II 118th CONGRESS 2d Session S. 3983 IN THE SENATE OF THE UNITED STATES March 20, 2024 Ms. Hirono (for herself, Ms. Duckworth , Mr. Blumenthal , Mr. Merkley , Ms. Butler , Mr. Welch , Mr. Heinrich , Mr. Padilla , Ms. Warren , and Mr. Whitehouse ) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To amend the Public Health Service Act to authorize a grant program to increase capacity for providing abortion services and other sexual and reproductive health care, and for other purposes.

1. Short title This Act may be cited as the Abortion Care Capacity Enhancement and Support Services Act of 2024 or the ACCESS Act of 2024 . 2. Findings Congress finds the following: (1) On June 24, 2022, in Dobbs v. Jackson Women’s Health Organization, the Supreme Court overturned Roe v. Wade, which had guaranteed the constitutional right to abortion. Following the decision, States were able to increase restrictions or ban access to abortion, which has exacerbated the abortion access crisis. Under this legal framework, abortion access varies widely by State. (2) Compared to April 2022, the number of abortions per month by June 2023, had dropped to zero in at least 12 States with abortion bans in place, while other States saw increases of over 2,000 abortions. (3) States that do not have an abortion ban or restrictions have experienced increased numbers of out-of-State patients seeking abortion services. Patients traveling for abortion services doubled in recent years with 1 in 5 patients crossing State lines to obtain an abortion in 2023, compared to 1 in 10 in 2020. (4) Abortion providers in States where abortion is legal have experienced an increase in the number of patients from out of State. This influx in patients has increased the demand for abortion services and strained the reproductive health care systems in many States. (5) The influx of out-of-State patients has also increased the backlogs in services and wait times for appointments in multiple States following increases in abortion bans and restrictions. To date, many facilities across the country still have reported wait times of a week or longer for abortion services. (6) The challenges to access abortion disproportionately impact individuals of color, low-income individuals, LGBTQ+ individuals, youth, and others who face existing barriers to access health care in their communities. (7) Over 15,000,000 reproductive-age women of color live in States that have banned or are likely to ban abortion following the Dobbs decision. Additionally, women of color, low-income women, young women, and women living in rural communities have been disproportionately impacted by travel for abortion services. (8) To address the challenges in accessing abortion services, proper investments need to be made to improve capacity to accommodate for both patients in State and those coming from out of State to receive comprehensive and high-quality abortion services and other sexual and reproductive health services. 3. Grants to increase capacity to provide abortion services and other sexual and reproductive health care Subpart V of part D of title III of the Public Health Service Act ( 42 U.S.C. 256 et seq. ) is amended by adding at the end the following: 340A–1. Grants to increase capacity to provide abortion services and other sexual and reproductive health care (a) In general The Secretary shall carry out a grant program consisting of awarding grants to eligible entities to increase their capacity to provide abortion services and other sexual and reproductive health care to individuals seeking to access abortion within or outside of their States of residence. (b) Eligible entities To be eligible to receive a grant under this section, an entity shall— (1) be a hospital, clinic, or other health care facility, university, nonprofit organization, community-based organization, local governmental entity, or Tribal government that, through programs, services, or activities that are unbiased and medically and factually accurate, provides or refers for abortion services; and (2) be in a State, the District of Columbia, or a commonwealth, territory, or possession of the United States where abortion services are permissible outside of exceptions for the life and health of the pregnant person. (c) Priority In awarding grants under this section, the Secretary shall give priority to eligible entities in States that, as determined by the Secretary, have experienced the highest increases of out-of-State patients seeking abortion services and other sexual and reproductive health care. (d) Authorized activities A grant under this section may be used for any of the following supplies, equipment, or services related to providing an abortion or other sexual and reproductive health care: (1) Expanding the grantee’s facilities, such as by creating more examination rooms, operation rooms, recovery areas, and other additional locations for care. (2) Purchasing medical supplies or equipment to provide reproductive health care services. (3) Administering telehealth services, which may include audio, video, and text messaging services. (4) Contracting or hiring clinical and nonclinical support staff, which may include intake coordinators, health educators, doulas, midwives, counselors, ultrasound technicians, and other relevant health care personnel. (5) Training programs to increase clinical and nonclinical support staff, which may include intake coordinators, health educators, doulas, midwives, counselors, ultrasound technicians, and other relevant health care personnel. (6) Creating and disseminating medically accurate, culturally and linguistically appropriate, accessible educational materials and resources for patients. (7) Interpretation and translation services. (8) Referrals and counseling. (9) Recovery care. (e) Application To seek a grant under this section, an eligible entity shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require, including a plan for increasing capacity as described in subsection (a). (f) Prohibition against exclusion of qualified eligible entities No Federal agency, grantee, subrecipient, or other entity shall, in the course of administering or carrying out any program or activity under this section, act in a manner which has the effect of excluding, limiting, or restricting the participation of any entity that would otherwise be eligible to apply for funds, on the basis of any factor unrelated to the entity’s qualifications to effectively carry out the program or activity. (g) Definition In this section, the term abortion services means a medical or surgical abortion and any medical or non-medical supplies, equipment, or services related to and provided in conjunction with an abortion. (h) Authorization of appropriations To carry out this section, there is authorized to be appropriated $200,000,000 for each of fiscal years 2024 through 2028. .