[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[S. 1208 Introduced in Senate (IS)]







105th CONGRESS
  1st Session
                                S. 1208

  To protect women's reproductive health and constitutional right to 
                    choice, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           September 23, 1997

Mrs. Boxer (for herself and Mrs. Murray) introduced the following bill; 
 which was read twice and referred to the Committee on Labor and Human 
                               Resources

_______________________________________________________________________

                                 A BILL


 
  To protect women's reproductive health and constitutional right to 
                    choice, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Family Planning and Choice 
Protection Act of 1997''.

SEC. 2. FINDINGS.

    Congress finds that--
            (1) reproductive rights are central to the ability of women 
        to exercise full enjoyment of rights secured to women by 
        Federal and State law;
            (2) abortion has been a legal and constitutionally 
        protected medical procedure throughout the United States since 
        1973 and has become part of mainstream medical practice as is 
        evidenced by the positions of medical institutions including 
        the American Medical Association, the American College of 
        Obstetricians and Gynecologists, the American Medical Women's 
        Association, the American Nurses Association, and the American 
        Public Health Association;
            (3) the availability of abortion services is diminishing 
        throughout the United States, as evidenced by--
                    (A) the fact that 84 percent of counties in the 
                United States have no abortion provider; and
                    (B) the fact that, between 1982 and 1992, the 
                number of abortion providers decreased in 45 States; 
                and
            (4)(A) the Department of Health and Human Services and the 
        Institute of Medicine of the National Academy of Sciences have 
        contributed to the development of a report entitled ``Healthy 
        People 2000'', which urges that the rate of unintended 
        pregnancy in the United States be reduced by nearly 50 percent 
        by the year 2000;
            (B) nearly 60 percent, or approximately 3,100,000, of all 
        pregnancies in the United States each year are unintended, 
        resulting in 1,500,000 abortions in the United States each 
        year; and
            (C) the provision of family planning services, including 
        emergency contraception, is a cost-effective way of reducing 
        the number of unintended pregnancies and abortions in the 
        United States; and
            (5) at a minimum, Congress must enact legislation 
        establishing or retaining the following policies to preserve 
        the choice and reproductive health of women:
                    (A) Authorization of family planning programs.
                    (B) The prohibition of any gag rule on information 
                pertaining to reproductive medical services.
                    (C) The promotion of equitable treatment and 
                coverage of prescription contraception drugs and 
                devices in the provision of health insurance.
                    (D) The provision of funding for emergency 
                contraceptive education.
                    (E) The establishment of breast cancer, cervical 
                cancer, and chlamydia screening programs in all 50 
                States.
                    (F) Full implementation of contraceptive and 
                infertility research programs.
                    (G) Funding through the medicaid program under 
                title XIX of the Social Security Act (42 U.S.C. 1396 et 
                seq.) for abortion services.
                    (H) Protection of women from clinic violence.
                    (I) Final approval of the drug called Mifepristone 
                or RU-486.
                    (J) The maintenance of a fundamental right to 
                choose, as stated in the Supreme Court decision in Roe 
                v. Wade, 410 U.S. 113 (1973).
                    (K) The establishment of the right of the District 
                of Columbia to access locally raised revenue to provide 
                abortion services to low-income women.
                    (L) The promotion of fairness in insurance.
                    (M) The establishment of the ability of military 
                personnel overseas to obtain abortion services.

                          TITLE I--PREVENTION

                      Subtitle A--Family Planning

SEC. 101. FAMILY PLANNING AMENDMENTS.

    Section 1001(d) of the Public Health Service Act (42 U.S.C. 300(d)) 
is amended to read as follows:
    ``(d) For the purpose of making grants and entering into contracts 
under this section, there are authorized to be appropriated 
$275,000,000 for fiscal year 1999 and such sums as may be necessary for 
each of fiscal years 2000 through 2003.''.

SEC. 102. FREEDOM OF FULL DISCLOSURE.

    Title XI of the Civil Rights Act of 1964 (42 U.S.C. 2000h et seq.) 
is amended by adding at the end the following:

``SEC. 1107. INFORMATION ABOUT AVAILABILITY OF REPRODUCTIVE HEALTH CARE 
              SERVICES.

    ``(a) Definition.--As used in this section, the term `governmental 
authority' means any authority of the United States.
    ``(b) General Authority.--Notwithstanding any other provision of 
law, no governmental authority shall, in or through any program or 
activity that is administered or assisted by such authority and that 
provides health care services or information, limit the right of any 
person to provide, or the right of any person to receive, nonfraudulent 
information about the availability of reproductive health care 
services, including family planning, prenatal care, adoption, and 
abortion services.''.

       Subtitle B--Prescription Equity and Contraceptive Coverage

SEC. 111. FINDINGS.

    Congress finds that--
            (1) each year, approximately 3,100,000 pregnancies, or 
        nearly 60 percent of all pregnancies, in this country are 
        unintended;
            (2) contraceptive services are part of basic health care, 
        allowing families to both adequately space desired pregnancies 
        and avoid unintended pregnancy;
            (3) studies show that contraceptives are cost-effective: 
        for every $1 of public funds invested in family planning, $4 to 
        $14 of public funds is saved in pregnancy and health care-
        related costs;
            (4) by reducing rates of unintended pregnancy, 
        contraceptives help reduce the need for abortion;
            (5) unintended pregnancies lead to higher rates of infant 
        mortality, low-birth weight, and maternal morbidity, and 
        threaten the economic viability of families;
            (6) the National Commission to Prevent Infant Mortality 
        determined that ``infant mortality could be reduced by 10 
        percent if all women not desiring pregnancy used 
        contraception'';
            (7) most women in the United States, including two-thirds 
        of women of childbearing age, rely on some form of private 
        employment-related insurance (through either their own employer 
        or a family member's employer) to defray their medical 
        expenses;
            (8) the vast majority of private insurers cover 
        prescription drugs, but many exclude coverage for prescription 
        contraceptives;
            (9) private insurance provides extremely limited coverage 
        of contraceptives: half of traditional indemnity plans and 
        preferred provider organizations, 20 percent of point-of-
        service networks, and 7 percent of health maintenance 
        organizations cover no contraceptive methods other than 
        sterilization;
            (10) women of reproductive age spend 68 percent more than 
        men on out-of-pocket health care costs, with contraceptives and 
        reproductive health care services accounting for much of the 
        difference;
            (11) the lack of contraceptive coverage in health insurance 
        places many effective forms of contraceptives beyond the 
        financial reach of many women, leading to unintended 
        pregnancies; and
            (12) the Institute of Medicine Committee on Unintended 
        Pregnancy recently recommended that ``financial barriers to 
        contraception be reduced by increasing the proportion of all 
        health insurance policies that cover contraceptive services and 
        supplies''.

SEC. 112. AMENDMENTS TO THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 
              1974.

    (a) In General.--Subpart B of part 7 of subtitle B of title I of 
the Employee Retirement Income Security Act of 1974 (as added by 
section 603(a) of the Newborns' and Mothers' Health Protection Act of 
1996 and amended by section 702(a) of the Mental Health Parity Act of 
1996) is further amended by adding at the end the following new 
section:

``SEC. 713. STANDARDS RELATING TO BENEFITS FOR CONTRACEPTIVES.

    ``(a) Requirements for Coverage.--A group health plan, and a health 
insurance issuer providing health insurance coverage in connection with 
a group health plan, may not--
            ``(1) exclude or restrict benefits for prescription 
        contraceptive drugs or devices approved by the Food and Drug 
Administration, or generic equivalents approved as substitutable by the 
Food and Drug Administration, if such plan provides benefits for other 
outpatient prescription drugs or devices; or
            ``(2) exclude or restrict benefits for outpatient 
        contraceptive services if such plan provides benefits for other 
        outpatient services provided by a health care professional 
        (referred to in this section as `outpatient health care 
        services').
    ``(b) Prohibitions.--A group health plan, and a health insurance 
issuer providing health insurance coverage in connection with a group 
health plan, may not--
            ``(1) deny to an individual eligibility, or continued 
        eligibility, to enroll or to renew coverage under the terms of 
        the plan because of the individual's or enrollee's use or 
        potential use of items or services that are covered in 
        accordance with the requirements of this section;
            ``(2) provide monetary payments or rebates to a covered 
        individual to encourage such individual to accept less than the 
        minimum protections available under this section;
            ``(3) penalize or otherwise reduce or limit the 
        reimbursement of a health care professional because such 
        professional prescribed contraceptive drugs or devices, or 
        provided contraceptive services, described in subsection (a), 
        in accordance with this section; or
            ``(4) provide incentives (monetary or otherwise) to a 
        health care professional to induce such professional to 
        withhold from a covered individual contraceptive drugs or 
        devices, or contraceptive services, described in subsection 
        (a).
    ``(c) Rules of Construction.--
            ``(1) In general.--Nothing in this section shall be 
        construed--
                    ``(A) as preventing a group health plan and a 
                health insurance issuer providing health insurance 
                coverage in connection with a group health plan from 
                imposing deductibles, coinsurance, or other cost-
                sharing or limitations in relation to--
                            ``(i) benefits for contraceptive drugs 
                        under the plan, except that such a deductible, 
                        coinsurance, or other cost-sharing or 
                        limitation for any such drug may not be greater 
                        than such a deductible, coinsurance, or cost-
                        sharing or limitation for any outpatient 
                        prescription drug otherwise covered under the 
                        plan;
                            ``(ii) benefits for contraceptive devices 
                        under the plan, except that such a deductible, 
                        coinsurance, or other cost-sharing or 
                        limitation for any such device may not be 
                        greater than such a deductible, coinsurance, or 
                        cost-sharing or limitation for any outpatient 
                        prescription device otherwise covered under the 
                        plan; and
                            ``(iii) benefits for outpatient 
                        contraceptive services under the plan, except 
                        that such a deductible, coinsurance, or other 
                        cost-sharing or limitation for any such service 
                        may not be greater than such a deductible, 
                        coinsurance, or cost-sharing or limitation for 
                        any outpatient health care service otherwise 
                        covered under the plan; and
                    ``(B) as requiring a group health plan and a health 
                insurance issuer providing health insurance coverage in 
                connection with a group health plan to cover 
                experimental or investigational contraceptive drugs or 
                devices, or experimental or investigational 
                contraceptive services, described in subsection (a), 
                except to the extent that the plan or issuer provides 
                coverage for other experimental or investigational 
                outpatient prescription drugs or devices, or 
                experimental or investigational outpatient health care 
                services.
            ``(2) Limitations.--As used in paragraph (1), the term 
        `limitation' includes--
                    ``(A) in the case of a contraceptive drug or 
                device, restricting the type of health care 
                professionals that may prescribe such drugs or devices, 
                utilization review provisions, and limits on the volume 
                of prescription drugs or devices that may be obtained 
                on the basis of a single consultation with a 
                professional; or
                    ``(B) in the case of an outpatient contraceptive 
                service, restricting the type of health care 
                professionals that may provide such services, 
                utilization review provisions, requirements relating to 
                second opinions prior to the coverage of such services, 
                and requirements relating to preauthorizations prior to 
                the coverage of such services.
    ``(d) Notice Under Group Health Plan.--The imposition of the 
requirements of this section shall be treated as a material 
modification in the terms of the plan described in section 102(a)(1), 
for purposes of assuring notice of such requirements under the plan, 
except that the summary description required to be provided under the 
last sentence of section 104(b)(1) with respect to such modification 
shall be provided by not later than 60 days after the first day of the 
first plan year in which such requirements apply.
    ``(e) Preemption.--Nothing in this section shall be construed to 
preempt any provision of State law to the extent that such State law 
establishes, implements, or continues in effect any standard or 
requirement that provides protections for enrollees that are greater 
than the protections provided under this section.
    ``(f) Definition.--In this section, the term `outpatient 
contraceptive services' means consultations, examinations, procedures, 
and medical services, provided on an outpatient basis and related to 
the use of contraceptive methods (including natural family planning) to 
prevent an unintended pregnancy.''.
    (b) Clerical Amendment.--The table of contents in section 1 of such 
Act, as amended by section 603 of the Newborns' and Mothers' Health 
Protection Act of 1996 and section 702 of the Mental Health Parity Act 
of 1996, is amended by inserting after the item relating to section 712 
the following new item:

``Sec. 713. Standards relating to benefits for contraceptives.''.
    (c) Effective Date.--The amendments made by this section shall 
apply with respect to plan years beginning on or after January 1, 1998.

SEC. 113. AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT RELATING TO THE 
              GROUP MARKET.

    (a) In General.--Subpart 2 of part A of title XXVII of the Public 
Health Service Act (as added by section 604(a) of the Newborns' and 
Mothers' Health Protection Act of 1996 and amended by section 703(a) of 
the Mental Health Parity Act of 1996) is further amended by adding at 
the end the following new section:

``SEC. 2706. STANDARDS RELATING TO BENEFITS FOR CONTRACEPTIVES.

    ``(a) Requirements for Coverage.--A group health plan, and a health 
insurance issuer providing health insurance coverage in connection with 
a group health plan, may not--
            ``(1) exclude or restrict benefits for prescription 
        contraceptive drugs or devices approved by the Food and Drug 
        Administration, or generic equivalents approved as 
        substitutable by the Food and Drug Administration, if such plan 
        provides benefits for other outpatient prescription drugs or 
        devices; or
            ``(2) exclude or restrict benefits for outpatient 
        contraceptive services if such plan provides benefits for other 
        outpatient services provided by a health care professional 
        (referred to in this section as `outpatient health care 
        services').
    ``(b) Prohibitions.--A group health plan, and a health insurance 
issuer providing health insurance coverage in connection with a group 
health plan, may not--
            ``(1) deny to an individual eligibility, or continued 
        eligibility, to enroll or to renew coverage under the terms of 
        the plan because of the individual's or enrollee's use or 
        potential use of items or services that are covered in 
        accordance with the requirements of this section;
            ``(2) provide monetary payments or rebates to a covered 
        individual to encourage such individual to accept less than the 
        minimum protections available under this section;
            ``(3) penalize or otherwise reduce or limit the 
        reimbursement of a health care professional because such 
        professional prescribed contraceptive drugs or devices, or 
        provided contraceptive services, described in subsection (a), 
        in accordance with this section; or
            ``(4) provide incentives (monetary or otherwise) to a 
        health care professional to induce such professional to 
        withhold from a covered individual contraceptive drugs or 
        devices, or contraceptive services, described in subsection 
        (a).
    ``(c) Rules of Construction.--
            ``(1) In general.--Nothing in this section shall be 
        construed--
                    ``(A) as preventing a group health plan and a 
                health insurance issuer providing health insurance 
                coverage in connection with a group health plan from 
                imposing deductibles, coinsurance, or other cost-
                sharing or limitations in relation to--
                            ``(i) benefits for contraceptive drugs 
                        under the plan, except that such a deductible, 
                        coinsurance, or other cost-sharing or 
                        limitation for any such drug may not be greater 
                        than such a deductible, coinsurance, or cost-
                        sharing or limitation for any outpatient 
                        prescription drug otherwise covered under the 
                        plan;
                            ``(ii) benefits for contraceptive devices 
                        under the plan, except that such a deductible, 
                        coinsurance, or other cost-sharing or 
                        limitation for any such device may not be 
                        greater than such a deductible, coinsurance, or 
                        cost-sharing or limitation for any outpatient 
prescription device otherwise covered under the plan; and
                            ``(iii) benefits for outpatient 
                        contraceptive services under the plan, except 
                        that such a deductible, coinsurance, or other 
                        cost-sharing or limitation for any such service 
                        may not be greater than such a deductible, 
                        coinsurance, or cost-sharing or limitation for 
                        any outpatient health care service otherwise 
                        covered under the plan; and
                    ``(B) as requiring a group health plan and a health 
                insurance issuer providing health insurance coverage in 
                connection with a group health plan to cover 
                experimental or investigational contraceptive drugs or 
                devices, or experimental or investigational 
                contraceptive services, described in subsection (a), 
                except to the extent that the plan or issuer provides 
                coverage for other experimental or investigational 
                outpatient prescription drugs or devices, or 
                experimental or investigational outpatient health care 
                services.
            ``(2) Limitations.--As used in paragraph (1), the term 
        `limitation' includes--
                    ``(A) in the case of a contraceptive drug or 
                device, restricting the type of health care 
                professionals that may prescribe such drugs or devices, 
                utilization review provisions, and limits on the volume 
                of prescription drugs or devices that may be obtained 
                on the basis of a single consultation with a 
                professional; or
                    ``(B) in the case of an outpatient contraceptive 
                service, restricting the type of health care 
                professionals that may provide such services, 
                utilization review provisions, requirements relating to 
                second opinions prior to the coverage of such services, 
                and requirements relating to preauthorizations prior to 
                the coverage of such services.
    ``(d) Notice.--A group health plan under this part shall comply 
with the notice requirement under section 713(d) of the Employee 
Retirement Income Security Act of 1974 with respect to the requirements 
of this section as if such section applied to such plan.
    ``(e) Preemption.--Nothing in this section shall be construed to 
preempt any provision of State law to the extent that such State law 
establishes, implements, or continues in effect any standard or 
requirement that provides protections for enrollees that are greater 
than the protections provided under this section.
    ``(f) Definition.--In this section, the term `outpatient 
contraceptive services' means consultations, examinations, procedures, 
and medical services, provided on an outpatient basis and related to 
the use of contraceptive methods (including natural family planning) to 
prevent an unintended pregnancy.''.
    (b) Effective Date.--The amendments made by this section shall 
apply with respect to group health plans for plan years beginning on or 
after January 1, 1998.

SEC. 114. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT RELATING TO THE 
              INDIVIDUAL MARKET.

    (a) In General.--Subpart 3 of part B of title XXVII of the Public 
Health Service Act (as added by section 605(a) of the Newborn's and 
Mother's Health Protection Act of 1996) is amended by adding at the end 
the following new section:

``SEC. 2752. STANDARDS RELATING TO BENEFITS FOR CONTRACEPTIVES.

    ``The provisions of section 2706 shall apply to health insurance 
coverage offered by a health insurance issuer in the individual market 
in the same manner as they apply to health insurance coverage offered 
by a health insurance issuer in connection with a group health plan in 
the small or large group market.''.
    (b) Effective Date.--The amendment made by this section shall apply 
with respect to health insurance coverage offered, sold, issued, 
renewed, in effect, or operated in the individual market on or after 
January 1, 1998.

                  Subtitle C--Emergency Contraceptives

SEC. 121. EMERGENCY CONTRACEPTIVE EDUCATION.

    (a) Definition.--In this section:
            (1) Emergency contraceptive.--The term ``emergency 
        contraceptive'' means a drug or device (as the terms are 
        defined in section 201 of the Federal Food, Drug, and Cosmetic 
        Act (21 U.S.C. 321)) that is designed--
                    (A) to be used after sexual relations; and
                    (B) to prevent pregnancy, by preventing ovulation, 
                fertilization of an egg, or implantation of an egg in a 
                uterus.
            (2) Health care provider.--The term ``health care 
        provider'' means anyone licensed or certified under State law 
        to provide health care services who is operating within the 
        scope of such license.
            (3) Institution of higher education.--The term 
        ``institution of higher education'' has the meaning given the 
term in section 1201(a) of the Higher Education Act of 1965 (20 U.S.C. 
1141(a)).
    (b) Emergency Contraceptive Public Education Program.--
            (1) In general.--The Secretary of Health and Human 
        Services, acting through the Director of the Centers for 
        Disease Control, shall develop and disseminate to the public 
        information on emergency contraceptives.
            (2) Development and dissemination.--The Secretary may 
        develop and disseminate the information directly or through 
        arrangements with nonprofit organizations, consumer groups, 
        institutions of higher education, Federal, State, or local 
        agencies, and clinics.
            (3) Information.--The information shall include, at a 
        minimum, information describing emergency contraceptives, and 
        explaining the use, effects, efficacy, and availability of the 
        contraceptives.
    (c) Emergency Contraceptive Information Program for Health Care 
Providers.--
            (1) In general.--The Secretary of Health and Human 
        Services, acting through the Administrator of the Health 
        Resources and Services Administration, shall develop and 
        disseminate to health care providers information on emergency 
        contraceptives.
            (2) Information.--The information shall include, at a 
        minimum--
                    (A) information describing the use, effects, and 
                efficacy and availability of the contraceptives;
                    (B) a recommendation from the Secretary regarding 
                the use of the contraceptives in appropriate cases; and
                    (C) information explaining how to obtain copies of 
                the information developed under subsection (b), for 
                distribution to the patients of the providers.
    (d) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $5,000,000 for the period 
consisting of fiscal years 1999 through 2001.

                           TITLE II--RESEARCH

SEC. 201. PREVENTIVE HEALTH MEASURES REGARDING BREAST AND CERVICAL 
              CANCER AND CHLAMYDIA.

    It is the sense of Congress that the programs of grants under 
section 318 and title XV of the Public Health Service Act (42 U.S.C. 
247c and 300k et seq.) should receive a level of funding that is 
adequate for all States, or entities in all States, as appropriate, to 
receive grants under such section and title.

SEC. 202. PROGRAMS REGARDING CONTRACEPTION AND INFERTILITY.

    (a) Research Centers.--It is the sense of Congress that the program 
assisting research centers under section 452A of the Public Health 
Service Act (42 U.S.C. 285g-5) should receive a level of funding that 
is adequate for a reasonable number of research centers to be operated 
under the program.
    (b) Loan Repayment Program Regarding Conduct of Research.--It is 
the sense of Congress that the program of loan-repayment contracts 
under section 487B of the Public Health Service Act (42 U.S.C 288-2) 
should receive a level of funding that is adequate for a reasonable 
number of individuals to conduct research under the program.

                      TITLE III--CHOICE PROTECTION

SEC. 301. FUNDING FOR ABORTION SERVICES.

    It is the sense of Congress that Federal and State governments 
should provide funding for abortion services to women eligible for 
assistance through the medicaid program carried out under title XIX of 
the Social Security Act (42 U.S.C. 1396 et seq.), as such services are 
essential to the health and well-being of women.

SEC. 302. CLINIC VIOLENCE.

    It is the sense of Congress that--
            (1) Federal resources are necessary to ensure that women 
        have safe access to reproductive health facilities and that 
        health professionals can deliver services in a secure 
        environment free from violence and threats of force; and
            (2) it is necessary and appropriate to use Federal 
        resources to combat the nationwide campaign of violence and 
        harassment against reproductive health centers.

SEC. 303. APPROVAL OF RU-486.

    The Secretary of Health and Human Services shall--
            (1) ensure that a decision by the Food and Drug 
        Administration to approve the drug called Mifepristone or RU-
        486 shall be made only on the basis provided in law; and
            (2) assess initiatives by which the Department of Health 
        and Human Services can promote the testing, licensing, and 
        manufacturing in the United States of the drug or other 
        antiprogestins.

SEC. 304. FREEDOM OF CHOICE.

    (a) Findings.--Congress finds the following:
            (1) The 1973 Supreme Court decision in Roe v. Wade, 410 
        U.S. 113 (1973) established constitutionally based limits on 
        the power of States to restrict the right of a woman to choose 
        to terminate a pregnancy. Under the strict scrutiny standard 
        enunciated in the Roe v. Wade decision, States were required to 
        demonstrate that laws restricting the right of a woman to 
        choose to terminate a pregnancy were the least restrictive 
        means available to achieve a compelling State interest. Since 
        1989, the Supreme Court has no longer applied the strict 
        scrutiny standard in reviewing challenges to the 
        constitutionality of State laws restricting such rights.
            (2) As a result of the recent modification by the Supreme 
        Court of the strict scrutiny standard enunciated in the Roe v. 
        Wade decision, certain States have restricted the right of 
        women to choose to terminate a pregnancy or to utilize some 
        forms of contraception, and the restrictions operate 
        cumulatively to--
                    (A)(i) increase the number of illegal or medically 
                less safe abortions, often resulting in physical 
                impairment, loss of reproductive capacity, or death to 
                the women involved;
                    (ii) burden interstate and international commerce 
                by forcing women to travel from States in which legal 
                barriers render contraception or abortion unavailable 
                or unsafe to other States or foreign nations;
                    (iii) interfere with freedom of travel between and 
                among the various States;
                    (iv) burden the medical and economic resources of 
                States that continue to provide women with access to 
                safe and legal abortion; and
                    (v) interfere with the ability of medical 
                professionals to provide health services;
                    (B) obstruct access to and use of contraceptive and 
                other medical techniques that are part of interstate 
                and international commerce;
                    (C) discriminate between women who are able to 
                afford interstate and international travel and women 
                who are not, a disproportionate number of whom belong 
                to racial or ethnic minorities; and
                    (D) infringe on the ability of women to exercise 
                full enjoyment of rights secured to the women by 
                Federal and State law, both statutory and 
                constitutional.
            (3) Although Congress may not by legislation create 
        constitutional rights, Congress may, where authorized by a 
        constitutional provision enumerating the powers of Congress and 
        not prohibited by a constitutional provision, enact legislation 
        to create and secure statutory rights in areas of legitimate 
        national concern.
            (4) Congress has the affirmative power under section 8 of 
        article I of the Constitution and under section 5 of the 14th 
        amendment to the Constitution to enact legislation to prohibit 
        State interference with interstate commerce, liberty, or equal 
        protection of the laws.
    (b) Purpose.--The purpose of this section is to establish, as a 
statutory matter, limitations on the power of a State to restrict the 
freedom of a woman to terminate a pregnancy in order to achieve the 
same limitations as were provided, as a constitutional matter, under 
the strict scrutiny standard of review enunciated in the Roe v. Wade 
decision and applied in subsequent cases from 1973 through 1988.
    (c) Definition.--As used in this section, the term ``State'' 
includes the District of Columbia, the Commonwealth of Puerto Rico, and 
each other territory or possession of the United States.
    (d) General Authority.--A State--
            (1) may not restrict the freedom of a woman to choose 
        whether or not to terminate a pregnancy before fetal viability;
            (2) may restrict the freedom of a woman to choose whether 
        or not to terminate a pregnancy after fetal viability unless 
        such a termination is necessary to preserve the life or health 
        of the woman; and
            (3) may impose requirements on the performance of abortion 
        procedures if such requirements are medically necessary to 
        protect the health of women undergoing such procedures.
    (e) Rules of Construction.--Nothing in this section shall be 
construed to--
            (1) prevent a State from protecting unwilling individuals 
        or private health care institutions from being required to 
        participate in the performance of abortions to which the 
        individuals or institutions are conscientiously opposed;
            (2) prevent a State from declining to pay for the 
        performance of abortions; or
            (3) prevent a State from requiring a minor to involve a 
        parent, guardian, or other responsible adult before terminating 
        a pregnancy.

SEC. 305. FAIRNESS IN INSURANCE.

    Notwithstanding any other provision of law, no Federal law shall be 
construed to prohibit a health plan from offering coverage for the full 
range of reproductive health care services, including abortion 
services.

SEC. 306. REPRODUCTIVE RIGHTS OF WOMEN IN THE MILITARY.

    Section 1093 of title 10, United States Code, is amended--
            (1) in subsection (a), by inserting before the period the 
        following: ``or in a case in which the pregnancy involved is 
        the result of an act of rape or incest or the abortion involved 
        is medically necessary or appropriate'';
            (2) by striking subsection (b) (as added by section 738 of 
        the National Defense Authorization Act for Fiscal Year 1996 
        (Public Law 104-106; 110 Stat. 383)); and
            (3) by adding at the end the following:
    ``(b) Abortions in Facilities Overseas.--Subsection (a) does not 
limit the performing of an abortion in a facility of the uniformed 
services located outside the 48 contiguous States of the United States 
if--
            ``(1) the cost of performing the abortion is fully paid 
        from a source or sources other than funds available to the 
        Department of Defense;
            ``(2) abortions are not prohibited by the laws of the 
        jurisdiction where the facility is located; and
            ``(3) the abortion would otherwise be permitted under the 
        laws applicable to the provision of health care to members and 
        former members of the uniformed services and their dependents 
        in such facility.''.
                                 <all>