not apply in cases of rape, incest, or where a physical disorder, injury, or illness endangers a woman's life unless an abortion is performed. The Hyde Amendment provides the same exceptions.
The bill also prohibits qualified health plans from including coverage for abortions. Currently, qualified health plans may cover abortion, but the portion of the premium attributable to abortion coverage is not eligible for subsidies.

To prohibit taxpayer funded abortions.

    Be it enacted by the Senate and House of Representatives 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 Insurance Full Disclosure Act of 
2021''.
    (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 surcharges.

            TITLE I--PROHIBITING FEDERALLY 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.
``308. Treatment of abortions related to rape, incest, or preserving 
                            the life of the mother.
``309. Application to District of Columbia.
``Sec. 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.
``Sec. 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.
``Sec. 303. Limitation on Federal facilities and employees
    ``No health care service furnished--
            ``(1) by or in a health care facility owned or operated by 
        the Federal Government; or
            ``(2) by any physician or other individual employed by the 
        Federal Government to provide health care services within the 
        scope of the physician's or individual's employment,
may include abortion.
``Sec. 304. Construction relating to separate coverage
    ``Nothing in this chapter shall be construed as prohibiting any 
individual, entity, or State or locality from 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 appropriated 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 contribution of Medicaid 
matching funds.
``Sec. 305. Construction relating to the use of non-Federal funds for 
              health coverage
    ``Nothing in this chapter shall be construed as restricting the 
ability of any non-Federal health benefits coverage provider from 
offering abortion coverage, or the ability 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, including a State's or locality's 
contribution of Medicaid matching funds.
``Sec. 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.
``Sec. 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 disorder that has been 
caused by or exacerbated by the performance 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 without 
regard to whether funding for the abortion is permissible under section 
308.
``Sec. 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 performed, including a life-endangering 
        physical condition caused by or arising from the pregnancy 
        itself.
``Sec. 309. Application to District of Columbia
    ``In this chapter:
            ``(1) Any reference to funds appropriated by Federal law 
        shall be treated as including any amounts within the budget of 
        the District of Columbia 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 REDUCTIONS 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 period at the end the 
                following: ``or 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)''.
                    (B) Option to purchase or offer separate coverage 
                or plan.--Paragraph (3) of section 36B(c) of such Code 
                is amended by adding at the end the following new 
                subparagraph:
                    ``(C) Separate abortion coverage or plan allowed.--
                            ``(i) Option to purchase separate coverage 
                        or plan.--Nothing in subparagraph (A) shall be 
                        construed as prohibiting any individual from 
                        purchasing separate coverage for abortions 
                        described 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 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 includes 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.--
        Subsection (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).
                    ``(B) Separate abortion coverage or plan allowed.--
                            ``(i) Option to purchase separate coverage 
                        or plan.--Nothing in subparagraph (A) shall be 
                        construed as prohibiting any employer from 
                        purchasing for its employees separate coverage 
                        for abortions described 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 includes such abortions, so long as 
                        such separate 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--
                    (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.--Paragraph (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, 2021, 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.

SEC. 202. REVISION OF NOTICE REQUIREMENTS REGARDING DISCLOSURE OF 
              EXTENT OF HEALTH PLAN COVERAGE OF ABORTION AND ABORTION 
              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 coverage (if any) 
                of services described in paragraph (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 advertising materials, comparison tools, 
                or summary of benefits and coverage explanation made 
                available with respect to such plan by the issuer of 
                the plan, by an Exchange, or by the Secretary, 
                including information made available through an 
                Internet portal or Exchange under sections 1311(c)(5) 
                and 1311(d)(4)(C).
                    ``(B) Separate disclosure of abortion 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 
                marketing or advertising materials or any other 
                information 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 information made available more 
than 30 days after the date of the enactment of this Act.
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