I 118th CONGRESS 2d Session H. R. 8855 IN THE HOUSE OF REPRESENTATIVES June 27, 2024 Mr. Good of Virginia (for himself, Mr. Lamborn , Mr. Duncan , and Mr. Rosendale ) introduced the following bill; which was referred to the Committee on Energy and Commerce , and in addition to the Committees on the Judiciary , Natural Resources , Ways and Means , and Oversight and Accountability , for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To amend title 18, United States Code, to protect unborn children.

1. Legislative findings and declaration of constitutional authority for enactment (a) Findings Congress finds the following: (1) The dignity of every human life is reflected in our Nation’s founding principles, Life, Liberty and the Pursuit of Happiness . (2) Abortion ends the life of a person entitled to rights under the Constitution and the laws of this Nation. Since the 1973 decision of Roe v. Wade, over 60,000,000 abortions have ended the lives of unborn children. Unborn children are among the most vulnerable and deserve full and equal protection of the law. (3) Congress exercised its authority under the Commerce Clause when it enacted the Partial-Birth Abortion Ban Act of 2003 and has used that authority to enact other criminal statutes, such as the prohibition on female genital mutilation ( 18 U.S.C. 116 ). (4) The Supreme Court has broadly interpreted Congress’ power to regulate interstate commerce, holding that it applies to activities with a substantial economic effect or that, cumulatively, affect commerce. See, e.g., NLRB v. Jones & Laughlin Steel Corp., 301 U.S. 1 (1937); United States v. Darby, 312 U.S. 657 (1941); and Wickard v. Filburn, 317 U.S. 111 (1942). (5) Abortion often involves commercial activity between states and across foreign borders. This includes the manufacturing and distribution of drugs that cause abortion and the use of equipment, instruments, and other supplies that have traveled in interstate commerce to perform surgical abortions. See, e.g., Scarborough v. United States, 431 U.S. 563 (1977). (6) Article I, section 8, clause 1 of the Constitution grants Congress broad spending powers, which Congress may attach conditions to: The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defense and general Welfare of the United States . Furthermore, in clause 18 Congress can make all Laws which shall be necessary and proper for carrying into Executive the foregoing Powers … . The Supreme Court has upheld this generally in cases like South Dakota v. Dole and in regard to abortion in Harris v. McRae. (7) Through the decision in Dobbs v. Jackson Women’s Health Organization, handed down in June 2022, the Supreme Court has redressed and corrected the grave injustice which for 50 years had been perpetuated by their decisions in Roe v. Wade, Doe v. Bolton, and Planned Parenthood v. Casey, allowing Congress and State legislators to enact legislation to limit abortion as the legislators see fit. The Court declared that the Constitution does not confer a right to abortion (Dobbs v. Jackson Women's Health Org., 142 S. Ct. 2228, 2234 (2022)). (8) The Supreme Court has held that [i]t is time to heed the Constitution and return the issue of abortion to the people’s elected representatives (Dobbs v. Jackson Women’s Health Organization, 142 S. Ct. 2228, 2243 (2022)). (9) The Supreme Court has also held that [a] law regulating abortion, like other health and welfare laws, is entitled to a strong presumption of validity. . . . It must be sustained if there is a rational basis on which the legislature could have thought that it would serve legitimate State interests . . . These legitimate interests include respect for and preservation of prenatal life at all stages of development . . . ; the protection of maternal health and safety; the elimination of particularly gruesome or barbaric medical procedures; the preservation of the integrity of the medical profession; the mitigation of fetal pain; and the prevention of discrimination on the basis of race, sex, or disability. (Dobbs v. Jackson Women’s Health Organization, 142 S. Ct. at 2239). (10) Medical and other authorities now know more about human prenatal development than ever before, including that life begins at the moment of conception and the child in a woman's womb is a human being. (11) Even if there exists some degree of uncertainty about an aspect of prenatal development, the Supreme Court has held that Congress and State legislatures retain wide discretion to pass legislation (Gonzales v. Carhart, 550 U.S. at 163). The law need not give abortion doctors unfettered choice in the course of their medical practice, nor should it elevate their status above other physicians in the medical community (Gonzales v. Carhart, 550 U.S. at 163). Medical uncertainty does not foreclose the exercise of legislative power in the abortion context any more than it does in other contexts (Gonzales v. Carhart, 550 U.S. at 164). (12) Scientific evidence and personal testimonies document the massive harm that abortion causes to women. Abortion heightens the risk of mental health issues with studies showing that after an abortion women are 34 percent more likely to develop anxiety disorders, 37 percent more likely to develop depression, 110 percent more likely to rely on alcohol use or abuse, 115 percent more likely to develop suicidal behavior, and 220 percent more likely to take on marijuana use or abuse. As many as 60 percent of women having an abortion experience some level of emotional distress afterwards, with 30 percent being classified as severe distress. Abortion also includes risks to physical health such as heavy or persistent bleeding, damage to cervix, abdominal pain or cramping, scarring of uterine lining, breast cancer, future premature births or miscarriages, infection or sepsis, placenta previa, perforation of uterus, damage to other organs, and even death. (13) More than 50 percent of abortions nationwide are committed by chemical abortion. Many of these abortions are obtained through telehealth visits and without the supervision of a licensed medical care professional. (14) Every State has enacted a safe haven law, relieving the responsibility of childcare for parents who do not wish to care for a child. (15) Public attitudes favoring adoption have created a culture of adoption in the United States, with many families waiting long periods of time to adopt newborn infants. (16) Abortion disproportionately affects minority communities. Black babies are 3.4 times more likely to be aborted as White babies. An estimated 19,000,000 Black babies have been killed by abortion since 1973. Minorities have been the unwitting victims of a hidden racist agenda of the abortion industry for over 50 years. (b) Purpose It is the intent of this Act to ensure that abortion is abolished and to protect the lives of unborn children. 2. Prohibition against certain abortion measures (a) In general Chapter 74 of title 18, United States Code, is amended by amending section 1531 to read as follows: 1531. Prohibition against certain abortion measures (a) Criminal offense Notwithstanding any other provision of law, a licensed physician who— (1) in the circumstances described in subsection (d), intentionally performs or attempts to perform an abortion at any point after fertilization; or (2) receives any Federal funds under any covered program that intentionally performs or attempts to perform an abortion at any point after fertilization, shall be guilty of a class D felony. . (b) Civil Remedies (1) Without consent A woman upon whom an abortion was performed or attempted, without consent or that occurred under duress, fraud, or inducement, may bring in an appropriate court a civil action against the licensed physician in violation of subsection (a) to obtain appropriate relief. (2) Remedy for parent of a minor A parent of a minor upon whom an abortion has been performed or attempted may bring in an appropriate court a civil action against the licensed physician in violation of subsection (a) to obtain appropriate relief. (3) Appropriate relief defined In this subsection, the term appropriate relief includes— (A) money damages for all injuries, psychological and physical, occasioned by the violation of this section; (B) statutory damages equal to the amount that is three times the cost of the abortion; (C) punitive damages; and (D) reasonable attorneys’ fees and costs. (c) Affirmative defense It is an affirmative defense to prosecution under this section if— (1) a licensed physician provides medical treatment to a pregnant woman which results in the accidental or unintentional injury or death to an unborn child; or (2) the abortion was performed with the purpose of— (A) saving the life of a pregnant woman whose life is endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy itself, but not including psychological or emotional conditions; (B) removing a dead unborn child caused by miscarriage or stillbirth; or (C) removing an ectopic pregnancy. (d) Circumstances described For the purposes of subsection (a), the circumstances described are that: (1) The licensed physician performed an abortion using a means, channel, facility, or instrumentality of interstate or foreign commerce in furtherance of or in connection with the conduct described in subsection (a). (2) A payment of any kind was made, directly or indirectly, in furtherance of or in connection with the conduct described in subsection (a) using any means, channel, facility, or instrumentality of interstate or foreign commerce or in or affecting interstate or foreign commerce. (3) Any instrument, item, substance, or other object that has traveled in interstate or foreign commerce was used to perform the conduct described in subsection (a). (4) The conduct described in subsection (a) occurred within the special maritime and territorial jurisdiction of the United States, or any territory or possession of the United States. (5) The conduct described in subsection (a) otherwise occurred in or affected interstate or foreign commerce. (6) The conduct described in subsection (a) occurred in the District of Columbia. (7) The conduct described in subsection (a) occurred in a health care facility owned or operated by the Federal Government. (e) Rules of construction (1) In general Nothing in this section shall be construed to— (A) authorize the criminal prosecution or conviction of a woman with the death of her own unborn child; (B) impose civil or criminal liability on a woman upon whom an abortion is performed or attempted; (C) prohibit the administration of misoprostol for the purposes of treatment of a miscarriage or stillbirth; or (D) prohibit the sale, use, prescription, or administration of contraception, if the contraception is sold, used, prescribed or administered in accordance with manufacturer instructions or for non-life-ending purposes. (2) State legislation Nothing in this section shall be construed to override or enforce a greater penalty established by State law with respect to the protection of the life of an unborn child at any point after fertilization. (f) Definitions In this section: (1) Abortion The term abortion means the act of using, prescribing, administering, procuring, or selling any instrument, medicine, drug, or any other substance, device, or means with the purpose to terminate a pregnancy of a woman, with knowledge that the termination by any of those means will with reasonable likelihood cause the death of the unborn child. (2) Contraception The term contraception is a measure, drug, or chemical that prevents a pregnancy before fertilization. (3) Covered program The term covered program means: (A) The program for medical assistance established under title XIX of the Social Security Act. (B) The State children's health insurance program established under title XXI of the Social Security Act. (C) The Indian Health Service. (D) The Veterans Health Administration. (E) The TRICARE program (as such program is defined in section 1072(7) of title 10). (F) Any project grant or contract for family planning services awarded under title X of the Public Health Services Act. (4) Fertilization The term fertilization means the fusion of a human spermatozoon with a human ovum. (5) Licensed physician The term licensed physician means a doctor of medicine or osteopathy legally authorized to practice medicine and surgery by the State in which the doctor performs such activity, or any other individual legally authorized by the State to perform abortions. (6) Miscarriage The term miscarriage is the spontaneous loss of pregnancy before 20 weeks of pregnancy. (7) Stillbirth The term stillbirth means the loss of a baby at or after 20 weeks of pregnancy. (8) Unborn child The term unborn child means an individual organism of the species Homo sapiens from fertilization until live birth. . (b) Table of contents The table of contents for chapter 74 of title 18, United States Code, the item relating to section 1531 is amended to read as follows: 1531. Prohibition against certain abortion measures. . (c) Chapter heading The header of chapter 74 of title 18, United States Code, is amended by striking Partial-birth Abortions and inserting Abortions . 3. Prohibition of abortions in health programs that accept Federal funds (a) Medicaid Section 1902 of the Social Security Act ( 42 U.S.C. 1396a ) is amended by adding at the end the following new subsection: (uu) Prohibition on State plan coverage of abortion Notwithstanding subsection (b), beginning on January 1 of the second year beginning on or after the date of the enactment of this subsection, the Secretary may not approve a State plan for medical assistance under this section, and shall revoke any such plan in effect as of such date, if such State plan provides payment for abortion (as such term is defined in section 1531 of title 18) furnished at any point after fertilization, except to save the life of a pregnant woman whose life is endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy itself, but not including psychological or emotional conditions. . (b) Children’s Health Insurance Program (1) In general Section 2107(e)(1) of the Social Security Act ( 42 U.S.C. 1397gg(e)(1) ) is amended by adding at the end the following new subparagraph: (U) Section 1902(uu) (relating to prohibition on payment for abortion). . (2) Conforming amendments (A) Limitation on funds provided to State Section 2105(c)(1) of the Social Security Act ( 42 U.S.C. 1397ee(c)(1) ) is amended by striking the mother or if the pregnancy is the result of an act of rape or incest and inserting a pregnant woman whose life is endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy itself, but not including psychological or emotional conditions . (B) Child health assistance defined Section 2110(a)(16) of the Social Security Act ( 42 U.S.C. 1397jj(a)(16) ) is amended by striking the mother or if the pregnancy is the result of an act of rape or incest and inserting a pregnant woman whose life is endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy itself, but not including psychological or emotional conditions . (c) Amendment to Indian Health Care Improvement Act Title II of the Indian Health Care Improvement Act ( 25 U.S.C. 1621 et seq. ) is amended by adding at the end a new section: 227. Prohibition against offering an abortion Amounts appropriated to carry out this title may not be used to offer an abortion (as such term is defined in section 1531 of title 18, United States Code) at any point after fertilization, except to save the life of a pregnant woman whose life is endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy itself, but not including psychological or emotional conditions. . (d) Amendment to Title X Section 1008 of the Public Health Service Act ( 42 U.S.C. 300a–6 ) is amended to read as follows: 1008. Prohibition of abortion (a) No funds may be made available under this title to any public or private entity if such entity or any affiliate or agency thereof offers abortions at any point after fertilization, except to save the life of a pregnant woman whose life is endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy itself, but not including psychological or emotional conditions. (b) In this section: (1) The term abortion has the meaning given to such term in section 1531 of title 18, United States Code. (2) The term affiliate means any company that controls, is controlled by, or is under common control with an entity referred to in subsection (a). . (e) Table of contents amendment The table of contents for title II of the Indian Health Care Improvement Act ( 25 U.S.C. 1621 et seq. ) is amended by adding at the end the following: 227. Prohibition against offering an abortion. . 4. Prohibition on group health coverage for abortions (a) Prohibiting coverage under group health plans and group and individual health insurance (1) In general Subpart II of part A of the Public Health Service Act ( 42 U.S.C. 300gg–11 et seq. ) is amended by adding at the end the following new section: 2730. Prohibition on coverage for abortion (a) In general A group health plan, and a health insurance issuer offering group or individual health insurance coverage, may not provide coverage for abortion (as such term is defined in section 1531 of title 18) at any point after fertilization, except to save the life of a pregnant woman whose life is endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy itself, but not including psychological or emotional conditions. (b) Rule of construction Nothing in this section shall be construed to prohibit the coverage of items or services that are furnished in order to— (1) remove a dead unborn child caused by miscarriage or stillbirth, or (2) remove an ectopic pregnancy. . (2) Effective date The amendments made by this subsection shall apply to plan years beginning on or after January 1 of the second year beginning on or after the date of the enactment of this subsection. (b) Application of abortion prohibition to premium credits and cost-Sharing reductions under ACA (1) In general Section 36B(c)(3)(A) of the Internal Revenue Code of 1986 ( 26 U.S.C. 36B(c)(3)(A) ) is amended by inserting before the period at the end the following: or a health plan that includes coverage for abortion (as such term is defined in section 1531 of title 18) furnished at any point after fertilization, except to save the life of a pregnant woman whose life is endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy itself, but not including psychological or emotional conditions . (2) Conforming ACA amendments Section 1303 of Public Law 111–148 ( 42 U.S.C. 18023 ) is amended— (A) in subsection (a)(1), by striking abortion coverage and inserting coverage of abortions described in subsection (b)(1)(B)(ii) ; and (B) in subsection (b)— (i) in paragraph (1)— (I) in the paragraph heading, by striking Voluntary choice of coverage of and inserting Prohibition on coverage of certain ; (II) in subparagraph (A)— (aa) in clause (i)— (AA) by striking subparagraph (B)(i) or ; and (BB) by striking and at the end; (bb) in clause (ii)— (AA) by striking subparagraph (B)(i) or ; and (BB) by striking the period at the end and inserting ; and ; and (cc) by adding at the end the following new clause: (iii) the issuer of a qualified health plan may not provide coverage of services described in subparagraph (B)(i). ; and (III) by amending subparagraph (B) to read as follows: (B) Abortion services (i) Prohibited abortion services The services described in this clause are any abortions (as such term is defined in section 1531 of title 18) furnished after fertilization that are not described in clause (ii). (ii) Permitted abortion services The services described in this clause are only abortions that are furnished to save the life of a pregnant woman whose life is endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy itself, but not including psychological or emotional conditions. ; (ii) by striking paragraphs (2) and (3); and (iii) by redesignating paragraph (4) as paragraph (2). (3) Application to multi-State plans Section 1334(a)(6) of Public Law 111–148 ( 42 U.S.C. 18054(a)(6) ) is amended— (A) in the paragraph heading, by striking Assured availability of varied coverage and inserting Prohibition of certain abortion coverage ; and (B) by striking there is at least one such plan that does not and inserting such plans do not . (4) Effective date The amendments made by paragraphs (1) and (2) shall apply to taxable years ending after January 1 of the second year beginning on or after the date of the enactment of this subsection, but only with respect to plan years beginning on or after such date, and the amendments made by paragraph (3) shall apply to plan years beginning on or after such date. (c) Amendment to title 5 Section 8902 of title 5, United States Code, is amended by adding at the end the following: (q) A contract may not be made or a plan approved that includes an obstetrical benefit that includes coverage for an abortion (as defined in section 1531 of title 18), except to save the life of a pregnant woman whose life is endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy itself, but not including a psychological or emotional condition. .