[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 4296 Introduced in Senate (IS)]

<DOC>






118th CONGRESS
  2d Session
                                S. 4296

 To amend the Public Health Service Act to provide more opportunities 
            for mothers to succeed, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 9, 2024

    Mrs. Britt (for herself, Mr. Rubio, Mr. Cramer, Mr. Daines, Mr. 
 Grassley, Mrs. Hyde-Smith, Mr. Marshall, Mr. Moran, Mr. Ricketts, Mr. 
    Rounds, Mr. Schmitt, Mr. Tillis, Mr. Wicker, and Mr. Lankford) 
introduced the following bill; which was read twice and referred to the 
          Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
 To amend the Public Health Service Act to provide more opportunities 
            for mothers to succeed, 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; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``More Opportunities 
for Moms to Succeed Act'' or the ``MOMS Act''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
     TITLE I--FEDERAL CLEARINGHOUSE OF RESOURCES FOR EXPECTING MOMS

Sec. 101. Pregnancy.gov.
Sec. 102. National list of licensed child placement agencies.
Sec. 103. List of funding opportunities available to pregnancy support 
                            centers.
     TITLE II--IMPROVING ACCESS TO PRENATAL AND POSTNATAL RESOURCES

Sec. 201. Positive alternatives for women.
Sec. 202. Improving access to prenatal and postnatal telehealth care.
                    TITLE III--UNBORN CHILD SUPPORT

Sec. 301. Child support enforcement on behalf of unborn children.

     TITLE I--FEDERAL CLEARINGHOUSE OF RESOURCES FOR EXPECTING MOMS

SEC. 101. PREGNANCY.GOV.

    The Public Health Service Act (42 U.S.C. 201 et seq.) is amended by 
adding at the end the following:

               ``TITLE XXXIV--RESOURCE DIRECTORY FOR MOMS

``SEC. 3401. ESTABLISHMENT OF PREGNANCY.GOV WEBSITE.

    ``(a) Website.--Not later than 1 year after the date of enactment 
of this section, the Secretary shall publish a public website entitled 
`pregnancy.gov'. The Secretary may not delegate implementation or 
administration of the website below the level of the Office of the 
Secretary. The website shall include the following:
            ``(1) A clearinghouse of relevant resources available for 
        pregnant and postpartum women, and women parenting young 
        children.
            ``(2) A series of questions through which a user is able to 
        generate a list of relevant resources of interest within the 
        user's ZIP Code.
            ``(3) A means to direct the user to identify whether to 
        list the relevant resources of interest that are available 
        online or within 1, 5, 10, 50, and 100 miles of the user.
            ``(4) A mechanism for users to take an assessment through 
        the website and provide consent to use the user's contact 
        information, which the Secretary may use to conduct outreach 
        via phone or email to follow up with users on additional 
        resources that would be helpful for the users to review.
    ``(b) Resource List Aggregation.--
            ``(1) In general.--The Secretary shall invite each State to 
        provide recommendations of relevant resources referred to in 
        subsection (a)(3) for such State.
            ``(2) Criteria for making recommendations.--The Secretary 
        shall develop criteria to provide to the States to determine 
        whether resources recommended as described in paragraph (1) 
        should appear on the website. Such criteria shall include the 
        requirement that the relevant resource is not a prohibited 
        entity.
            ``(3) Grant program.--
                    ``(A) In general.--The Secretary shall provide 
                grants to States to establish or support a system 
                that--
                            ``(i) aggregates relevant resources 
                        referred to in subsection (a)(3), in accordance 
                        with the criteria developed under paragraph 
                        (2); and
                            ``(ii) may be coordinated, to the extent 
                        determined appropriate by the State, by a 
                        statewide, regionally based, or community-based 
                        public or private entity.
                    ``(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 relevant 
                resources that would be included in the State system 
                supported by the grant.
    ``(c) Prohibition Regarding Certain Entities.--Relevant resources 
listed on the website, and any additional resources promoted by the 
Secretary, may not include any resource offered by a prohibited entity. 
No prohibited entity may receive a grant provided under subsection 
(b)(3).
    ``(d) Services in Different Languages.--The Secretary shall ensure 
that the website provides the widest possible access to services for 
families who speak languages other than English.
    ``(e) Reporting Requirements.--
            ``(1) In general.--Not later than 180 days after the date 
        on which the website is established under this section, the 
        Secretary shall submit to Congress a report on--
                    ``(A) the traffic of the website;
                    ``(B) user feedback on the accessibility and 
                helpfulness of the website in tailoring to the user's 
                needs;
                    ``(C) insights on gaps in relevant resources with 
                respect to services for pregnant and postpartum women, 
                or women parenting young children;
                    ``(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; and
                    ``(E) certification that no prohibited entities are 
                listed as a relevant resource or are in receipt of a 
                grant under subsection (b)(3).
            ``(2) Confidentiality.--The report under paragraph (1) 
        shall not include any personal identifying information 
        regarding individuals who have used the website.
    ``(f) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated such sums as may be necessary 
for each of fiscal years 2024 through 2029.
    ``(g) 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) Relevant resources.--The term `relevant resources' 
        means the Federal, State, local governmental, and private 
        resources that serve pregnant and postpartum women, or women 
        parenting young children in the categories of the following 
        topics:
                    ``(A) Mentorship opportunities, including pregnancy 
                and parenting help and case management resources.
                    ``(B) 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.
                    ``(C) Financial assistance, work opportunities, 
                nutrition assistance, childcare, and education 
                opportunities for parents.
                    ``(D) 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.
                    ``(E) 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.
                    ``(F) 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.
                    ``(G) Healing and support services for abortion 
                survivors and their families.
                    ``(H) Services providing childcare, adoption, 
                foster care, and short term childcare services and 
                resources.
                    ``(I) Comprehensive information on alternatives to 
                abortion.
                    ``(J) Information about abortion risks, including 
                complications and failures.
                    ``(K) Links to information on child development 
                from moment of conception.
            ``(5) Unborn child.--The term `unborn child' has the 
        meaning given such term in section 1841(d) of title 18, United 
        States Code.
            ``(6) Website.--The term `website' means the public website 
        entitled `pregnancy.gov' required to be established under 
        subsection (a).''.

SEC. 102. NATIONAL LIST OF LICENSED CHILD PLACEMENT AGENCIES.

    (a) In General.--Section 474 of the Social Security Act (42 U.S.C. 
674) is amended by adding at the end the following:
    ``(h) National List of Licensed Child Placement Agencies.--
            ``(1) State reporting.--
                    ``(A) In general.--Not later than January 1 of each 
                fiscal year, a State with a plan approved under this 
                part for the fiscal year shall submit to the Secretary 
                a list of private child placement agencies that, as of 
                the end of the preceding fiscal year, were licensed or 
                accredited by, and in good standing with, the State and 
                exempt from Federal income tax by reason of section 
                501(c)(3) of the Internal Revenue Code of 1986.
                    ``(B) Child placement agency.--In subparagraph (A), 
                the term `child placement agency' means an agency that 
                places children in prospective adoptive homes.
            ``(2) National list.--The Secretary, through the United 
        States Children's Bureau, shall compile and maintain on the 
        public website entitled `pregnancy.gov' required to be 
        established under title XXXIV of the Public Health Service Act, 
        a publicly available list consisting of each list most recently 
        submitted by a State under paragraph (1).
            ``(3) Annual reports to congress.--Not later than the 2nd 
        December 31 after the date of the enactment of this subsection, 
        and annually thereafter, the Secretary shall submit to the 
        Congress a written report that contains the list maintained 
        under paragraph (2) and identifies any child placement agency 
        that is licensed by a State and is not on the list, and a 
        specification of any disciplinary actions that a State has 
        taken against a private child placement agency.''.
    (b) Loss of Eligibility for Adoption and Legal Guardianship 
Incentive Payments for Failure of State To Comply With List Submission 
Requirement.--Section 473A(b) of such Act (42 U.S.C. 673b(b)) is 
amended--
            (1) by striking ``and'' at the end of paragraph (3);
            (2) by striking the period at the end of paragraph (4) and 
        inserting ``; and''; and
            (3) by adding at the end the following:
            ``(5) the State has complied with section 474(h)(1) with 
        respect to the preceding fiscal year.''.

SEC. 103. LIST OF FUNDING OPPORTUNITIES AVAILABLE TO PREGNANCY SUPPORT 
              CENTERS.

    Title XXXIV of the Public Health Service Act (as added by section 
101) is amended by adding at the end the following:

``SEC. 3402. LIST OF FUNDING OPPORTUNITIES AVAILABLE TO PREGNANCY 
              SUPPORT CENTERS.

    ``The Secretary shall compile and maintain on the public website 
entitled `pregnancy.gov' required to be established under section 3401, 
a publicly available list of Federal funding opportunities available to 
nonprofit and health care entities for pregnancy support services that 
offer or provide the relevant resources (as defined in subsection (g) 
of such section).''.

     TITLE II--IMPROVING ACCESS TO PRENATAL AND POSTNATAL RESOURCES

SEC. 201. 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 themselves and 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(b)(3))) 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 to 
        pregnant and postpartum women, or women parenting young 
        children, 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) 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.
    (f) 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.
    (g) 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.
    (h) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated such sums as may be necessary 
for each of fiscal years 2024 through 2029.

SEC. 202. IMPROVING ACCESS TO PRENATAL AND POSTNATAL TELEHEALTH CARE.

    (a) In General.--The Secretary shall award grants to, or enter into 
cooperative agreements with, 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) Ineligible Entities.--An entity shall be ineligible to receive 
a grant or enter into a cooperative agreement under this section if the 
entity or any affiliate, subsidiary, successor, or clinic thereof--
            (1) performs, induces, refers for, or counsels in favor of 
        abortions; or
            (2) provides financial support to any other entity that 
        conducts any activity described in paragraph (1).
    (c) Use of Funds.--A recipient of a grant or cooperative agreement 
under this section shall use the award funds 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).
    (d) Report to Congress.--Not later than September 30, 2028, the 
Secretary shall submit to Congress a report on activities supported 
through grants and cooperative agreements under this section, 
including--
            (1) a description of the activities conducted pursuant to 
        such grants and cooperative agreements; and
            (2) an analysis of the effects of such grants and 
        cooperative agreements on improving prenatal and postnatal care 
        in areas and jurisdictions described in subsection (a).
    (e) Definitions.--In this section:
            (1) Eligible entity.--The term ``eligible entity'' means an 
        entity that provides prenatal care, labor care, birthing, or 
        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) Frontier county.--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) Indian tribe; tribal organization.--The terms ``Indian 
        Tribe'' and ``Tribal organization'' have the meanings given 
        such terms in section 4 of the Indian Self-Determination and 
        Education Assistance Act (25 U.S.C. 5304).
            (4) Medically underserved area.--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) Rural area.--The term ``rural area'' has the meaning 
        given such term in section 330J(e) of the Public Health Service 
        Act (42 U.S.C. 254c-15(e)).
            (6) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
    (f) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated such sums as may be necessary 
for each of fiscal years 2024 through 2029.

                    TITLE III--UNBORN CHILD SUPPORT

SEC. 301. CHILD SUPPORT ENFORCEMENT ON BEHALF OF UNBORN CHILDREN.

    (a) State Plan Amendment.--Section 454 of the Social Security Act 
(42 U.S.C. 654) is amended--
            (1) in paragraph (4)(A)--
                    (A) in clause (i)--
                            (i) by inserting ``, including an unborn 
                        child,'' after ``child''; and
                            (ii) by inserting ``and'' after the 
                        semicolon; and
                    (B) in clause (ii), by inserting ``, including an 
                unborn child'' after ``other child'';
            (2) in paragraph (33), by striking ``and'' after the 
        semicolon;
            (3) in paragraph (34), by striking the period and inserting 
        ``; and'';
            (4) by inserting after paragraph (34), the following:
            ``(35) provide that the State will establish and enforce 
        child support obligations of the biological father of an unborn 
        child (and subsequent to the birth of the child) to the mother 
        of such child provided that--
                    ``(A) the mother has requested payment of such 
                child support obligations;
                    ``(B) the start date for such obligations may begin 
                with the first month in which the child was conceived, 
                as determined by a physician (and shall begin with that 
                month if the mother so requests);
                    ``(C) payments for such obligations may be 
                retroactively collected or awarded, including in the 
                case where paternity is established subsequent to the 
                birth of the child;
                    ``(D) the payment amount for such obligations shall 
                be determined by a court, in consultation with the 
                mother, taking into account the best interests of the 
                mother and child;
                    ``(E) any measure to establish the paternity of a 
                child (born or unborn) shall not be required without 
                the consent of the mother; and
                    ``(F) any measure to establish the paternity of an 
                unborn child shall not be taken if the measure poses 
                any risk of harm to the child if unborn.''; and
            (5) by adding at the end the following: ``For purposes of 
        paragraphs (4) and (35), the term `unborn child' means a member 
        of the species homo sapiens, at any stage of development, who 
        is carried in the womb.''.
    (b) Limitation of Waiver Authority.--Section 1115 of the Social 
Security Act (42 U.S.C. 1315) is amended--
            (1) in subsection (a), in the matter preceding paragraph 
        (1), by striking ``In the case of'' and inserting ``Except as 
        provided in subsection (c), in the case of'';
            (2) in subsection (b)(1), in the matter preceding 
        subparagraph (A), by striking ``In the case of'' and inserting 
        ``Except as provided in subsection (c), in the case of''; and
            (3) by striking subsection (c) and inserting the following:
    ``(c) No experimental, pilot, or demonstration project undertaken 
under subsection (a) to assist in promoting the objectives of part D of 
title IV, may permit modifications of paragraphs (4)(A)(ii) and (35) of 
section 454 to establish and enforce child support obligations of the 
biological father of an unborn child. For purposes of the preceding 
sentence, the term `unborn child' means a member of the species homo 
sapiens, at any stage of development, who is carried in the womb.''.
    (c) Effective Date.--The amendments made by this section shall take 
effect on the date that is 2 years after the date of enactment of this 
Act and shall apply to payments under part D of title IV of the Social 
Security Act (42 U.S.C. 651 et seq.) for calendar quarters beginning on 
or after such date.
                                 <all>