[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 12 Introduced in House (IH)]

<DOC>






118th CONGRESS
  1st Session
                                 H. R. 12

To protect a person's ability to determine whether to continue or end a 
 pregnancy, and to protect a health care provider's ability to provide 
                           abortion services.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 30, 2023

     Ms. Chu (for herself, Ms. Adams, Mr. Aguilar, Mr. Allred, Mr. 
   Auchincloss, Ms. Balint, Ms. Barragan, Mrs. Beatty, Mr. Bera, Mr. 
 Beyer, Mr. Blumenauer, Ms. Blunt Rochester, Ms. Bonamici, Mr. Bowman, 
  Ms. Brown, Ms. Brownley, Ms. Budzinski, Ms. Bush, Ms. Caraveo, Mr. 
   Carbajal, Mr. Cardenas, Mr. Carson, Mr. Carter of Louisiana, Mr. 
Cartwright, Mr. Casar, Mr. Casten, Ms. Castor of Florida, Mr. Castro of 
 Texas, Mr. Cicilline, Ms. Clarke of New York, Mr. Cleaver, Mr. Cohen, 
  Mr. Connolly, Mr. Courtney, Ms. Craig, Ms. Crockett, Mr. Crow, Ms. 
Davids of Kansas, Mr. Davis of Illinois, Ms. Dean of Pennsylvania, Ms. 
 DeGette, Ms. DeLauro, Ms. DelBene, Mr. Deluzio, Mr. DeSaulnier, Mrs. 
   Dingell, Mr. Doggett, Ms. Escobar, Mr. Espaillat, Mr. Evans, Mrs. 
   Fletcher, Mr. Foster, Ms. Lois Frankel of Florida, Mr. Frost, Mr. 
 Garamendi, Ms. Garcia of Texas, Mr. Robert Garcia of California, Mr. 
Garcia of Illinois, Ms. Perez, Mr. Goldman of New York, Mr. Gomez, Mr. 
Gottheimer, Mr. Green of Texas, Mr. Grijalva, Mr. Himes, Mr. Horsford, 
 Ms. Houlahan, Ms. Hoyle of Oregon, Mr. Huffman, Mr. Ivey, Mr. Jackson 
   of North Carolina, Ms. Jackson Lee, Ms. Jacobs, Ms. Jayapal, Mr. 
  Jeffries, Ms. Kamlager-Dove, Ms. Kelly of Illinois, Mr. Khanna, Mr. 
   Kildee, Mr. Kilmer, Mr. Krishnamoorthi, Ms. Kuster, Mr. Larsen of 
 Washington, Mr. Larson of Connecticut, Mrs. Lee of Nevada, Ms. Lee of 
California, Ms. Lee of Pennsylvania, Mr. Levin, Mr. Lieu, Ms. Lofgren, 
 Mr. Lynch, Mr. Magaziner, Ms. Manning, Ms. Matsui, Mrs. McBath, Mrs. 
  McClellan, Ms. McCollum, Mr. McGovern, Mr. Gallego, Mr. Meeks, Ms. 
Meng, Ms. Moore of Wisconsin, Mr. Morelle, Mr. Moskowitz, Mr. Moulton, 
   Mr. Mrvan, Mr. Mullin, Mr. Nadler, Mrs. Napolitano, Mr. Neal, Mr. 
 Nickel, Mr. Norcross, Ms. Norton, Ms. Omar, Mr. Pallone, Mr. Panetta, 
  Mr. Pascrell, Mr. Payne, Ms. Pelosi, Mr. Peters, Ms. Pettersen, Ms. 
Pingree, Mr. Pocan, Ms. Porter, Ms. Pressley, Mr. Quigley, Mr. Raskin, 
 Mr. Thanedar, Ms. Ross, Mr. Ruppersberger, Mr. Ryan, Ms. Salinas, Ms. 
  Sanchez, Mr. Sarbanes, Ms. Scanlon, Ms. Schakowsky, Mr. Schiff, Mr. 
Schneider, Ms. Schrier, Mr. Scott of Virginia, Ms. Sewell, Mr. Sherman, 
 Ms. Sherrill, Ms. Slotkin, Mr. Smith of Washington, Mr. Sorensen, Ms. 
Stansbury, Mr. Stanton, Ms. Stevens, Ms. Strickland, Mr. Swalwell, Mrs. 
    Sykes, Mr. Takano, Mr. Thompson of California, Mr. Thompson of 
 Mississippi, Ms. Titus, Ms. Tlaib, Ms. Tokuda, Mr. Tonko, Mrs. Torres 
  of California, Mr. Torres of New York, Mrs. Trahan, Mr. Trone, Ms. 
 Underwood, Ms. Velazquez, Ms. Wasserman Schultz, Mrs. Watson Coleman, 
 Ms. Wexton, Ms. Wild, Ms. Williams of Georgia, Ms. Wilson of Florida, 
 Mrs. Hayes, Mr. Mfume, Mr. Johnson of Georgia, Mr. Kim of New Jersey, 
Mr. Costa, Ms. Leger Fernandez, Ms. Clark of Massachusetts, Ms. Eshoo, 
 Mr. Vasquez, Ms. Spanberger, Mr. Landsman, Mr. Keating, Mrs. Foushee, 
   Mr. Menendez, Mr. Hoyer, Mr. Boyle of Pennsylvania, Mr. Soto, Ms. 
  Ocasio-Cortez, Mr. Phillips, Ms. Plaskett, Mr. Golden of Maine, Mr. 
 McGarvey, Mr. Ruiz, Ms. Scholten, Mrs. Peltola, Ms. Kaptur, Mr. Case, 
Mr. Neguse, Mr. Bishop of Georgia, Mr. Jackson of Illinois, Ms. Waters, 
  Mr. Vargas, Mrs. Ramirez, Mr. Clyburn, Mr. Veasey, and Mr. Correa) 
 introduced the following bill; which was referred to the Committee on 
Energy and Commerce, and in addition to the Committee on the Judiciary, 
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 protect a person's ability to determine whether to continue or end a 
 pregnancy, and to protect a health care provider's ability to provide 
                           abortion services.

    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 ``Women's Health Protection Act of 
2023''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) Abortion services are essential health care, and access 
        to those services is central to people's ability to participate 
        equally in the economic and social life of the United States. 
        Abortion access allows people who are pregnant to make their 
        own decisions about their pregnancies, their families, and 
        their lives.
            (2) Reproductive justice requires every individual to have 
        the right to make their own decisions about having children 
        regardless of their circumstances and without interference and 
        discrimination. Reproductive justice is a human right that can 
        and will be achieved when all people, regardless of actual or 
        perceived race, color, national origin, immigration status, sex 
        (including gender identity, sex stereotyping, or sexual 
        orientation), age, or disability status have the economic, 
        social, and political power and resources to define and make 
        decisions about their bodies, health, sexuality, families, and 
        communities in all areas of their lives, with dignity and self-
        determination.
            (3) Abortion care, like all health care, is a human right 
        that should not depend on one's ZIP Code or region, age, actual 
        or perceived race, national origin, immigration status, sex, or 
        disability status. Unfortunately, this is the current reality 
        for millions, creating a patchwork of abortion access across 
        the United States. Protecting the right to determine whether to 
        continue or end a pregnancy, and the right of health care 
        providers to provide abortion care, is necessary and essential 
        to achieving this human right, and ultimately reproductive 
        justice.
            (4) On June 24, 2022, in its decision in Dobbs v. Jackson 
        Women's Health Organization, the Supreme Court overruled Roe v. 
        Wade, reversing decades of precedent recognizing a 
        constitutional right to terminate a pregnancy before fetal 
        viability.
            (5) The effects of the Dobbs decision were immediate and 
        disastrous. In the aftermath of the Dobbs decision, many States 
        imposed near-total bans on abortion. As of March 2023, abortion 
        is unavailable in 14 States, leaving 17.8 million women of 
        reproductive age (15-49) and transgender and gender 
        nonconforming individuals with the capacity to become pregnant 
        without abortion access in their home State. Within 100 days of 
        the ruling, 66 clinics across 15 States were forced to stop 
        offering abortions.
            (6) Travel time to an abortion clinic, already a burden for 
        abortion seekers under Roe, has more than tripled since Dobbs. 
        As distance to an abortion facility increases, so do the 
        accompanying (and potentially prohibitive) burdens of time off 
        work or school, lost wages, transportation costs, lodging, 
        child care costs, and other ancillary costs.
            (7) Even before the Dobbs decision, access to abortion 
        services had long been obstructed across the United States in 
        various ways, including: prohibitions of, and restrictions on, 
        insurance coverage; mandatory parental involvement laws; 
        restrictions that shame and stigmatize people seeking abortion 
        services; and medically unnecessary regulations that fail to 
        further the safety of abortion services, but instead cause harm 
        people by delaying, complicating access to, and reducing the 
        availability of, abortion services.
            (8) Being denied an abortion can have serious consequences 
        for people's physical, mental, and economic health and well-
        being, and that of their families. According to the Turnaway 
        Study, a longitudinal study published by Advancing New 
        Standards In Reproductive Health (ANSIRH) in 2019, individuals 
        who are denied a wanted abortion are more likely to experience 
        economic insecurity than individuals who receive a wanted 
        abortion. After following participants for five years, the 
        study found that people who were denied abortion care were more 
        likely to live in poverty, experience debt, and have lower 
        credit scores for several years after the denial. These 
        findings demonstrate that when people have control over when to 
        have children and how many children to have, their children 
        benefit through increased economic security and better maternal 
        bonding.
            (9) Abortion bans and restrictions have repercussions for a 
        broad range of health care beyond pregnancy termination, 
        including exacerbating the existing maternal health crisis 
        facing the United States. The United States has the highest 
        maternal mortality rate of any industrialized nations, and 
        Black women and birthing people face three times the risk of 
        dying from pregnancy related causes as their white 
        counterparts. Even prior to Dobbs, research found that States 
        that enacted abortion restrictions based on gestation increased 
        their maternal mortality rate by 38 percent. Research has found 
        that a nationwide ban would increase the United States maternal 
        mortality rate by an additional 24 percent. Furthermore, States 
        that have banned, are planning to ban, or have severely 
        restricted abortion care have fewer maternal health providers, 
        more maternity care deserts, higher rates of both maternal and 
        infant mortality, and greater racial inequity in health care.
            (10) Abortion bans and restrictions additionally harm 
        people's health by reducing access to other essential health 
        care services offered by many of the providers targeted by the 
        restrictions, including--
                    (A) screenings and preventive services, including 
                contraceptive services;
                    (B) testing and treatment for sexually transmitted 
                infections;
                    (C) LGBTQ health services; and
                    (D) referrals for primary care, intimate partner 
                violence prevention, prenatal care, and adoption 
                services.
            (11) This ripple effect has only worsened since the Dobbs 
        decision. Clinicians and pharmacists have denied access to 
        essential medication for conditions including gastric ulcers 
        and autoimmune diseases because those drugs are also used for 
        medication abortion care. Patients are reporting being denied 
        or delayed in their receipt of necessary and potentially 
        lifesaving treatment for ectopic pregnancies and miscarriage 
        management because of the newfound legal risks facing 
        providers.
            (12) Reproductive justice seeks to address restrictions on 
        reproductive health, including abortion, that perpetuate 
        systems of oppression, lack of bodily autonomy, white 
        supremacy, and anti-Black racism. This violent legacy has 
        manifested in policies including enslavement, rape, and 
        experimentation on Black women; forced sterilizations, medical 
        experimentation on low-income women's reproductive systems; and 
        the forcible removal of Indigenous children. Access to 
        equitable reproductive health care, including abortion 
        services, has always been deficient in the United States for 
        Black, Indigenous, Latina/x, Asian American and Pacific 
        Islander, and People of Color (BIPOC) and their families.
            (13) The legacy of restrictions on reproductive health, 
        rights, and justice is not a dated vestige of a dark history. 
        Data show the harms of abortion-specific restrictions fall 
        especially heavily on people with low incomes, people of color, 
        immigrants, young people, people with disabilities, and those 
        living in rural and other medically underserved areas. Abortion 
        bans and restrictions are compounded further by the ongoing 
        criminalization of people who are pregnant, including those who 
        are incarcerated, living with HIV, or with substance-use 
        disorders. These populations already experience health 
        disparities due to social, political, and environmental 
        inequities, and restrictions on abortion services exacerbate 
        these harms. Removing bans and restrictions on abortion 
        services would constitute one important step on the path toward 
        realizing reproductive justice by ensuring that the full range 
        of reproductive health care is accessible to all who need it.
            (14) Abortion bans and restrictions are tools of gender 
        oppression, as they target health care services that are used 
        primarily by women. These paternalistic bans and restrictions 
        rely on and reinforce harmful stereotypes about gender roles 
        and women's decisionmaking, undermining their ability to 
        control their own lives and well-being. These restrictions harm 
        the basic autonomy, dignity, and equality of women.
            (15) The terms ``woman'' and ``women'' are used in this 
        bill to reflect the identity of the majority of people targeted 
        and most directly affected by bans and restrictions on abortion 
        services, which are rooted in misogyny. However, access to 
        abortion services is critical to the health of every person 
        capable of becoming pregnant. This Act is intended to protect 
        all people with the capacity for pregnancy--cisgender women, 
        transgender men, nonbinary individuals, those who identify with 
        a different gender, and others--who are unjustly harmed by 
        restrictions on abortion services.
            (16) Pregnant individuals will continue to experience a 
        range of pregnancy outcomes, including abortion, miscarriage, 
        stillbirths, and infant losses regardless of how the State 
        attempts to exert power over their reproductive decisionmaking, 
        and will continue to need support for their health and well-
        being through their reproductive lifespans.
            (17) Evidence from the United States and around the globe 
        bears out that criminalizing abortion invariably leads to 
        arrests, investigations, and imprisonment of people who end 
        their pregnancies or experience pregnancy loss, leading to 
        violations of fundamental rights to liberty, dignity, bodily 
        autonomy, equality, due process, privacy, health, and freedom 
        from cruel and inhumane treatment.
            (18) All major experts in public health and medicine such 
        as the American Medical Association, American Public Health 
        Association, American Academy of Pediatrics, American Society 
        of Addiction Medicine, and the American College of 
        Obstetricians and Gynecologists, oppose the criminalization of 
        pregnancy outcomes because the threat of being subject to 
        investigation or punishment through the criminal legal system 
        when seeking health care threatens pregnant people's lives and 
        undermines public health by deterring people from seeking care 
        for obstetrical emergencies.
            (19) Antiabortion stigma that is compounded by abortion 
        bans and restrictions also contributes to violence and 
        harassment that put both people seeking and people providing 
        abortion care at risk. From 1977 to 2021, there were 11 
        murders, 42 bombings, 196 acts of arson, 491 assaults, and 
        thousands of other incidents of criminal activity directed at 
        abortion seekers, providers, volunteers, and clinic staff. This 
        violence existed under Roe and has been steadily escalating for 
        years. The presence of dangerous protestors and organized 
        extremists acts as yet another barrier to abortion care, and 
        this threat has become even more urgent as abortion bans 
        proliferate and stigma around abortion care increases.
            (20) Abortion is one of the safest medical procedures in 
        the United States. An independent, comprehensive review of the 
        state of science on the safety and quality of abortion 
        services, published by the National Academies of Sciences, 
        Engineering, and Medicine in 2018, found that abortion in the 
        United States is safe and effective and that the biggest 
        threats to the quality of abortion services in the United 
        States are State regulations that create barriers to care. Such 
        abortion-specific restrictions, as well as broader State bans, 
        conflict with medical standards and are not supported by the 
        recommendations and guidelines issued by leading reproductive 
        health care professional organizations including the American 
        College of Obstetricians and Gynecologists, the Society of 
        Family Planning, the National Abortion Federation, the World 
        Health Organization, and others.
            (21) For over 20 years, medication abortion care has been 
        available in the United States as a safe, effective, Food and 
        Drug Administration (FDA)-approved treatment to end an early 
        pregnancy. Today, medication abortion care accounts for more 
        than half of all pregnancy terminations in the United States; 
        however, significant barriers to access remain in place, 
        particularly in States that have imposed onerous restrictions 
        that conflict with FDA's regulation of medication abortion. 
        Additionally, opponents of abortion are now deploying new 
        tactics to limit access to this FDA-approved medication that 
        would set a dangerous precedent for the Federal regulation of 
        medication products and have national repercussions.
            (22) Health care providers are subject to licensing laws in 
        various jurisdictions, which are not affected by this Act 
        except as expressly provided in this Act.
            (23) International human rights law recognizes that access 
        to abortion is intrinsically linked to the rights to life, 
        health, equality and nondiscrimination, privacy, and freedom 
        from ill treatment. United Nations (UN) human rights treaty 
        monitoring bodies have found that legal abortion services, like 
        other reproductive health care services, must be available, 
        accessible, affordable, acceptable, and of good quality. UN 
        human rights treaty bodies have condemned criminalization of 
        abortion and medically unnecessary barriers to abortion 
        services, including mandatory waiting periods, biased 
        counseling requirements, and third-party authorization 
        requirements.
            (24) Core human rights treaties ratified by the United 
        States protect access to abortion. For example, in 2018, the UN 
        Human Rights Committee, which oversees implementation of the 
        International Covenant on Civil and Political Rights (ICCPR), 
        made clear that the right to life, enshrined in Article 6 of 
        the ICCPR, at a minimum requires governments to provide safe, 
        legal, and effective access to abortion where a person's life 
        and health are at risk, or when carrying a pregnancy to term 
        would otherwise cause substantial pain or suffering. The 
        Committee stated that governments must not impose restrictions 
        on abortion which subject women and girls to physical or mental 
        pain or suffering, discriminate against them, arbitrarily 
        interfere with their privacy, or place them at risk of 
        undertaking unsafe abortions. The Committee stated that 
        governments should not apply criminal sanctions to women and 
        girls who undergo abortion or to medical service providers who 
        assist them in doing so. Furthermore, the Committee stated that 
        governments should remove existing barriers that deny effective 
        access to safe and legal abortion, refrain from introducing new 
        barriers to abortion, and prevent the stigmatization of those 
        seeking abortion.
            (25) International human rights experts have condemned the 
        Dobbs decision and regression on abortion rights in the United 
        States more generally as a violation of human rights. 
        Immediately upon release of the decision, then-UN High 
        Commissioner for Human Rights Michelle Bachelet reiterated 
        human rights protections for abortion and the impact that the 
        decision will have on the fundamental rights of millions within 
        the United States, particularly people with low incomes and 
        people belonging to racial and ethnic minorities. UN 
        independent human rights experts, including the UN Working 
        Group on discrimination against women and girls, the UN Special 
        Rapporteur on the right to health, and the UN Special 
        Rapporteur on violence against women and girls, similarly 
        denounced the decision. At the conclusion of a human rights 
        review of the United States in August 2022, the UN Committee on 
        the Elimination of Racial Discrimination noted deep concerns 
        with the Dobbs decision and recommended that the United States 
        address the disparate impact that it will have on racial and 
        ethnic minorities, Indigenous women, and those with low 
        incomes.
            (26) Abortion bans and restrictions affect the cost and 
        availability of abortion services, and the settings in which 
        abortion services are delivered. People travel across State 
        lines and otherwise engage in interstate commerce to access 
        this essential medical care. Likewise, health care providers 
        travel across State lines and otherwise engage in interstate 
        commerce in order to provide abortion services to patients, and 
        more would be forced to do so absent this Act.
            (27) Legal limitations and requirements imposed upon health 
        care providers or their patients invariably affect commerce 
        over which the United States has jurisdiction. Health care 
        providers engage in a form of economic and commercial activity 
        when they provide abortion services, and there is an interstate 
        market for abortion services.
            (28) Abortion bans and restrictions substantially affect 
        interstate commerce in numerous ways. For example, to provide 
        abortion services, health care providers engage in interstate 
        commerce to purchase medicine, medical equipment, and other 
        necessary goods and services. To provide and assist others in 
        providing abortion services, health care providers engage in 
        interstate commerce to obtain and provide training. To provide 
        abortion services, health care providers employ and obtain 
        commercial services from doctors, nurses, and other personnel 
        who engage in interstate commerce, including by and traveling 
        across State lines.
            (29) Congress has the authority to enact this Act to 
        protect access to abortion services pursuant to--
                    (A) its powers under the commerce clause of section 
                8 of article I of the Constitution of the United 
                States;
                    (B) its powers under section 5 of the Fourteenth 
                Amendment to the Constitution of the United States to 
                enforce the provisions of section 1 of the Fourteenth 
                Amendment; and
                    (C) its powers under the necessary and proper 
                clause of section 8 of article I of the Constitution of 
                the United States.
            (30) Congress has used its authority in the past to protect 
        access to abortion services and health care providers' ability 
        to provide abortion services. In the early 1990s, protests and 
        blockades at health care facilities where abortion services 
        were provided, and associated violence, increased dramatically 
        and reached crisis level, requiring congressional action. 
        Congress passed the Freedom of Access to Clinic Entrances Act 
        (Public Law 103-259; 108 Stat. 694) to address that situation 
        and protect physical access to abortion services.
            (31) Congressional action is necessary to put an end to 
        harmful restrictions, to protect access to abortion services 
        for everyone regardless of where they live, to protect the 
        ability of health care providers to provide these services in a 
        safe and accessible manner, and to eliminate unwarranted 
        burdens on commerce and the right to travel.

SEC. 3. PURPOSE.

    The purposes of this Act are as follows:
            (1) To permit people to seek and obtain abortion services, 
        and to permit health care providers to provide abortion 
        services, without harmful or unwarranted limitations or 
        requirements that single out the provision of abortion services 
        for restrictions that are more burdensome than those 
        restrictions imposed on medically comparable procedures, do not 
        significantly advance reproductive health or the safety of 
        abortion services, or make abortion services more difficult to 
        access.
            (2) To promote access to abortion services and thereby 
        protect women's ability to participate equally in the economic 
        and social life of the United States.
            (3) To protect people's ability to make decisions about 
        their bodies, medical care, family, and life's course.
            (4) To eliminate unwarranted burdens on commerce and the 
        right to travel. Abortion bans and restrictions invariably 
        affect commerce over which the United States has jurisdiction. 
        Health care providers engage in economic and commercial 
        activity when they provide abortion services. Moreover, there 
        is an interstate market for abortion services and, in order to 
        provide such services, health care providers engage in 
        interstate commerce to purchase medicine, medical equipment, 
        and other necessary goods and services; to obtain and provide 
        training; and to employ and obtain commercial services from 
        health care personnel, many of whom themselves engage in 
        interstate commerce, including by traveling across State lines. 
        Congress has the authority to enact this Act to protect access 
        to abortion services pursuant to--
                    (A) its powers under the commerce clause of section 
                8 of article I of the Constitution of the United 
                States;
                    (B) its powers under section 5 of the Fourteenth 
                Amendment to the Constitution of the United States to 
                enforce the provisions of section 1 of the Fourteenth 
                Amendment; and
                    (C) its powers under the necessary and proper 
                clause of section 8 of article I of the Constitution of 
                the United States.

SEC. 4. DEFINITIONS.

    In this Act:
            (1) Abortion services.--The term ``abortion services'' 
        means an abortion and any medical or non-medical services 
        related to and provided in conjunction with an abortion 
        (whether or not provided at the same time or on the same day as 
        the abortion).
            (2) Government.--The term ``government'' includes each 
        branch, department, agency, instrumentality, and official of 
        the United States or a State.
            (3) Health care provider.--The term ``health care 
        provider'' means any entity (including any hospital, clinic, or 
        pharmacy) or individual (including any physician, certified 
        nurse-midwife, nurse practitioner, pharmacist, or physician 
        assistant) that--
                    (A) is engaged or seeks to engage in the delivery 
                of health care services, including abortion services; 
                and
                    (B) if required by law or regulation to be licensed 
                or certified to engage in the delivery of such 
                services--
                            (i) is so licensed or certified; or
                            (ii) would be so licensed or certified but 
                        for their past, present, or potential provision 
                        of abortion services protected by section 4.
            (4) Medically comparable procedures.--The term ``medically 
        comparable procedures'' means medical procedures that are 
        similar in terms of health and safety risks to the patient, 
        complexity, or the clinical setting that is indicated.
            (5) Pregnancy.--The term ``pregnancy'' refers to the period 
        of the human reproductive process beginning with the 
        implantation of a fertilized egg.
            (6) State.--The term ``State'' includes the District of 
        Columbia, the Commonwealth of Puerto Rico, and each territory 
        and possession of the United States, and any subdivision of any 
        of the foregoing, including any unit of local government, such 
        as a county, city, town, village, or other general purpose 
        political subdivision of a State.
            (7) Viability.--The term ``viability'' means the point in a 
        pregnancy at which, in the good-faith medical judgment of the 
        treating health care provider, and based on the particular 
        facts of the case before the health care provider, there is a 
        reasonable likelihood of sustained fetal survival outside the 
        uterus with or without artificial support.

SEC. 5. PROTECTED ACTIVITIES AND SERVICES.

    (a) General Rules.--
            (1) Pre-viability.--A health care provider has a right 
        under this Act to provide abortion services, and a patient has 
        a corresponding right under this Act to terminate a pregnancy 
        prior to viability without being subject to any of the 
        following limitations or requirements:
                    (A) A prohibition on abortion prior to viability, 
                including a prohibition or restriction on a particular 
                abortion procedure or method, or a prohibition on 
                providing or obtaining such abortions.
                    (B) A limitation on a health care provider's 
                ability to prescribe or dispense drugs that could be 
                used for reproductive health purposes based on current 
                evidence-based regimens or the provider's good-faith 
                medical judgment, or a limitation on a patient's 
                ability to receive or use such drugs, other than a 
                limitation generally applicable to the prescription, 
                dispensing, or distribution of drugs.
                    (C) A limitation on a health care provider's 
                ability to provide, or a patient's ability to receive, 
                abortion services via telemedicine, other than a 
                limitation generally applicable to the provision of 
                medically comparable services via telemedicine.
                    (D) A limitation or prohibition on a patient's 
                ability to receive, or a provider's ability to provide, 
                abortion services in a State based on the State of 
                residency of the patient, or a prohibition or 
                limitation on the ability of any individual to assist 
                or support a patient seeking abortion.
                    (E) A requirement that a health care provider 
                perform specific tests or medical procedures in 
                connection with the provision of abortion services 
                (including prior to or subsequent to the abortion), 
                unless generally required for the provision of 
                medically comparable procedures.
                    (F) A requirement that a health care provider offer 
                or provide a patient seeking abortion services 
                medically inaccurate information.
                    (G) A limitation or requirement concerning the 
                physical plant, equipment, staffing, or hospital 
                transfer arrangements of facilities where abortion 
                services are provided, or the credentials or hospital 
                privileges or status of personnel at such facilities, 
                that is not imposed on facilities or the personnel of 
                facilities where medically comparable procedures are 
                performed.
                    (H) A requirement that, prior to obtaining an 
                abortion, a patient make one or more medically 
                unnecessary in-person visits to the provider of 
                abortion services or to any individual or entity that 
                does not provide abortion services.
                    (I) A limitation on a health care provider's 
                ability to provide immediate abortion services when 
                that health care provider believes, based on the good-
                faith medical judgment of the provider, that delay 
                would pose a risk to the patient's life or health.
                    (J) A requirement that a patient seeking abortion 
                services at any point or points in time prior to 
                viability disclose the patient's reason or reasons for 
                seeking abortion services, or a limitation on providing 
                or obtaining abortion services at any point or points 
                in time prior to viability based on any actual, 
                perceived, or potential reason or reasons of the 
                patient for obtaining abortion services, regardless of 
                whether the limitation is based on a health care 
                provider's actual or constructive knowledge of such 
                reason or reasons.
            (2) Post-viability.--
                    (A) In general.--A health care provider has a right 
                under this Act to provide abortion services and a 
                patient has a corresponding right under this Act to 
                terminate a pregnancy after viability when, in the 
                good-faith medical judgement of the treating health 
                care provider, it is necessary to protect the life or 
                health of the patient. This subparagraph shall not 
                otherwise apply after viability.
                    (B) Additional circumstances.--A State may provide 
                additional circumstances under which post viability 
                abortions are permitted under this paragraph.
                    (C) Limitation.--In the case where a termination of 
                a pregnancy after viability, in the good-faith medical 
                judgement of the treating health care provider, is 
                necessary to protect the life or health of the patient, 
                a State shall not impose any of the limitations or 
                requirements described in paragraph (1).
    (b) Other Limitations or Requirements.--The rights described in 
subsection (a) shall not be limited or otherwise infringed through any 
other limitation or requirement that--
            (1) expressly, effectively, implicitly, or as implemented, 
        singles out abortion, the provision of abortion services, 
        individuals who seek abortion services or who provide 
        assistance and support to those seeking abortion services, 
        health care providers who provide abortion services, or 
        facilities in which abortion services are provided; and
            (2) impedes access to abortion services.
    (c) Factors for Consideration.--A court may consider the following 
factors, among others, in determining whether a limitation or 
requirement impedes access to abortion services for purposes of 
subsection (b)(2):
            (1) Whether the limitation or requirement, in a provider's 
        good-faith medical judgment, interferes with a health care 
        provider's ability to provide care and render services, or 
        poses a risk to the patient's health or safety.
            (2) Whether the limitation or requirement is reasonably 
        likely to delay or deter a patient in accessing abortion 
        services.
            (3) Whether the limitation or requirement is reasonably 
        likely to directly or indirectly increase the cost of providing 
        abortion services or the cost for obtaining abortion services 
        such as costs associated with travel, childcare, or time off 
        work.
            (4) Whether the limitation or requirement is reasonably 
        likely to have the effect of necessitating patient travel that 
        would not otherwise have been required, including by making it 
        necessary for a patient to travel out of State to obtain 
        services.
            (5) Whether the limitation or requirement is reasonably 
        likely to result in a decrease in the availability of abortion 
        services in a given State or geographic region.
            (6) Whether the limitation or requirement imposes penalties 
        that are not imposed on other health care providers for 
        comparable conduct or failure to act, or that are more severe 
        than penalties imposed on other health care providers for 
        comparable conduct or failure to act.
            (7) The cumulative impact of the limitation or requirement 
        combined with other limitations or requirements.
    (d) Exception.--To defend against a claim that a limitation or 
requirement violates a health care provider's or patient's rights under 
subsection (b) a party must establish, by clear and convincing 
evidence, that the limitation or requirement is essential to 
significantly advance the safety of abortion services or the health of 
patients and that the safety or health objective cannot be accomplished 
by a different means that does not interfere with the right protected 
under subsection (b).

SEC. 6. PROTECTION OF THE RIGHT TO TRAVEL.

    A person has a fundamental right under the Constitution of the 
United States and this Act to travel to a State other than the person's 
State of residence, including to obtain reproductive health services 
such as prenatal, childbirth, fertility, and abortion services, and a 
person has a right under this Act to assist another person to obtain 
such services or otherwise exercise the right described in this 
section.

SEC. 7. APPLICABILITY AND PREEMPTION.

    (a) In General.--
            (1) Superseding inconsistent laws.--Except as provided 
        under subsection (b), this Act shall supersede any inconsistent 
        Federal or State law, and the implementation of such law, 
        whether statutory, common law, or otherwise, and whether 
        adopted prior to or after the date of enactment of this Act. A 
        Federal or State government official shall not administer, 
        implement, or enforce any law, rule, regulation, standard, or 
        other provision having the force and effect of law that 
        conflicts with any provision of this Act, notwithstanding any 
        other provision of Federal law, including the Religious Freedom 
        Restoration Act of 1993 (42 U.S.C. 2000bb et seq.).
            (2) Laws after date of enactment.--Federal law enacted 
        after the date of the enactment of this Act shall be subject to 
        this Act unless such law explicitly excludes such application 
        by reference to this Act.
    (b) Limitations.--The provisions of this Act shall not supersede or 
apply to--
            (1) laws regulating physical access to clinic entrances;
            (2) laws regulating insurance or medical assistance 
        coverage of abortion services;
            (3) the procedure described in section 1531(b)(1) of title 
        18, United States Code; or
            (4) generally applicable State contract law.
    (c) Preemption Defense.--In any legal or administrative action 
against a person or entity who has exercised or attempted to exercise a 
right protected by section 4 or section 5 or against any person or 
entity who has taken any step to assist any such person or entity in 
exercising such right, this Act shall also apply to, and may be raised 
as a defense by, such person or entity, in addition to the remedies 
specified in section 8.

SEC. 8. RULES OF CONSTRUCTION.

    (a) Liberal Construction by Courts.--In any action before a court 
under this Act, the court shall liberally construe the provisions of 
this Act to effectuate the purposes of the Act.
    (b) Protection of Life and Health.--Nothing in this Act shall be 
construed to authorize any government official to interfere with, 
diminish, or negatively affect a person's ability to obtain or provide 
abortion services prior to viability, or after viability when, in the 
good-faith medical judgment of the treating health care provider, 
continuation of the pregnancy would pose a risk to the pregnant 
patient's life or health.
    (c) Government Officials.--Any person who, by operation of a 
provision of Federal or State law, is permitted to implement or enforce 
a limitation or requirement that violates section 4 or 5 shall be 
considered a government official for purposes of this Act.

SEC. 9. ENFORCEMENT.

    (a) Attorney General.--The Attorney General may commence a civil 
action on behalf of the United States in any district court of the 
United States against any State that violates, or against any 
government official (including a person described in section 7(c)) who 
implements or enforces a limitation or requirement that violates, 
section 4 or 5. The court shall declare unlawful the limitation or 
requirement if it is determined to be in violation of this Act.
    (b) Private Right of Action.--
            (1) In general.--Any individual or entity adversely 
        affected by an alleged violation of this Act, including any 
        person or health care provider, may commence a civil action 
        against any government official (including a person described 
        in section 7(c)) that implements or enforces a limitation or 
        requirement that violates, section 4 or 5. The court shall 
        declare unlawful the limitation or requirement if it is 
        determined to be in violation of this Act.
            (2) Health care provider.--A health care provider may 
        commence an action for relief on its own behalf, on behalf of 
        the provider's staff, and on behalf of the provider's patients 
        who are or may be adversely affected by an alleged violation of 
        this Act.
    (c) Pre-Enforcement Challenges.--A suit under subsection (a) or (b) 
may be brought to prevent enforcement or implementation by any 
government of a State limitation or requirement that is inconsistent 
with section 4 or 5.
    (d) Declaratory and Equitable Relief.--In any action under this 
section, the court may award appropriate declaratory and equitable 
relief, including temporary, preliminary, or permanent injunctive 
relief.
    (e) Costs.--In any action under this section, the court shall award 
costs of litigation, as well as reasonable attorney's fees, to any 
prevailing plaintiff. A plaintiff shall not be liable to a defendant 
for costs or attorney's fees in any non-frivolous action under this 
section.
    (f) Jurisdiction.--The district courts of the United States shall 
have jurisdiction over proceedings under this Act and shall exercise 
the same without regard to whether the party aggrieved shall have 
exhausted any administrative or other remedies that may be provided for 
by law.
    (g) Abrogation of State Immunity.--Neither a State that enforces or 
maintains, nor a government official (including a person described in 
section 7(c)) who is permitted to implement or enforce any limitation 
or requirement that violates section 4 or 5 shall be immune under the 
Tenth Amendment to the Constitution of the United States, the Eleventh 
Amendment to the Constitution of the United States, or any other source 
of law, from an action in a Federal or State court of competent 
jurisdiction challenging that limitation or requirement, unless such 
immunity is required by clearly established Federal law, as determined 
by the Supreme Court of the United States.

SEC. 10. EFFECTIVE DATE.

    This Act shall take effect upon the date of enactment of this Act.

SEC. 11. SEVERABILITY.

    If any provision of this Act, or the application of such provision 
to any person, entity, government, or circumstance, is held to be 
unconstitutional, the remainder of this Act, or the application of such 
provision to all other persons, entities, governments, or 
circumstances, shall not be affected thereby.
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