II 118th CONGRESS 1st Session S. 929 IN THE SENATE OF THE UNITED STATES March 22, 2023 Mr. Booker (for himself, Ms. Smith , Ms. Hirono , Ms. Duckworth , Mr. Blumenthal , Mr. Cardin , Mrs. Gillibrand , Mr. Markey , Mr. Merkley , Mr. Padilla , Mr. Welch , Mr. Schatz , Ms. Warren , Mr. Heinrich , Mr. Murphy , Ms. Baldwin , Ms. Klobuchar , Mr. Wyden , Mr. Sanders , Mrs. Murray , Mrs. Feinstein , Mr. Brown , Ms. Rosen , Ms. Cortez Masto , and Mr. Luján ) introduced the following bill; which was read twice and referred to the Committee on Foreign Relations A BILL To amend the Foreign Assistance Act of 1961 to authorize the use of Federal foreign assistance funds for comprehensive reproductive health care services, and for other purposes.

1. Short title This Act may be cited as the Abortion is Health Care Everywhere Act of 2023 . 2. Findings Congress makes the following findings: (1) Abortion is a critical component of sexual and reproductive health care and should be accessible and affordable for all people. (2) All people have the right to make their own choices about their sexual and reproductive health, and to access quality and affordable sexual and reproductive health care. International agreements have recognized reproductive rights for over 25 years, and the Sustainable Development Goals, which were adopted by United Nations in September 2015, reiterated the centrality of reproductive rights to gender equality. (3) Studies have repeatedly demonstrated that when people, including young women and adolescent girls, gender nonconforming individuals, and transgender men, are able to control their reproductive lives, there are enormous social and economic benefits, not just for the individual and their family, but for entire communities. Countries that prioritize reproductive health rights, justice, and human rights are more likely to have better overall health among their population. (4) Health system cost is reduced when abortion is widely available and integrated with other types of health care. (5) Without access to safe abortion care, people risk their lives to end their pregnancies. At least 24,100 people in low- and middle-income countries die every year as a result of complications from unsafe abortions. (6) Ninety-seven percent of unsafe abortions occur in developing countries in Africa, Asia, and Latin America. In low- and middle-income countries, the annual cost of post-abortion care for all who need it would be $4,000,000,000. The majority of this cost is attributed to treating complications from abortions provided in unsafe conditions. (7) Restricting abortion does not reduce either the need for, or number of, abortions. Abortion rates are similar in countries where it is highly restricted by law and where it is broadly legal. (8) As part of their commitment to prevent unsafe abortions and preventable deaths and ensure all people have access to comprehensive sexual and reproductive health care and can exercise their right to full control over their sexuality and reproduction, developing countries and donor governments must work collaboratively to deploy funding, align policies, and mobilize expertise to make safe abortion services available to those seeking to terminate pregnancies. (9) United States law restricting United States foreign assistance funding from being used to provide safe abortion services has the effect of harming people who seek to terminate their pregnancies in several ways, including by blocking access to services and erecting barriers to providers obtaining the training and equipment needed to deliver care to those in need. (10) Since section 104(f)(1) of the Foreign Assistance Act of 1961 ( 22 U.S.C. 2151b(f)(1) ) (commonly referred to as the Helms amendment ) was enacted in 1973, dozens of governments across the globe have liberalized abortion laws and policies. (11) In countries where the United States supports family planning and reproductive health care and in which abortion is legal on at least some grounds, support for safe abortion could avert over 19 million unsafe abortions and 17,000 maternal deaths each year. (12) When an abortion is performed in accordance with World Health Organization (WHO) guidelines and standards, it is a simple and safe procedure. The most recent WHO abortion guidelines recommend the full decriminalization of abortion and removal of grounds-based restrictions on abortion. (13) The Dobbs v. Jackson Women’s Health Organization (142 S. Ct. 2228 (2022)) decision goes against the global trend toward expanding access to sexual and reproductive health and rights, including abortion, and negatively impacts abortion access across the United States and globally. The decision has emboldened anti-abortion rights actors, increased abortion stigma, and created new challenges for countries that have relied on the Roe v. Wade (410 U.S. 113 (1973)) decision in the liberalization of their own laws. 3. Statement of policy It is the policy of the United States Government— (1) to recognize that safe abortion is a critical component of comprehensive maternal and reproductive health care and should be included as part of foreign assistance programs funded by the United States Government; (2) to make safe abortion widely available and integrated with other types of health care; and (3) to work to end unsafe abortion and promote safe abortion services by providing funding and collaborating with affected governments and service providers to provide training, commodities, equipment, and access to safe abortion services. 4. Authorizing the use of Federal foreign assistance funds for comprehensive reproductive health care services Section 104 of the Foreign Assistance Act of 1961 ( 22 U.S.C. 2151b ) is amended— (1) in subsection (f)— (A) by striking paragraph (1); and (B) by redesignating paragraphs (2) and (3) as paragraphs (1) and (2), respectively; (2) by redesignating subsection (g) as subsection (h); and (3) by inserting after subsection (f), as amended, the following: (g) Use of funds for comprehensive reproductive health care services Notwithstanding any other provision of law, funds made available to carry out this part may be used to provide comprehensive reproductive health care services, including abortion services, training, and equipment. .