HOPE Act

Bill: 118-hr-1126
Sponsor: full_name: Rep. Fischbach, Michelle [R-MN-7]
Introduced: 2023-02-21
Policy area: Crime and Law Enforcement
Subjects: Abortion

Civil actions and liability

Computers and information technology

Congressional oversight

Emergency communications systems

Family planning and birth control

Family relationships

Government information and archives

Health care coverage and access

Health information and medical records

Health personnel

Health programs administration and funding

Health technology, devices, supplies

Mental health

Rural conditions and development

Sex and reproductive health

Women's health
Latest action: action_date: 2023-03-03
text: Referred to the Subcommittee on Health.

Summaries:
action_date: 2023-02-21
action_desc: Introduced in House
text: <p><b>Health, Opportunity, Protecting life, Education Act or the HOPE Act</b></p> <p>This bill provides funding for grants and other activities related to maternal care. It also establishes informed consent and parental notification requirements for abortion providers.</p> <p>The Department of Health and Human Services (HHS) must award grants to (1) entities that provide maternal care in rural and medically underserved areas and on tribal lands for purchasing equipment to conduct at-home telehealth visits; and (2) nonprofits (excluding those that provide abortions) for providing, at no cost, information about and referrals for medical care, nutritional services, and other social supports to encourage pregnant women to continue their pregnancies and care for the infants. Additionally, HHS must also disseminate, through a public website, pregnancy-related resources that are available through federal, state, and local governments and private entities.</p> <p>Further, abortion providers must obtain informed consent 24 hours before performing an abortion through a form that must be signed by the woman seeking the abortion, and the bill specifies information that must be contained in the form, such as medical risks. Abortion providers must also notify parents at least 24 hours prior to performing an abortion on an individual who is under 18. The bill outlines specified exceptions to, enforcement mechanisms for, and civil penalties for violations of the informed consent and parental notification requirements.</p> <p>The bill also prohibits federal funding of Planned Parenthood of America, Inc. or its affiliates, subject to certain exceptions, for one year following the enactment of the bill.</p>

tv_txt: I 118th CONGRESS 1st Session H. R. 1126 IN THE HOUSE OF REPRESENTATIVES February 21, 2023 Mrs. Fischbach introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To make improvements in prenatal and maternal care, and for other purposes.

1. Short title This Act may be cited as the Health, Opportunity, Protecting life, Education Act or the HOPE Act . 2. Table of contents The table of contents for this Act is as follows: Sec. 1. Short title. Sec. 2. Table of contents. Title I—Alternatives to abortion Sec. 101. Improving access to prenatal telehealth care. Sec. 102. Positive alternatives for women. Sec. 103. Educated decisions on maternal health. Sec. 104. Life.Gov: awareness for expecting mothers. Sec. 105. Parental notification. Sec. 106. Moratorium on Federal funding to Planned Parenthood Federation of America, Inc. Sec. 107. Funding. Title II—General provisions Sec. 201. Rule of construction. I Alternatives to abortion 101. Improving access to prenatal telehealth care (a) In general The Secretary of Health and Human Services shall award grants or cooperative agreements to eligible entities to purchase equipment necessary for carrying out at-home telehealth visits for screening, monitoring, and management of prenatal and postnatal care for the purpose of improving maternal and infant health outcomes, and reducing maternal mortality, by improving access to care in rural areas, frontier counties, medically underserved areas, or jurisdictions of Indian Tribes and Tribal organizations. (b) Use of funds A recipient of a grant under this section shall use the grant as described in subsection (a), which may include purchasing or providing equipment necessary for carrying out at-home telehealth visits (such as remote physiologic devices and related services, including pulse oximeters, blood pressure cuffs, scales, and blood glucose monitors) to screen, monitor, and manage prenatal and postnatal care at home by means of telehealth visits and services for the purpose described in subsection (a). (c) Report to Congress Not later than September 30, 2028, the Secretary shall submit to the Congress a report on activities supported through grants under this section, including— (1) a description of the activities conducted pursuant to such grants; and (2) an analysis of the effects of such grants on improving prenatal and postnatal care in areas and jurisdictions described in subsection (a). (d) Definitions In this section: (1) The term eligible entity means an entity providing prenatal care, labor care, birthing, and postpartum care services in a rural area, a frontier county, a medically underserved area, or the jurisdiction of an Indian Tribe or Tribal organization. (2) The term frontier county has the meaning given such term in section 1886(d)(3)(E)(iii)(III) of the Social Security Act ( 42 U.S.C. 1395ww(d)(3)(E)(iii)(III) ). (3) The terms Indian Tribe and Tribal organization have the meanings given to such terms in section 4 of the Indian Self-Determination and Education Assistance Act ( 25 U.S.C. 5304 ). (4) The term medically underserved area means a health professional shortage area designated under section 332 of the Public Health Service Act ( 42 U.S.C. 254e ). (5) The term rural area has the meaning given to such term in section 330J(e) of the Public Health Service Act ( 42 U.S.C. 254c–15(e) ). (6) The term Secretary means the Secretary of Health and Human Services. (e) Authorization of appropriations To carry out this section, there are authorized to be appropriated such sums as may be necessary for fiscal years 2024 through 2029. 102. Positive alternatives for women (a) Program authority (1) Purpose The purpose of grants under this section shall be to support, encourage, and assist women— (A) to carry their pregnancies to term; and (B) to care for their babies after birth. (2) Grants For the purpose described in paragraph (1), the Secretary shall award grants to eligible entities described in subsection (b) to provide information on, referral to, and direct services as described in subsection (c). (b) Eligibility (1) Eligible entities To be eligible for a grant under this section, an entity shall— (A) be a nonprofit organization; (B) support, encourage, and assist women as described in subsection (a)(1); (C) agree to be subject to such monitoring and review as the Secretary may require under subsection (g); (D) agree to not charge women for services provided through the grant; (E) provide each pregnant woman counseled through the grant with accurate information on the developmental characteristics of babies and of unborn children, including offering printed information; and (F) have a privacy policy and procedures in place to ensure that— (i) the name, address, telephone number, or any other information that might identify any woman seeking services supported through the grant is not made public or shared with any other entity without the written consent of the woman; and (ii) the grantee adheres to requirements comparable to those applicable under the HIPAA privacy regulation (as defined in section 1180(b)(3) of the Social Security Act ( 42 U.S.C. 1320d–9 )) to covered entities (as defined for purposes of such regulation). (2) Ineligible entities An entity shall be ineligible to receive a grant under this section if the entity or any affiliate, subsidiary, successor, or clinic thereof— (A) performs, induces, refers for, or counsels in favor of abortions; or (B) provides financial support to any other entity that conducts any activity described in subparagraph (A). (3) Financial records As a condition on receipt of a grant under this section, an eligible entity shall agree to maintain and make available to the Secretary records, including financial records, that demonstrate that the entity satisfies the requirements of paragraph (1) and is not ineligible by operation of paragraph (2). (c) Covered services (1) Required information and referral For the purpose described in subsection (a)(1), an eligible entity receiving a grant under this section shall use the grant to provide information on, and referral to, each of the following services: (A) Medical care. (B) Nutritional services. (C) Housing assistance. (D) Adoption services. (E) Education and employment assistance, including services that support the continuation and completion of high school. (F) Child care assistance. (G) Parenting education and support services. (H) Voluntary substance abuse counseling and treatment. (2) Permissible direct provision of services For the purpose described in subsection (a)(1), in addition to using a grant under this section as described in paragraph (1), an eligible entity receiving a grant under this section may use the grant for the direct provision of one or more services listed in paragraph (1). (d) Prohibited uses of funds None of the funds made available under this section shall be used— (1) for health benefits coverage that includes coverage of abortion; (2) for providing or assisting a woman to obtain adoption services from a provider of adoption services that is not licensed; and (3) for any of the activities described in subsection (b)(2). (e) Approval of information as medically accurate As a condition on the receipt of a grant under this section, an eligible entity shall refrain from providing any information pursuant to the grant on the health risks associated with abortions other than information that has been approved by the Secretary as medically accurate. (f) Consideration In selecting the recipients of grants under this section, the Secretary shall consider each applicant’s demonstrated capacity in providing services to assist a pregnant woman in carrying her pregnancy to term. (g) Monitoring and review The Secretary shall— (1) monitor and review each program funded through a grant under this section to ensure that the grantee carefully adheres to— (A) the purpose described in subsection (a)(1); and (B) the requirements of this section; and (2) cease to fund a program under this section if the grantee fails to adhere to such purpose and requirements. (h) Definitions In this section: (1) Abortion The term abortion means the use or prescription of any instrument, medicine, drug, or any other substance or device to intentionally— (A) kill the unborn child of a woman known to be pregnant; or (B) terminate the pregnancy of a woman known to be pregnant, with an intention other than— (i) after viability, to produce a live birth and preserve the life and health of the child born alive; (ii) to remove a dead unborn child; or (iii) to treat an ectopic pregnancy. (2) Secretary The term Secretary means the Secretary of Health and Human Services. (i) Authorization of appropriations To carry out this section, there are authorized to be appropriated such sums as may be necessary for fiscal years 2024 through 2029. 103. Educated decisions on maternal health (a) In general (1) Requirement of compliance by providers Any abortion provider, acting in or affecting interstate or foreign commerce, who knowingly performs, or attempts to perform, any abortion shall comply with the requirements of this section. (2) Review of medical risks and unborn health status An abortion provider who intends to perform, or attempt to perform, an abortion may not perform any part of the abortion procedure without first obtaining a signed Informed Consent Authorization form in accordance with this subsection. (3) Informed consent authorization form (A) In general The Informed Consent Authorization form required under this subsection shall— (i) be presented in person by the abortion provider 24 hours prior to performing, or attempting to perform, the abortion to the woman seeking the abortion; and (ii) consist of— (I) a statement, in easily understandable common language, by the abortion provider indicating— (aa) the probable gestational age, in completed days, of the child; (bb) all medical risks associated with the specific abortion procedure; and (cc) the major developmental characteristics of unborn children at such gestational age, including the presence of a heartbeat, the ability to react to painful stimuli, and the development of organs, fingers, and facial features; (II) a statement, in easily understandable common language, that the requirements of this subsection are binding upon the abortion provider and all other medical personnel, that such abortion providers and medical personnel are subject to criminal and civil penalties for violations of these requirements, and that a woman on whom an abortion has been performed may take civil action if these requirements are not followed; and (III) an affirmation that each individual signing the Informed Consent Authorization form has filled out the form to the best of his or her knowledge and understands the information contained in the form. (B) Signatories required The Informed Consent Authorization form required under this subsection shall be signed in person by the woman seeking the abortion, the abortion provider performing or attempting to perform the abortion, and a witness. (C) Retention of consent form The abortion provider performing or attempting to perform an abortion shall retain the signed Informed Consent Authorization form required under this subsection in the patient's medical file. (D) Requirement for data retention Paragraph (j)(2) of section 164.530 of title 45, Code of Federal Regulations, shall apply to the Informed Consent Authorization form required to be placed in a patient's medical file pursuant to subparagraph (C) in the same manner and to the same extent as such paragraph applies to documentation required by paragraph (j)(1) of such section. (E) Copy of form A copy of the signed Informed Consent Authorization required under this subsection shall be provided to the woman seeking an abortion. (4) Exceptions The requirements of this subsection shall not apply if, in reasonable medical judgment, compliance with paragraph (2) would pose a greater risk of— (A) the death of the pregnant woman; or (B) the substantial and irreversible physical impairment of a major bodily function, not including psychological or emotional conditions, of the pregnant woman. (b) Penalty for failure To comply (1) Civil penalty (A) Enforcement by Attorney General The Attorney General shall commence a civil action in an appropriate district court of the United States under this subsection against any abortion provider who knowingly commits a violation of subsection (a). (B) Penalty In a civil action under subparagraph (A), the court may, to vindicate the public interest, assess a civil penalty against the abortion provider in an amount— (i) not less than $100,000 and not more than $150,000, for each such violation that is adjudicated in the first proceeding against such abortion provider under this subsection; or (ii) not less than $150,001 and not more than $250,000, for each such violation that is adjudicated in a subsequent proceeding against such abortion provider under this subsection. (C) Notification Upon the assessment of a civil penalty under subparagraph (B), the Attorney General shall notify the appropriate State medical licensing authority. (D) No penalties for pregnant women A pregnant woman shall not be subject to any penalty under this section. (2) Private right of action (A) In general A woman or a parent of a minor upon whom an abortion has been performed in violation of subsection (a) may commence a civil action against the abortion provider for appropriate relief. (B) Appropriate relief Appropriate relief in a civil action under this paragraph includes— (i) objectively verifiable money damages for all injuries, psychological and physical, occasioned by the violation; (ii) statutory damages equal to 3 times the cost of the abortion; and (iii) punitive damages. (C) Attorney's fees for plaintiff The court shall award a reasonable attorney's fee as part of the costs to a prevailing plaintiff in a civil action under this paragraph. (D) Attorney's fees for defendant If a defendant in a civil action under this paragraph prevails and the court finds that the plaintiff's suit was frivolous, the court shall award a reasonable attorney's fee in favor of the defendant against the plaintiff. (E) Awards against woman In any civil action under this paragraph, no damages or other monetary relief, and no attorney's fees except as provided under subparagraph (D), may be assessed against the woman upon whom the abortion was performed or attempted. (c) Preemption Nothing in this title or the amendments made by this title shall be construed to preempt any provision of State law to the extent that such State law establishes, implements, or continues in effect disclosure requirements regarding abortion or penalties for failure to comply with such requirements that are more extensive than those provided under the amendment made by this title. (d) Rule of construction Nothing in this title shall be construed to prohibit an abortion provider from presenting the information required under subsection (a) to a pregnant woman at the same time as acquiring informed consent for an abortion from such woman in accordance with State law, provided that the presentation of such information occurs at least 24 hours before the abortion. (e) Definitions In this section: (1) Abortion The term abortion means the use or prescription of any instrument, medicine, drug, or any other substance or device to intentionally— (A) kill the unborn child of a woman known to be pregnant; or (B) terminate the pregnancy of a woman known to be pregnant, with an intention other than— (i) after viability, to produce a live birth and preserve the life and health of the child born alive; (ii) to remove a dead unborn child; or (iii) to treat an ectopic pregnancy. (2) Abortion provider The term abortion provider means a person— (A) licensed to practice medicine and surgery or osteopathic medicine and surgery; or (B) otherwise legally authorized to perform an abortion. (3) Attempt The term attempt , with respect to an abortion, means conduct that, under the circumstances as the actor believes them to be, constitutes a substantial step in a course of conduct planned to culminate in performing an abortion. (4) Minor The term minor means an individual who has not attained the age of 18 years. (5) Perform The term perform , with respect to an abortion, includes inducing an abortion through a medical or chemical intervention including writing a prescription for a drug or device intended to result in an abortion. (6) Reasonable medical judgment The term reasonable medical judgment means a medical judgment that would be made by a reasonably prudent abortion provider, knowledgeable about the case and the treatment possibilities with respect to the medical conditions involved. (7) Unborn child The term unborn child means an individual organism of the species homo sapiens, beginning at fertilization, until the point of being born alive as defined in section 8(b) of title 1, United States Code. (8) Woman The term woman means a female human being whether or not she has reached the age of majority. 104. Life.Gov: awareness for expecting mothers The Public Health Service Act ( 42 U.S.C. 201 et seq. ) is amended by adding at the end the following: XXXIV AWARENESS FOR EXPECTING MOTHERS 3401. Website and portal (a) Website Not later than 1 year after the date of enactment of this section, the Secretary shall publish a user-friendly public website, life.gov, to provide a comprehensive list of Federal, State, local governmental, and private resources available to pregnant women including— (1) resources to mental health counseling, pregnancy counseling, and other prepartum and postpartum services; (2) comprehensive information on alternatives to abortion; (3) information about abortion risks, including complications and failures; and (4) links to information on child development from moment of conception. (b) Portal Not later than 1 year after the date of enactment of this section, the Secretary shall publish a portal on the public website of the Department of Health and Human Services that— (1) through a series of questions, will furnish specific tailored information to the user on what pregnancy-related information they are looking for, such as— (A) Federal, State, local governmental, and private resources that may be available to the woman within her ZIP Code, including the resources specified in subsection (c); and (B) risks related to abortion at all stages of fetal gestation; and (2) provides for the submission of feedback on how user-friendly and helpful the portal was in providing the tailored information the user was seeking. (c) Resources The Federal, State, local governmental, and private resources specified in this subsection are the following: (1) Mentorship opportunities, including pregnancy help and case management resources. (2) Health and well-being services, including women’s medical services such as obstetrical and gynecological support services for women, abortion pill reversal, breastfeeding, general health services, primary care, and dental care. (3) Financial assistance, work opportunities, nutrition assistance, childcare, and education opportunities. (4) Material or legal support, including transportation, food, nutrition, clothing, household goods, baby supplies, housing, shelters, maternity homes, tax preparation, legal support for child support, family leave, breastfeeding protections, and custody issues. (5) Recovery and mental health services, including services with respect to addiction or suicide intervention, intimate partner violence, sexual assault, rape, sex trafficking, and counseling for women and families surrounding unexpected loss of a child. (6) Prenatal diagnostic services, including disability support organizations, medical interventions for a baby, perinatal hospice resources, pregnancy and infant loss support, and literature on pregnancy wellness. (7) Healing and support services for abortion survivors and their families. (8) Services providing care for children, including family planning education, adoption, foster care, and short-term care resources. (d) Administration The Secretary may not delegate implementation or administration of the portal established under subsection (b) below the level of the Office of the Secretary. (e) Follow-Up The Secretary shall develop a plan under which— (1) the Secretary includes in the portal established under subsection (b), a mechanism for users of the portal to take an assessment through the portal and provide consent to use the user’s contact information; (2) the Secretary conducts outreach via phone or email to follow up with users of the portal established under subsection (b) on additional resources that would be helpful for the users to review; and (3) upon the request of a user of the portal for specific information, after learning of the additional resources through the portal, agents of the Department of Health and Human Services make every effort to furnish specific information to such user in coordination with Federal, State, local governmental, and private health care providers and resources. (f) Resource list aggregation (1) In general Pursuant to criteria developed in subsection (e)(2), each State shall provide recommendations of State, local governmental, and private resources under subsection (b)(1)(A) to include in the portal. (2) Criteria for making recommendations The Secretary shall develop, and make public, criteria to provide to the States to determine whether resources recommended as described in paragraph (1) for inclusion in the portal can appear in the portal. Such criteria shall include the requirement that the resource provider is not a prohibited entity and the requirement that the resource provider has been engaged in providing services for a minimum of 3 consecutive years. The Secretary shall establish a process for a resource provider to appeal a decision on inclusion. (3) Grant program (A) In general The Secretary may provide grants to States to establish or support a system that aggregates the resources described in subsection (b)(1)(A), in accordance with the criteria developed under paragraph (2), and that may be coordinated, to the extent determined appropriate by the State, by a statewide, regionally based, or community-based public entity or private nonprofit. (B) Applications To be eligible to receive a grant under subparagraph (A), a State 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 outreach and awareness activities, and a list of service providers that would be included in the State system supported by the grant. (g) Maternal mental health hotline The Secretary shall ensure that the Maternal Mental Health Hotline of the Health Resources and Services Administration— (1) disseminates information regarding, and linkages to, the life.gov website and portal described in subsections (a) and (b); (2) has the capacity to help families in every State and community in the Nation; and (3) includes live chat features, 24 hours a day, to connect individuals to the information the portal hosts. (h) Prohibition regarding certain entities The resources listed on the life.gov website, and made available through the portal and hotline established under this section may not include any resource offered by a prohibited entity. (i) Services in different languages The life.gov website and hotline shall ensure the widest possible access to services for families who speak languages other than English. (j) Privacy Protection (1) Any entity providing resources under this title must have a privacy policy and procedures in place to ensure that the name, address, telephone number, or any other information that might identify any woman seeking the services of the program is not made public or shared with any other agency or organization without the written consent of the woman. All communications between the resource and the woman must remain confidential and any entity providing resources shall adhere to requirements comparable to those applicable under the HIPAA privacy regulation (as defined in section 1180(b)(3) of the Social Security Act) to covered entities (as defined for purposes of such regulation). (2) Notwithstanding paragraph (1), the Secretary has access to any information necessary to monitor and review a grantee’s program as required under subsection (k). (k) Reporting requirements (1) In general Not later than 180 days after the date on which the life.gov website and portal are established under subsection (a), the Secretary shall submit to Congress a report on— (A) the traffic of the website and the interactive portal; (B) user feedback on the accessibility and helpfulness of the website and interactive portal in tailoring to the user’s needs; (C) insights on gaps in Federal, State, local governmental, and private programming with respect to services for pregnant and postpartum women; and (D) suggestions on how to improve user experience and accessibility based on user feedback and missing resources that would be helpful to include in future updates. (2) Confidentiality The report under paragraph (1) shall not include any personal identifying information regarding individuals who have used the website or portal. (l) Definitions In this section: (1) Abortion The term abortion means the use or prescription of any instrument, medicine, drug, or any other substance or device to intentionally— (A) kill the unborn child of a woman known to be pregnant; or (B) terminate the pregnancy of a woman known to be pregnant, with an intention other than— (i) after viability, to produce a live birth and preserve the life and health of the child born alive; (ii) to remove a dead unborn child; or (iii) to treat an ectopic pregnancy. (2) Born alive The term born alive has the meaning given such term in section 8(b) of title 1, United States Code. (3) Prohibited entity The term prohibited entity means an entity, including its affiliates, subsidiaries, successors, and clinics that performs, induces, refers for, or counsels in favor of abortions, or provides financial support to any other organization that conducts such activities. (4) Unborn child The term unborn child means an individual organism of the species homo sapiens, beginning at fertilization, until the point of being born alive. . 105. Parental notification (a) Requirement Any physician who, in or affecting interstate or foreign commerce, performs or induces an abortion on a minor shall provide, or cause his or her agent to provide— (1) at least 24 hours of actual notice to a parent of the minor before performing or inducing the abortion; or (2) at least 48 hours of constructive notice to a parent of the minor before performing or inducing the abortion. (b) Exceptions The notification requirement of subsection (a) does not apply if— (1) the abortion is performed or induced in a State that has, in force, a law requiring parental involvement in a minor’s abortion decision and the physician complies with the requirements of that law; (2) the physician is presented with documentation showing with a reasonable degree of certainty that a court in the minor’s State of residence has waived any parental notification required by the laws of that State, or has otherwise authorized that the minor be allowed to procure an abortion; (3) the minor declares in a signed written statement that she is the victim of sexual abuse, neglect, or physical abuse by a parent, and, before an abortion is performed on the minor, the physician notifies the authorities specified to receive reports of child abuse or neglect by the law of the State in which the minor resides of the known or suspected abuse or neglect; (4) the abortion is necessary to save the life of the minor because her life was endangered by a physical disorder, physical injury, or physical illness, including a life endangering physical condition caused by or arising from the pregnancy itself, but an exception under this paragraph does not apply unless the attending physician or an agent of such physician, within 24 hours after completion of the abortion, notifies a parent in writing that an abortion was performed on the minor and of the circumstances that warranted invocation of this paragraph; or (5) the minor is physically accompanied by a person who presents the physician or his agent with documentation showing with a reasonable degree of certainty that he or she is in fact the parent of that minor. (c) Penalty for failure To comply (1) Civil penalty (A) Enforcement by Attorney General The Attorney General shall commence a civil action in an appropriate district court of the United States under this subsection against any physician who commits a violation of subsection (a). (B) Penalty In a civil action under subparagraph (A), the court may, to vindicate the public interest, assess a civil penalty against the physician in an amount— (i) not less than $100,000 and not more than $150,000, for each such violation that is adjudicated in the first proceeding against such physician under this subsection; or (ii) not less than $150,001 and not more than $250,000, for each such violation that is adjudicated in a subsequent proceeding against such physician under this subsection. (C) Notification Upon the assessment of a civil penalty under subparagraph (B), the Attorney General shall notify the appropriate State medical licensing authority. (D) No penalties for pregnant women A pregnant woman shall not be subject to any penalty under this section. (2) Private right of action (A) In general A parent of a minor upon whom an abortion has been performed or induced in violation of subsection (a) (other than a parent described in subsection (b)(3)) may commence a civil action against the physician for appropriate relief. (B) Appropriate relief Appropriate relief in a civil action under this paragraph includes— (i) objectively verifiable money damages for all injuries, psychological and physical, occasioned by the violation; (ii) statutory damages equal to 3 times the cost of the abortion; and (iii) punitive damages. (C) Attorney's fees for plaintiff The court shall award a reasonable attorney's fee as part of the costs to a prevailing party in a civil action under this paragraph. (d) Definitions For the purposes of this section— (1) the term abortion means the use or prescription of any instrument, medicine, drug, or any other substance or device to intentionally— (A) kill the unborn child of a woman known to be pregnant; or (B) terminate the pregnancy of a woman known to be pregnant, with an intention other than— (i) after viability, to produce a live birth and preserve the life and health of the child born alive; (ii) to remove a dead unborn child; or (iii) to treat an ectopic pregnancy; (2) the term actual notice means the giving of written notice directly, in person, by the physician or any agent of the physician; (3) the term constructive notice means notice that is given by certified mail, return receipt requested, restricted delivery to the last known address of the person being notified, with delivery deemed to have occurred 48 hours following noon on the next day subsequent to mailing on which regular mail delivery takes place, days on which mail is not delivered excluded; (4) the term law requiring parental involvement in a minor’s abortion decision means a law— (A) requiring, before an abortion is performed on a minor, either— (i) the notification to a parent of that minor; or (ii) proceedings in a State court; and (B) that does not provide as an alternative to the requirements described in subparagraph (A) notification to any person or entity who is not described in that subparagraph; (5) the term minor means an individual who has not attained the age of 18 years and who is not emancipated under the law of the State in which the minor resides; (6) the term parent means— (A) a parent or guardian; (B) a legal custodian; or (C) a person standing in loco parentis who has care and control of the minor, and with whom the minor regularly resides, as determined by State law; (7) the term physician means a doctor of medicine legally authorized to practice medicine by the State in which such doctor practices medicine, or any other person legally empowered under State law to perform an abortion; and (8) the term State includes the District of Columbia and any commonwealth, possession, or other territory of the United States, and any Indian Tribe or reservation. 106. Moratorium on Federal funding to Planned Parenthood Federation of America, Inc (a) In general For the one-year period beginning on the date of the enactment of this Act, subject to subsection (b), no funds authorized or appropriated by Federal law may be made available for any purpose to Planned Parenthood Federation of America, Inc., or any affiliate or clinic of Planned Parenthood Federation of America, Inc., unless such entities certify that Planned Parenthood Federation of America affiliates and clinics will not perform, and will not provide any funds to any other entity that performs, an abortion during such period. (b) Exception Subsection (a) 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. (c) Repayment The Secretary of Health and Human Services and the Secretary of Agriculture shall seek repayment of any Federal assistance received by Planned Parenthood Federation of America, Inc., or any affiliate or clinic of Planned Parenthood Federation of America, Inc., if it violates the terms of the certification required by subsection (a) during the period specified in subsection (a). 107. Funding There is authorized to be appropriated, and appropriated, $235,000,000 to carry out sections 101, 102, and 103 of this Act, and section 3401 of the Public Health Service Act, as added by section 104. II General provisions 201. Rule of construction Nothing in this Act shall be construed to reduce overall Federal funding available in support of women’s health.