[House Report 112-671]
[From the U.S. Government Publishing Office]


112th Congress                                                   Report
                        HOUSE OF REPRESENTATIVES
 2d Session                                                     112-671

======================================================================



 
               CHILD INTERSTATE ABORTION NOTIFICATION ACT

                                _______
                                

 September 14, 2012.--Committed to the Committee of the Whole House on 
            the State of the Union and ordered to be printed

                                _______
                                

Mr. Smith of Texas, from the Committee on the Judiciary, submitted the 
                               following

                              R E P O R T

                             together with

                            DISSENTING VIEWS

                        [To accompany H.R. 2299]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on the Judiciary, to whom was referred the 
bill (H.R. 2299) to amend title 18, United States Code, to 
prohibit taking minors across State lines in circumvention of 
laws requiring the involvement of parents in abortion 
decisions, having considered the same, reports favorably 
thereon without amendment and recommends that the bill do pass.

                                CONTENTS

                                                                   Page

Purpose and Summary..............................................     2
Background and Need for the Legislation..........................     4
Hearings.........................................................    45
Committee Consideration..........................................    45
Committee Votes..................................................    45
Committee Oversight Findings.....................................    58
New Budget Authority and Tax Expenditures........................    58
Congressional Budget Office Cost Estimate........................    58
Performance Goals and Objectives.................................    59
Advisory on Earmarks.............................................    60
Section-by-Section Analysis......................................    60
Changes in Existing Law Made by the Bill, as Reported............    62
Dissenting Views.................................................    67

                          Purpose and Summary

    H.R. 2299, the ``Child Interstate Abortion Notification 
Act'' (``CIANA''), has two primary purposes. The first is to 
protect the health and safety of young girls by preventing 
valid and constitutional state parental involvement laws from 
being circumvented. The second is to protect the health and 
safety of young girls by protecting the rights of parents to be 
involved in the medical decisions of their minor daughters when 
such decisions involve interstate abortions.
    To achieve these purposes, CIANA contains two sections, 
each of which creates a new Federal crime subject to up to a 
$100,000 fine, or 1 year in jail, or both.\1\
---------------------------------------------------------------------------
    \1\Under 18 U.S.C. Sec. 3559(a)(6) (``An offense that is not 
specifically classified by a letter grade in the section defining it, 
is classified if the maximum term of imprisonment authorized is 1 year 
or less but more than 6 months, as a Class A misdemeanor.''), CIANA 
would be classified as a Class A misdemeanor. Under the Federal fine 
statute, the sentence for a Class A misdemeanor that does not result in 
death is not more than $100,000, and for one that does result in death 
is not more than $250,000. See 18 U.S.C. Sec. 3571(b)(4)-(5).
---------------------------------------------------------------------------
    First, CIANA makes it a Federal crime to transport a minor 
across state lines to obtain an abortion in another state in 
order to avoid a state law requiring parental involvement in a 
minor's abortion decision. According to the Guttmacher 
Institute, 34 states have laws in effect that require parental 
involvement in minors' abortions.\2\ But too often, such laws 
are circumvented. Indeed, according to ``The Impact of Laws 
Requiring Parental Involvement for Abortion: A Literature 
Review,'' published by the Guttmacher Institute in 2009, ``The 
clearest documented impact of parental involvement laws is an 
increase in the number of minors traveling outside their home 
states to obtain abortion services in states that do not 
mandate parental involvement or that have less restrictive 
laws.''\3\
---------------------------------------------------------------------------
    \2\Those states are Alabama, Arizona, Arkansas, Colorado, Delaware, 
Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, 
Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, 
North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode 
Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, 
West Virginia, Wisconsin and Wyoming.
    \3\Amanda Dennis, Stanley K. Henshaw, Theodore J. Joyce, Lawrence 
B. Finer, and Kelly Blanchard, ``The Impact of Laws Requiring Parental 
Involvement for Abortion: A Literature Review'' (Guttmacher Institute: 
March 2009) at 1.
---------------------------------------------------------------------------
    The purpose of the first section of CIANA is to prevent 
people--including abusive boyfriends and older men who may have 
committed rape--from pressuring young girls into circumventing 
their state's parental involvement laws by receiving a secret 
out-of-state abortion. This section of CIANA does not apply to 
minors themselves, or to their parents. It also does not apply 
in life-threatening emergencies that may require that an 
abortion be provided immediately.
    Second, CIANA applies when a minor from one state crosses 
state lines to have an abortion in another state that does not 
have a state law requiring parental involvement in a minor's 
abortion decision, or when a minor from one state crosses state 
lines to have an abortion in another state that does have a 
state law requiring parental involvement in a minor's abortion 
decision, but the physician fails to comply with such law. In 
such a case, CIANA makes it a Federal crime for the abortion 
provider to fail to give one of the minor's parents, or a legal 
guardian if necessary, 24 hours' notice (or notice by mail if 
necessary) of the minor's abortion decision before the abortion 
is performed. The purpose of this section is to protect 
fundamental parental rights by giving parents a chance to help 
their young daughters through difficult circumstances as best 
they can, including by giving a health care provider their 
daughter's medical history to ensure she receives safe medical 
care and any necessary follow-up treatment.
    Dr. Bruce A. Lucero, an abortion provider, has supported 
this legislation because ``parents are usually the ones who can 
best help their teenager consider her options'' and because 
``patients who receive abortions at out-of-state clinics 
frequently do not return for follow-up care, which can lead to 
dangerous complications.''\4\ Parental notification also allows 
parents to assist their daughter in the selection of a 
competent abortion provider. This section of CIANA does not 
apply in the following circumstances: where the abortion 
provider is presented with court papers showing that the 
parental involvement law in effect in the minor's state of 
residence has been complied with; where the minor states that 
she has been the victim of abuse by a parent and the abortion 
provider informs the appropriate state authorities of such 
abuse; or where a life-threatening emergency may require that 
an abortion be provided immediately.
---------------------------------------------------------------------------
    \4\Bruce A. Lucero, M.D., ``Parental Guidance Needed,'' The New 
York Times (July 12, 1998), section 4, at 1.
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    CIANA supports state laws that provide parents with the 
necessary information to fulfill their obligation to care for 
their minor children, and it affirms the common-sense notion 
that parents have the legal right to be involved in medical 
decisions relating to their minor children when those decisions 
involve interstate abortions.
    CIANA does not supercede, override, or in any way alter 
existing state parental involvement laws. CIANA addresses the 
interstate transportation of minors in order to circumvent 
valid, existing state laws, and uses Congress' authority to 
regulate interstate activity to protect those laws from evasion 
and to protect parental involvement when minors cross state 
lines to obtain an abortion.
    The vast majority of States have enacted some form of a 
parental involvement law. Such laws reflect widespread 
agreement that it is the parents of a pregnant minor who are 
best suited to provide her counsel, guidance, and support as 
she decides whether to continue her pregnancy or to undergo an 
abortion. These laws not only help to ensure the health and 
safety of pregnant young girls, but also protect fundamental 
parental rights.
    Despite widespread support for parental involvement laws 
and clear public policy considerations justifying them, 
substantial evidence exists that such laws are regularly evaded 
by adults who transport minors to abortion providers in States 
that do not have parental notification or consent laws. CIANA 
would curb the interstate circumvention of these laws, thereby 
protecting the rights of parents and the interests of 
vulnerable minors. CIANA ensures that State parental 
involvement laws are not evaded through interstate activity.
    Parental involvement in the abortion decisions of minor 
girls will lead to improved medical care for minors seeking 
abortions and provide increased protection for young girls 
against sexual exploitation by adult men. When parents are not 
involved in the abortion decisions of a child, the risks to the 
child's health significantly increase. Parental involvement 
will ensure that parents have the opportunity to provide 
additional medical history and information to abortion 
providers prior to performance of an abortion. The medical, 
emotional and psychological consequences of an abortion are 
serious and lasting. An adequate medical and psychological case 
history is important to the physician, and parents can provide 
such information for their daughters as well as any pertinent 
family medical history, refer the physician to other sources of 
medical history, such as family physicians, and authorize 
family physicians to give relevant data.
    Only parents are likely to know a young girl's allergies to 
anesthesia and medication or previous bouts with specific 
medical conditions, including depression. A more complete and 
thus more accurate medical history of the patient will enable 
abortion providers to disclose not only medical risks that 
ordinarily accompany abortions but also those risks that may be 
specific to the pregnant minor.
    Parental involvement also improves medical treatment of 
pregnant minors by ensuring that parents have adequate 
knowledge to recognize and respond to any post-abortion 
complications that may develop. Without the knowledge that 
their daughters have had abortions, parents are unable to 
ensure that their children obtain routine postoperative care 
and unable to provide an adequate medical history to physicians 
called upon to treat any complications that may arise. These 
omissions may allow complications such as infection, 
perforation, or depression to continue untreated. Such 
complications may be lethal if left untreated.
    Teenage pregnancies often occur as a result of predatory 
practices of men who are substantially older than the minor 
victim, resulting in the transportation of the girl across 
State lines by an individual who has a great incentive to avoid 
criminal liability for his conduct. Experience suggests that 
sexual predators recognize the advantage of their victims 
obtaining an abortion. Not only does an abortion eliminate 
critical evidence of the criminal conduct, it allows the abuse 
to continue undetected. Parental involvement laws ensure that 
parents have the opportunity to protect their daughters from 
those who would victimize them further.

                Background and Need for the Legislation

    H.R. 2299 is much-needed legislation, overwhelmingly 
supported by the American people, that will protect both the 
health and safety of our minor children and parental rights.

                           SUPPORT FOR CIANA

    Polls show that the American people overwhelmingly support 
parental involvement laws by huge majorities. A July 2011 
Gallup Poll asked ``Do you favor or oppose each of the 
following proposals? . . . A law requiring women under 18 to 
get parental consent for any abortion.'' 71% responded in 
favor, 27% opposed.\5\ An August 2009 Pew Research Center 
Survey asked ``Do you strongly favor, favor, oppose, or 
strongly oppose? . . . requiring that women under the age of 18 
get the consent of at least one parent before they are allowed 
to have an abortion.'' 76% responded in favor, (45% strongly 
favor, 31% favor), 19% opposed.\6\ An October 2008 Marist Poll 
National Survey asked ``Except in a medical emergency, which do 
you think is more important: the privacy of a daughter under 
the age of 18 to have an abortion or the right of a parent to 
know their underage daughter is about to have this surgical 
procedure?'' 77% of registered voters, and 78% of registered 
Catholic voters supported the parent's right to know.\7\ A 
December 2008 Harris Interactive survey commissioned by the 
U.S. Conference of Cathlolic Bishops also found that ``73 
percent favor laws that require giving parents the chance to be 
involved in their minor daughter's abortion decision.''\8\
---------------------------------------------------------------------------
    \5\http://www.gallup.com/poll/148631/Common-State-Abortion-
Restrictions-Spark-Mixed-Reviews.aspx.
    \6\The relevant question appears on page 5 of this document: http:/
/www.pewforum.org/uploadedfiles/Topics/Issues/Abortion/
abortion09topline.pdf. Also, on p.10 of this Pew report from October 
2009 there is a comparison of the 2005 & 2009 results of the survey 
that may be helpful (support for parental consent was 73% in 2005, 76% 
in 2009). See http://www.pewforum.org/uploadedfiles/Topics/Issues/
Abortion/abortion09.pdf.
    \7\See page 38 of this appendix of topline data found on the 
Knights of Columbus website, available at http://www.kofc.org/un/en/
resources/communications/documents/moralissues_appendix.pdf.
    \8\See USCCB press release, available at http://old.usccb.org/comm/
archives/2008/08-206.shtml.
---------------------------------------------------------------------------
    Earlier polls reveal similar results. In March, 2005, 75% 
of over 1,500 registered voters surveyed favored ``requiring 
parental notification before a minor could get an abortion,'' 
and only 18% were opposed.\9\ According to another poll 
conducted in 2003, 73% of non-whites and 82% of Hispanics 
support parental notification laws.\10\ A Wirthlin Worldwide 
poll conducted in October, 2001, found that 83% of those 
surveyed support laws requiring notification to one parent 
before an abortion can be performed on a minor daughter.\11\
---------------------------------------------------------------------------
    \9\Quinnipiac University Poll (conducted March 2-7, 2005, with 
1,534 registered voters surveyed; margin of error: +/- 2.5%).
    \10\Wirthlin Worldwide Poll (October 21-23, 2003).
    \11\Wirthlin Worldwide National Poll (October 19-22, 2001).
---------------------------------------------------------------------------
    African Americans and Hispanics overwhelmingly support 
parental notification laws. A Public Opinion Strategies poll 
surveyed 1,000 African-American registered voters on the 
question: ``Would you favor or oppose a law that would require 
a parent or guardian to be notified before a minor child, under 
the age of 18, undergoes an abortion procedure?'' 84% favored 
such a law (74% ``strongly favor'' and 10% ``somewhat 
favor'').\12\
---------------------------------------------------------------------------
    \12\Public Opinion Strategies Survey (July 30, 2002).
---------------------------------------------------------------------------
    A Zogby poll of California voters showed that 71% of those 
surveyed in that state support laws requiring notification to 
one parent before an abortion can be performed on a minor 
daughter.\13\
---------------------------------------------------------------------------
    \13\Zogby California Poll (June 2002).
---------------------------------------------------------------------------
    Moreover, during the November, 2004, elections, Florida 
overwhelmingly passed an amendment to its state constitution 
that provides that ``the Legislature is authorized to require 
by general law for notification to a parent or guardian of a 
minor before the termination of the minor's pregnancy.''\14\ 
Nearly 65 percent of Florida voters in November, 2004, approved 
this state constitutional amendment.\15\
---------------------------------------------------------------------------
    \14\F.S.A. Const. Art. 10 Sec. 22.
    \15\See Jackie Hallifax, ``Group Seeks Parental Notice End,'' The 
Brandenton Herald (January 11, 2005) at 5.
---------------------------------------------------------------------------
    Even more rigid requirements of parental consent are 
overwhelmingly supported by the American public. A Gallup poll 
conducted in January, 2003, showed that 78% of those surveyed 
favor laws requiring a 24-hour waiting period before an 
abortion can be obtained, and 73% favor laws requiring minors 
to get parental consent before an abortion can be obtained.\16\ 
These numbers have been confirmed in other polls.\17\ Similar 
results are found in polls that consistently reflect over 70% 
of the American public support parental consent or notification 
laws,\18\ including 69% of the Hispanic population.\19\
---------------------------------------------------------------------------
    \16\Lydia Saad, Gallup News Service (January 20, 2003).
    \17\See Los Angeles Times Poll (June 8-13, 2000); CBS News/New York 
Times Poll (January 1998).
    \18\See, e.g., CBS News/NY Times Poll (released January 15, 1998) 
(78% of those polled favor requiring parental consent before a girl 
under 18 years of age could have an abortion); Americans United for 
Life, Abortion and Moral Beliefs, A Survey of American Opinion (1991); 
Wirthlin Group Survey, Public Opinion, May-June 1989; Life/Contemporary 
American Family (released December, 1981) (78% of those polled believed 
that ``a girl who is under 18 years of age [should] have to notify her 
parents before she can have an abortion'').
    \19\Latino Opinions poll (October 5, 2004) (survey of 1,000 
national adult Hispanics on the question ``[D]o you support or oppose 
requiring underage teenage girls to get permission from their parents 
before they are allowed to get an abortion?'' to which 58% reported 
``strongly support'' and 11% reported ``somewhat support'').
---------------------------------------------------------------------------
    As the Associated Press has reported, even ``[o]pponents 
[of parental notice laws] agree that young women are better off 
telling parents about a pregnancy[.]''\20\
---------------------------------------------------------------------------
    \20\David Crary, ``Passage of Teen Abortion Bill Called Likely,'' 
The Associated Press (January 31, 2005).
---------------------------------------------------------------------------
    There is widespread agreement among abortion rights 
advocates and pro-life advocates that it is the parents of a 
pregnant minor who are best suited to provide her counsel, 
guidance, and support as she decides whether to continue her 
pregnancy or to undergo an abortion. Organizations such as 
Planned Parenthood and the National Abortion and Reproductive 
Rights Action League all advise pregnant minors to consult 
their parents before proceeding with an abortion.\21\ In 
addition, the American Medical Association urges physicians to 
``strongly encourage minors to discuss their pregnancy with 
their parents'' and to ``explain how parental involvement can 
be helpful and that parents are generally very understanding 
and supportive.''\22\
---------------------------------------------------------------------------
    \21\See Planned Parenthood Federation of America, Inc., Fact 
Sheets: Teenagers, Abortion, and Government Intrusion Laws, at http://
www.plannedparenthood.org/library/ABORTION/laws.html (last visited 
February 2, 2005) (``Few would deny that most teenagers, especially 
younger ones, would benefit from adult guidance when faced with an 
unwanted pregnancy. Few would deny that such guidance ideally should 
come from the teenager's parents.''); National Abortion and 
Reproductive Rights Action League, Young Women: Reproductive Rights 
Issues, at http://www.naral.org/Issues/youngwomen/index.cfm (last 
visited February 1, 2005) (``Responsible parents should be involved 
when their young daughters face a crisis pregnancy.'').
    \22\Council on Ethical and Judicial Affairs, American Medical 
Association, ``Mandatory Parental Consent to Abortion,'' 269 JAMA 82, 
83 (1993).
---------------------------------------------------------------------------

          THE SCOPE OF THE INTERSTATE PROBLEM CIANA ADDRESSES

    There is no serious dispute regarding the fact that the 
transportation of minors across state lines in order to obtain 
abortions is both a widespread and frequent practice. Even 
groups opposed to this bill acknowledge that large numbers of 
minors are transported across state lines to obtain abortions, 
in many cases by adults other than their parents. As Dr. Anne 
Foster Rosales, as Medical Director of Planned Parenthood 
Golden Gate in San Francisco, said ``You may see an artificial 
decrease in the abortion rate in teens in [a] state [that 
adopts a parental involvement law], but when you look at 
neighboring states, and the origin of patients, you see that 
what's happening is those young women are just shifting 
themselves to another state.''\23\
---------------------------------------------------------------------------
    \23\Carolyn Johnson, ``Abortion Parental Notification Back on 
Ballot,'' ABC 7 News (KGO) (November 1, 2006), available at http://
abclocal.go.com/kgo/story?section=news/politics&id=4714527.
---------------------------------------------------------------------------
    In 1995, Kathryn Kolbert, then an attorney with the Center 
for Reproductive Law and Policy (a national legal defense 
organization that supports abortion), stated that thousands of 
adults are helping minors cross state lines to get abortions in 
states whose parental involvement requirements are less 
stringent or non-existent: ``There are thousands of minors who 
cross state lines for an abortion every year and who need the 
assistance of adults to do that.''\24\ She asked, ``How does a 
14-year-old get to New Hampshire from Boston without getting a 
ride?''\25\ In 2001, New Jersey's Star-Ledger reported that 
Laurie Lowenstein, Executive Director of Right to Choose, an 
abortion rights advocacy group, stated that she would quit her 
job to shuttle pregnant young girls to states without parental 
notification laws if New Jersey enacted a parental notification 
law.\26\ Only Congress, with its constitutional authority to 
regulate interstate commerce, can curb such flagrant disregard 
of state laws. The experience of a number of States illuminates 
the scope of this problem.
---------------------------------------------------------------------------
    \24\``Labor of Love Is Deemed Criminal,'' The National Law Journal 
(November 11, 1996) at A8.
    \25\See ``Woman Charged in Secret Abortion,'' Philadelphia 
Inquirer, (September 16, 1995).
    \26\Jeff Whelan, ``McGreevey Reveals Latest Abortion Stance,'' The 
Star-Ledger (August 30, 2001).
---------------------------------------------------------------------------
Pennsylvania
    Since Pennsylvania's current parental consent law took 
effect in March, 1994, news reports have confirmed that many 
Pennsylvania teenagers are going out of state to New Jersey and 
New York to obtain abortions. In 1995, the New York Times 
reported that ``Planned Parenthood in Philadelphia has a list 
of clinics, from New York to Baltimore, to which they will 
refer teenagers, according to the organization's executive 
director, Joan Coombs.''\27\ Moreover, the New York Times gave 
accounts of clinics that had seen an increase in patients from 
Pennsylvania.\28\ One clinic, in Cherry Hill, New Jersey, 
reported seeing a threefold increase in Pennsylvania teenagers 
coming for abortions.\29\ Likewise, a clinic in Queens, New 
York, reported that it was not unusual to see Pennsylvania 
teenagers as patients in 1995, though earlier it had been 
rare.\30\
---------------------------------------------------------------------------
    \27\``Teen-Agers Cross State Lines in Abortion Exodus,'' The New 
York Times (December 18, 1995) at B6.
    \28\See id.
    \29\See id.
    \30\See id.
---------------------------------------------------------------------------
    In the period just prior to the Pennsylvania law taking 
effect, efforts were underway to make it easier for teenagers 
to go out of state for abortions. For instance, Newsday 
reported that ``[c]ounselors and activists are meeting to plot 
strategy and printing maps with directions to clinics in New 
York, New Jersey, Delaware and Washington, D.C., where 
teenagers can still get abortions without parental consent . . 
. `We will definitely be encouraging teenagers to go out of 
state,' said Shawn Towey, director of the Greater Philadelphia 
Woman's Medical Fund, a nonprofit organization that gives money 
to women who can't afford to pay for their abortions.''\31\
---------------------------------------------------------------------------
    \31\Charles V. Zehren, ``New Restrictive Abortion Law,'' Newsday 
(February 22, 1994).
---------------------------------------------------------------------------
    Moreover, some abortion clinics in nearby states, such as 
New Jersey and Maryland, and others, use the lack of parental 
involvement requirements in their own states as a ``selling 
point'' in advertising directed at minors in Pennsylvania, 
stating ``No Parental Consent Required.''\32\ A Rockville, 
Maryland, abortionist ran a similar advertisement in the May 
1998-April 1999 Yellow Pages for Harrisburg, Pennsylvania. Such 
advertisements have appeared in telephone directories for 
Wilkes-Barre and Dallas, Scranton, Clarks Summit, and 
Carbondale, Bethlehem, Allentown, York, and Erie.
---------------------------------------------------------------------------
    \32\Copies of such advertisements are attached at the end of this 
report.
---------------------------------------------------------------------------
Missouri
    A study in the American Journal of Public Health reported 
that a leading abortion provider in Missouri refers minors out 
of state for abortions if the girls do not want to involve 
their parents. Reproductive Health Services, which performs 
over half of the abortions performed in Missouri, refers minors 
to the Hope Clinic for Women in Granite City, Illinois.\33\ 
Research reveals that based on the available data the odds of a 
minor traveling out of state for an abortion increased by over 
50 percent when Missouri's parental consent law went into 
effect. Furthermore, compared to older women, underage girls 
were significantly more likely to travel out of state to have 
their abortions.\34\
---------------------------------------------------------------------------
    \33\See Charlotte Ellertson, Ph.D., ``Mandatory Parental 
Involvement in Minors' Abortions: Effects of the Laws in Minnesota, 
Missouri, and Indiana,'' American Journal of Public Health (August 
1997).
    \34\See id. at 1371.
---------------------------------------------------------------------------
    A St. Louis Post-Dispatch news report confirms that the 
Hope Clinic in Illinois continues to attract underage girls 
seeking abortions without parental involvement.\35\ A clinic 
counselor estimates that she sees two girls each week seeking 
to avoid their home state's parental involvement law. One 
example was a 16-year-old girl from Missouri who had called 
abortion clinics in St. Louis and learned that parental consent 
was required before a minor could obtain an abortion. According 
to the report, the Hope Clinic performed 3,200 abortions on 
out-of-state women in 1998, and the clinic's executive director 
estimates that number is 45% of the total abortions performed 
at the clinic. The executive director also estimates that 13% 
of the clinic's clients are minors.
---------------------------------------------------------------------------
    \35\See Kevin McDermott and Mark Schauerte, ``Illinois May Tighten 
Rules on Abortions For Teens; Parental Consent Is Not Required; 
Abortion Bill Targets Illinois as Teen Haven For Abortion,'' St. Louis 
Post-Dispatch (February 25, 1999).
---------------------------------------------------------------------------
Massachusetts
    Massachusetts has also seen an increase in out-of-state 
abortions performed on its teenage residents since the state's 
parental consent law went into effect in April 1981, according 
to a published study.\36\ A study published in the American 
Journal of Public Health found that in the 4 months prior to 
implementation of the parental consent law, an average of 29 
Massachusetts minors obtained out-of-state abortions each month 
in Rhode Island, New Hampshire, Connecticut, and New York.\37\ 
After the parental consent law was implemented, however, the 
average jumped to between 90 and 95 out-of-state abortions per 
month, using data from the five states of Rhode Island, New 
Hampshire, Connecticut, New York, and Maine, representing one-
third of the abortions obtained by Massachusetts' minors.\38\
---------------------------------------------------------------------------
    \36\The Massachusetts law was changed in 1997 to require the 
consent of one parent (or judicial authorization), rather than both 
parents as previously required.
    \37\See Virginia G. Cartoof & Lorraine V. Klerman, ``Parental 
Consent for Abortion: Impact of the Massachusetts Law,'' American 
Journal of Public Health 397 (April 1986).
    \38\See id. at 398.
---------------------------------------------------------------------------
    The study noted that due to what the authors described as 
``astute marketing,'' one abortion clinic in New Hampshire was 
able to nearly double the monthly average of abortions 
performed on Massachusetts minors (from 14 in 1981 to 27 in 
1982). The abortionist ``began advertising in the 1982 Yellow 
Pages of metropolitan areas along the northern Massachusetts 
border, stating `consent for minors not required.'''\39\
---------------------------------------------------------------------------
    \39\Id. at 399.
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    In April 1991, the Planned Parenthood League of 
Massachusetts estimated that approximately 1,200 Massachusetts 
minor girls travel out of state for abortions each year, the 
majority of them to New Hampshire. Planned Parenthood said that 
surveys of New Hampshire clinics revealed an average of 100 
appointments per month by Massachusetts minors.\40\
---------------------------------------------------------------------------
    \40\See M.A.J. McKenna, ``Mass. Abortion Laws Push Teens Over 
Border,'' Boston Herald (April 7, 1991) at A1.
---------------------------------------------------------------------------
Mississippi
    A study of the effect of Mississippi's parental consent law 
revealed that Mississippi has also experienced an increase in 
the number of minors traveling out of state for abortions. The 
study, published in Family Planning Perspectives, compared data 
for the 5 months before the parental consent law took effect in 
June 1993, with data for the 6 months after it took effect, and 
found that ``[a]mong Mississippi residents having an abortion 
in the state, the ratio of minors to older women decreased by 
13% . . . However, this decline was largely offset by a 32% 
increase in the ratio of minors to older women among 
Mississippi residents traveling to other states for abortion 
services.''\41\ Based on the available data, the study suggests 
that the Mississippi parental consent law appeared to have 
``little or no effect on the abortion rate among minors but a 
large increase in the proportion of minors who travel to other 
states to have abortions, along with a decrease in minors 
coming from other states to Mississippi.''\42\
---------------------------------------------------------------------------
    \41\Stanley K. Henshaw, ``The Impact of Requirements for Parental 
Consent on Minors' Abortions in Mississippi,'' Family Planning 
Perspectives (June, 1995) at 121.
    \42\Id. at 122.
---------------------------------------------------------------------------
Virginia
    Grace S. Sparks, executive director of the Virginia League 
of Planned Parenthood, predicted in February 1997 that if 
Virginia were to pass a parental notification law, teenagers 
would travel out of state for abortions: ``In every state where 
they've passed parental notification, . . . there's been an 
increase in out-of-state abortions,'' she said, adding, ``I 
suspect that that's what will happen in Virginia, that teen-
agers who cannot tell their parents . . . will go out of state 
and have abortions . . .''\43\
---------------------------------------------------------------------------
    \43\Lisa A. Singh, ``Those Are the People Who Are Being Hurt,'' 
Style Weekly (February 11, 1997).
---------------------------------------------------------------------------
    Virginia's parental notification law took effect on July 1, 
1997. Initial reports indicated that abortions performed on 
Virginia minors dropped 20 percent during the first 5 months 
that the law was in effect (from 903 abortions during the same 
time period in 1996 to approximately 700 abortions in 
1997).\44\ It appears, however, that Virginia teenagers are 
traveling to the District of Columbia in order to obtain an 
abortion without involving their parents. In fact, the National 
Abortion Federation (``NAF''), which runs a toll-free national 
abortion hotline, said that calls from Virginia teenagers 
seeking information on how to obtain an abortion out of state 
were the largest source of teenage callers seeking out-of-state 
abortions, at seven to ten calls per day.\45\ NAF hotline 
operator Amy Schriefer has gone so far as to talk a Richmond 
area teenage girl through the route (involving a Greyhound bus 
and the Metro's Red Line) to obtain an abortion in the District 
of Columbia.\46\
---------------------------------------------------------------------------
    \44\Ellen Nakashima, ``Fewer Teens Receiving Abortions In 
Virginia,'' The Washington Post (March 3, 1998).
    \45\See id.
    \46\See id.
---------------------------------------------------------------------------

             CONGRESSIONAL TESTIMONIALS HIGHLIGHT THE NEED 
                          FOR IMMEDIATE ACTION

    At hearings during the 105th, 106th, 107th, and 108th 
Congresses, the Subcommittee on the Constitution heard 
testimony from two mothers whose daughters were secretly taken 
for abortions, with devastating consequences.
    Joyce Farley, the mother of a minor girl, recounted how her 
12-year-old daughter was provided alcohol, raped, and then 
taken out of state by the rapist's mother for an abortion.\47\ 
In the words of Joyce Farley, the abortion was arranged to 
destroy evidence--evidence that her 12-year-old daughter had 
been raped.\48\ On August 31, 1995, her daughter, who had just 
turned 13, underwent a dangerous medical procedure without 
anyone present who knew her past medical history (as shown by 
the false medical history that was given to the 
abortionist).\49\ Following the abortion, the mother of the 
rapist dropped off the child in another town 30 miles from the 
child's home.\50\ The child returned to her home with severe 
pain and bleeding which revealed complications from an 
incomplete abortion.\51\ When Joyce Farley contacted the 
original clinic that performed the abortion, the clinic told 
her that the bleeding was normal and to increase her daughter's 
Naprosyn, a medication given to her for pain, every hour if 
needed.\52\ Fortunately, Ms. Farley, being a nurse, knew this 
advice was wrong and could be harmful, but her daughter would 
not have known this.\53\ Because of her mother's intervention, 
Ms. Farley's daughter ultimately received further medical care 
and a second procedure to complete the abortion.\54\
---------------------------------------------------------------------------
    \47\See Child Custody Protection Act: Hearings on H.R. 3682 Before 
the Subcomm. on the Constitution of the House Comm. on the Judiciary, 
105th Cong., (May 21, 1998) (statement of Joyce Farley).
    \48\See id.
    \49\See id.
    \50\See id.
    \51\See id.
    \52\See id.
    \53\See id.
    \54\See id.
---------------------------------------------------------------------------
    As Ms. Farley testified before the House Constitution 
Subcommittee in 2004:

        [I]n 1995, my then 12-year-old daughter, Crystal, was 
        intoxicated and raped by a 19-year-old male . . . On 
        August 31, 1995, I discovered my 13-year-old daughter, 
        Crystal, was missing from home. An investigation by the 
        police, school officials and myself revealed the 
        possibility that Crystal had been transported out of 
        State for an abortion. I can't begin to tell you the 
        fear that enveloped me not knowing where my daughter 
        was, who she was with, if she was in harm's way, and to 
        learn in this manner that my young daughter was 
        pregnant. By early afternoon Crystal was home safe with 
        me, but so much had taken place in that 1 day. The 
        mother of this 19-year-old male had taken Crystal for 
        an abortion in the State of New York. Apparently, this 
        woman decided this was the best solution for the 
        situation caused by her son, with little regard for the 
        welfare of my daughter. Situations such as this is what 
        the Child Custody Act [H.R. 1755 in the 108th Congress, 
        which included provisions that are also in CIANA] was 
        designed to help prevent. I am a loving, responsible 
        parent, whose parenting was interfered with by an adult 
        unknown to me. My child was taken for a medical 
        procedure to an unknown facility and physician without 
        my permission. When Crystal developed complications 
        from this medical procedure, this physician was not 
        available. He refused to supply necessary medical 
        records to a physician that was available to provide 
        Crystal the medical care she needed. I ask you to 
        please, in considering the Child Custody Protection 
        Act, to put aside your personal opinions on abortion. 
        Please just consider the safety of the minor children 
        of our Nation whose lives are put at risk when taken 
        out of their home State . . . Please allow loving, 
        careful and responsible parents the freedom to provide 
        the care their adolescent daughters need without 
        interference from criminals or people who think they 
        may be helping, but actually cause more harm than good. 
        An abortion is a medical procedure with physical and 
        emotional risks. An adolescent who's had an abortion 
        needs the care and support of family. Crystal, 
        unfortunately, developed both physical and emotional 
        side effects. Some of the effects are still present 
        today after 9 years have lapsed.\55\
---------------------------------------------------------------------------
    \55\Child Custody Protection Act: Hearings on H.R. 1755 Before the 
Subcomm. on the Constitution of the House Comm. on the Judiciary, 108th 
Cong., 6-7 (July 20, 2004) (statement of Joyce Farley).

    In the 109th Congress, Marcia Carroll testified before the 
Constitution Subcommittee and described the following 
terrifying story that CIANA, had it been enacted into law, 
---------------------------------------------------------------------------
would have prevented:

        On Christmas Eve 2004, my daughter informed me she was 
        pregnant. I assured her I would seek out all resources 
        and help that was available. As her parents, her father 
        and I would stand beside her and support any decision 
        she made. We scheduled appointments with her 
        pediatrician, her private counselor, and her school 
        nurse. I followed all of their advice and 
        recommendations. They referred us to Healthy Beginnings 
        Plus, Lancaster Family Services, and the WIC program. 
        They discussed all her options with her. I purposefully 
        allowed my daughter to speak alone with professionals 
        so that she would speak her mind and not just say what 
        she thought I wanted to hear. My daughter chose to have 
        the baby and raise it. My family fully supported my 
        daughter's decision to keep her baby and offered her 
        our love and support.
          Subsequently, her boyfriend's family began to harass 
        my daughter and my family. They started showing up at 
        our house to express their desire for my daughter to 
        have an abortion. When that did not work, his 
        grandmother started calling my daughter without my 
        knowledge. They would tell her that if she kept the 
        baby, she couldn't see her boyfriend again. They 
        threatened to move out of state.
          I told his family that my daughter had our full 
        support in her decision to keep the baby. She also had 
        the best doctors, counselors, and professionals to help 
        her through the pregnancy. We all had her best 
        interests in mind.
          The behavior of the boy's family began to concern me 
        to the point where I called my local police department 
        for advice. Additionally, I called the number for an 
        abortion center to see how old you have to be to have 
        an abortion in our state.
          I felt safe when they told me my minor daughter had 
        to be 16 years of age in the state of Pennsylvania to 
        have an abortion without parental consent. I found out 
        later that the Pennsylvania Abortion Control Act 
        actually says that parental consent is needed for a 
        minor under 18 years of age. It never occurred to me 
        that I would need to check the laws of other states 
        around me. I thought as a resident of the state of 
        Pennsylvania that she was protected by Pennsylvania 
        state laws. Boy, was I ever wrong.
          On Feb. 16th, I sent my daughter to her bus stop with 
        $2.00 of lunch money. I thought she was safe at school. 
        She and her boyfriend even had a prenatal class 
        scheduled after school.
          However, what really happened was that her boyfriend 
        and his family met with her down the road from her bus 
        stop and called a taxi. The adults put the children in 
        the taxi to take them to the train station. His 
        stepfather met the children at the train station, where 
        he had to purchase my daughter's ticket since she was 
        only fourteen. They put the children on the train from 
        Lancaster to Philadelphia. From there, they took two 
        subways to New Jersey. That is where his family met the 
        children and took them to the abortion clinic, where 
        one of the adults had made the appointment.
          When my daughter started to cry and have second 
        thoughts, they told her they would leave her in New 
        Jersey. They planned, paid for, coerced, harassed, and 
        threatened her into having the abortion. They left her 
        alone during the abortion and went to eat lunch.
          After the abortion, his stepfather and grandmother 
        drove my daughter home from New Jersey and dropped her 
        off down the road from our house.
          My daughter told me that on the way home she started 
        to cry, they got angry at her and told her there was 
        nothing to cry about.
          Anything could have happened to my daughter at the 
        abortion facility or on the ride back home. These 
        people did not know my daughter's medical history, yet 
        they took her across state lines to have a medical 
        procedure without my knowledge or consent. Our family 
        will be responsible for the medical and psychological 
        consequences for my daughter as a result of this 
        procedure that was completed unbeknownst to me.
          I was so devastated that this could have been done 
        that I called the local police department to see what 
        could be done. They were just as shocked and surprised 
        as I was that there was nothing that could be done in 
        this horrible situation.
          The state of Pennsylvania does have a parental 
        consent law. Something has to be done to prevent this 
        from happening to other families. This is just not 
        acceptable to me and should not happen to families in 
        this country. If your child goes to her school clinic 
        for a headache, a registered nurse can't give her a 
        Tylenol or aspirin without a parent's written 
        permission.
          As a consequence of my daughter being taken out of 
        our state for an abortion without parental knowledge, 
        she is suffering intense grief. My daughter cries 
        herself to sleep at night and lives with this everyday.
          I think about what I could or should have done to 
        keep her safe. Everybody tells me I did everything I 
        could have and should have done. It doesn't make me 
        feel any better, knowing everything I did was not 
        enough to protect my daughter.
          It does ease my mind to know with your help that we 
        can make a difference and change the law to protect 
        other girls and their families. I urge your support for 
        The Child Interstate Abortion Notification Act. It is 
        critical that this law passes in Congress. The right of 
        parents to protect the health and welfare of their 
        minor daughters needs to be protected. No one should be 
        able to circumvent state laws by performing an abortion 
        in another state on a minor daughter without parental 
        consent.\56\
---------------------------------------------------------------------------
    \56\Child Interstate Abortion Notification Act: Hearing Before the 
Subcomm. on the Constitution of the H. Comm. on the Judiciary, 109th 
Cong. 6-7 (2005) (statement of Marcia Carroll).

    The physician who performed an abortion on Marcia Carroll's 
daughter, Dr. Vikram Kaji, had a long history of sexually 
abusing his patients. Marcia Carroll should have been given an 
opportunity to learn about the history of her child's doctor. 
Apparently the people who coerced her daughter into having the 
abortion did not care who performed an abortion on her. Dr. 
Kaji was professionally disciplined by the State of New Jersey 
on November 1, 1993, and given a 12-month suspension for 
sexually abusing three patients and indiscriminately 
prescribing controlled dangerous substances.\57\ He was 
disciplined for having sex with one patient in his office, and 
for performing ``improper'' rectal and breast exams on two 
other patients.\58\ According to a consent order, Dr. Kaji knew 
the woman he had sex with suffered from severe depression, had 
been sexually abused as a child, and had once been hospitalized 
for psychiatric problems.\59\ He was also disciplined by the 
Federal Drug Enforcement Agency on February 22, 1994, and made 
to surrender his controlled substance license.\60\ He was also 
disciplined by the State of Pennsylvania on December 23, 1994, 
and his license was suspended for 36 months.\61\
---------------------------------------------------------------------------
    \57\See Sidney Wolfe, M.D., Mary Gabay, Phyllis McCarthy, Alana 
Bame, and Benita Marcus Adler, ``Questionable Doctors: Disciplined by 
States or the Federal Government'' (State Listing for New Jersey; A 
Public Citizen Health Research Group Report) (March 1996) at 68.
    \58\See American Political Network, ``State Reports Pennsylvania: 
PA Suspends Abortion Provider's License,'' (March 23, 1995) at 6.
    \59\See Kathy Boccella, ``Abortion Doctor Banned One Year,'' The 
Philadelphia Inquirer (October 29, 1993) at B1 (``A woman who had been 
a patient of Kaji's since 1976 said that `numerous times (he) made 
sexual advances toward her and fondled her' in his office between 1980 
and 1988, the consent order read . . . Kaji knew the woman suffered 
from severe depression, had been sexually abused as a child and had 
once been hospitalized for psychiatric problems, the order read.'').
    \60\See id. at 68.
    \61\See id. at 68.
---------------------------------------------------------------------------
    When Marcia Carroll was asked why she came to testify on 
behalf of CIANA, she said, ``[my daughter] does suffer. She has 
gone to counseling for this. I just know that she cries and she 
wished she could redo everything, relive that day over. It's 
just sad that it had to happen this way and this is what she 
had to go through. But she did want me to come here today and 
speak on her behalf. She said, `Mom, just one phone call is all 
it would have taken to stop this from happening . . .' So she 
asked me to come here for her sake and for other girls' safety 
to speak and let you know what was happening.'' That is 
precisely what CIANA affirms: the right of parents to be given 
the chance to help their children through difficult times. The 
parents of this Nation want to be given the chance to make sure 
their children's doctors are not potential sexual abusers and 
controlled substance pushers, and CIANA would give them that 
chance.
    Eileen Roberts also testified that her 13-year-old daughter 
was encouraged by a boyfriend, with the assistance of his adult 
friend, to obtain a secret abortion.\62\ The adult friend drove 
Ms. Roberts' daughter to an abortion clinic 45 miles from her 
home and paid for her daughter to receive the abortion.\63\ 
After 2 weeks of observing their daughter's depression, Ms. 
Roberts and her husband learned that the young girl had an 
abortion from a questionnaire they found under her pillow, 
which their daughter had failed to return to the abortion 
clinic.\64\
---------------------------------------------------------------------------
    \62\See Child Custody Protection Act: Hearings on H.R. 476 Before 
the Subcomm. on the Constitution of the House Comm. on the Judiciary, 
107th Cong. (Sept. 6, 2001) (statement of Eileen Roberts).
    \63\See id. While Ms. Roberts' daughter was not taken to another 
state, her story is illustrative of the harms involved when a child is 
secretly taken away from her parents for an abortion. After this 
experience, Ms. Roberts formed an organization called Mothers Against 
Minor Abortions (MAMA). Ms. Roberts testified: ``I speak today for 
those parents I know around the country, whose daughters have been 
taken out of State for their abortions.'' Id.
    \64\See id.
---------------------------------------------------------------------------
    Ms. Roberts' daughter was then hospitalized as a result of 
the depression, and a physical examination revealed that the 
abortion had been incompletely performed and required surgery 
to repair the damage done by the abortionist.\65\ The hospital 
called Ms. Roberts and told her that they could not do 
reparative surgery without a signed consent form.\66\ The 
following year, Ms. Robert's daughter developed an infection 
and was diagnosed with having pelvic inflammatory disease, 
which again required a 2-day hospitalization for antibiotic 
therapy and a signed consent form.\67\ Ms. Roberts and her 
family were responsible for over $27,000 in medical costs, all 
of which resulted from this one secret abortion.\68\
---------------------------------------------------------------------------
    \65\See id.
    \66\See id.
    \67\See id.
    \68\See id.
---------------------------------------------------------------------------
    Other examples that illustrate the need for CIANA include 
the following. As reported in LifeNews (which refers to a 
mother and daughter as ``Anna'' and ``Jane,'' respectively):

        Anna's daughter, who the Anchor has identified as 
        ``Jane'' was like many teens. In the winter of 2008, 
        she started hanging out with someone her parents didn't 
        approve of. Anna and her husband tried to steer Jane 
        away from the young man, but he had become part of her 
        group of friends. Months later, Anna took Jane for a 
        drive into the Mat-Su Valley in an effort to reach her 
        increasingly distant daughter. Anna could tell 
        something was weighing on Jane's mind. Finally, at 
        lunch, Jane admitted, ``There's something I need to 
        tell you.'' Jane wrote a message on a napkin and slid 
        it across the table. ``I'm pregnant,'' it said . . .
          ``I'm going to have this baby,'' said the resolute 
        teen. ``Well, good!'' Anna responded happily. ``She had 
        our love and support,'' Anna said. Anna recalled that 
        over the ensuing weeks, Jane was excited. She returned 
        from an ultrasound appointment with images of her 
        unborn daughter--one for every member of the family, 
        each addressed to the new grandparents and aunts and 
        uncles. Anna's read, ``Hi, Grandma!'' And the family 
        went shopping for maternity clothes and baby gifts. But 
        not everyone welcomed the new baby. Jane told Anna that 
        the boyfriend's father had offered her $5,000 to abort. 
        But Jane was adamant to give birth to the baby. When 
        the offer rose to $10,000, Anna and her husband were 
        again concerned for their impressionable daughter and 
        reminded her, ``We're here to support you. We're here 
        to help you,'' Anna said. But soon, the boyfriend had 
        convinced Jane to move out and in with him. Then came 
        the boyfriend's ``speech.'' It began with, ``Don't tell 
        your family,'' explained Anna, who with Jane, later 
        found the boyfriend's highly crafted, typewritten 
        draft. ``Here is the need for parental notification,'' 
        Anna stressed. ``Manipulative boyfriend. `Don't 
        tell.''' ``Isn't that what every abuser does to his 
        victim--gets them into a `Don't tell' situation?''' 
        Anna observed . . . ``I finally said, `OK [to the 
        abortion],''' Jane later explained to her mother. ``I 
        didn't say, `Yes.''' The boyfriend flew Jane to 
        Seattle, where Alaska abortion clinics often refer 
        late-term pregnant mothers. As with Alaska, Washington 
        does not require abortion practitioners to notify a 
        minor girl's parent before performing an abortion on 
        her. The day of the secret abortion, Jane was 17 years 
        old. Her unborn baby daughter was heading into her 
        sixth month. And because of the abortionist's silence, 
        Anna believes her own rights as a mother were 
        sacrificed that day, too.\69\
---------------------------------------------------------------------------
    \69\Steven Ertelt, ``Alaska Mother Mourns Her Daughter's Secret 
Abortion,'' LifeNews.com (August 6, 2010), available at http://
www.lifenews.com/2010/08/06/state-5320/.

---------------------------------------------------------------------------
    Also, as reported by LifeNews:

          Hagerstown, MD--When the Senate approved a bill last 
        week prohibiting taking a teenager to another state for 
        an abortion without her parents' knowledge or consent, 
        abortion advocates claimed the practice rarely occurs. 
        However, the director of a Maryland abortion business 
        says it routinely gets calls from teens wanting to 
        avoid parental involvement laws. Teenagers in 
        Pennsylvania's York County are apparently heading to 
        the Hagerstown Reproductive Health Services abortion 
        business in neighboring Maryland. They appear to be 
        wanting to avoid a Pennsylvania state law that requires 
        parental consent for a minor girl to have an abortion 
        and requires all women to wait 24 hours to have an 
        abortion after getting information on fetal development 
        and abortion's medical risks and alternatives.
          The HRHS abortion facility sits just 8-10 miles away 
        from the Pennsylvania-Maryland border and it regularly 
        advertises in York County's Yellow Pages.
          ``It's clear to us that we receive calls from young 
        women in Pennsylvania who already called a clinic in 
        Pennsylvania, and they want to circumvent the state 
        laws,'' the HRHS abortion center administrator told the 
        York Daily Record . . .
          Sheryl Wolf, spokeswoman for Hillcrest Clinic, 
        another Maryland abortion business, said 70 young women 
        came there from Pennsylvania . . . Missouri teens 
        frequently are taken to the Hope Clinic abortion 
        facility in Granite City, Illinois, which neighbors St. 
        Louis, Missouri. Though Missouri requires parental 
        involvement before an abortion, Illinois does not. Last 
        year, Shawn Reagan told Missouri state lawmakers about 
        her problems with the Illinois abortion center.
          Reagan said she wept as she talked with staff at Hope 
        Clinic who refused to let her talk to her 14-year-old 
        daughter who was inside the facility preparing for an 
        abortion. She was eventually arrested trying to find 
        her daughter in the abortion facility. The girl was 
        reportedly taken to Hope Clinic by the mother of the 
        man who allegedly impregnated the 14-year-old. The 
        woman, posing as the girl's grandmother, had the girl 
        called off from school. When the girl left the abortion 
        facility after having an abortion, employees told her, 
        ``No one will ever know you were here, we'll bury your 
        records.''\70\
---------------------------------------------------------------------------
    \70\Steven Ertelt, ``Abortion Center Director Admits Out-of-State 
Teens Go There to Avoid Parents,'' LifeNews.com (July 30, 2006), 
available at http://www.lifenews.com/2006/07/30/nat-2461/.

    As reported in American Medical News, about ``6% of the 
[Hope] clinic's patients are teens. Of those, 40% are from 
Missouri, compared with 50% from Illinois.''\71\ CIANA would 
require Hope Clinic to notify a parent of any minor girl who 
comes from Missouri for an abortion.
---------------------------------------------------------------------------
    \71\Amy Lynn Sorrel, ``State High Court Limits Reach of Missouri 
Abortion Consent Law,'' American Medical News (June 4, 2007), available 
at http://www.ama-assn.org/amednews/2007/06/04/gvsb0604.htm.
---------------------------------------------------------------------------
    Congress must act to maintain the integrity of state 
parental involvement laws. In October, 2011, the Connecticut 
Catholic Public Affairs Conference prepared this report on the 
state of abortion in Connecticut, relying on data from the 
Connecticut Department of Public Health. Table 3 on page 2 of 
the report notes that ``of the 863 abortions performed on 
minors from out-of-state between 2002 and 2010, 91% of those 
cases came from bordering states with parental consent laws 
[361 teens from Rhode Island and 422 from Massachusetts, 53 
from New York].''\72\
---------------------------------------------------------------------------
    \72\Available at http://www.courant.com/media/acrobat/2011-10/
65523671.pdf.
---------------------------------------------------------------------------
    Further, in 2005, the State of Missouri enacted a law 
creating a civil cause of action against any person who 
violates the statutory prohibition that ``[n]o person shall 
intentionally cause, aid, or assist a minor to obtain an 
abortion'' without the consent (or court order) required by 
Missouri law.\73\ In 2007, the Missouri Supreme Court 
interpreted this statutory language so that it would not apply 
to out-of-state abortionists. The court held that the statute 
``applies to in-state conduct and not to wholly out-of-state 
conduct.''\74\ The court said that ``it is beyond Missouri's 
authority to regulate conduct that occurs wholly outside of 
Missouri, and section 188.250 cannot constitutionally be read 
to apply to such wholly out-of-state conduct. Missouri simply 
does not have the authority to make lawful out-of-state conduct 
actionable here, for its laws do not have extraterritorial 
effect.''\75\ This is all the more reason why Congress needs to 
exercise its authority and enact CIANA. Congress has the 
constitutional authority to pass CIANA under the Commerce 
Clause of the Constitution, which expressly authorizes Congress 
to regulate interstate activity.
---------------------------------------------------------------------------
    \73\Vernon's Annotated Missouri Statutes 188.250.
    \74\Planned Parenthood of Kansas v. Nixon, 220 S.W.3d. 722, 743 
(Mo. 2007).
    \75\Planned Parenthood of Kansas v. Nixon, 220 S.W.3d. 722, 742 
(Mo. 2007).
---------------------------------------------------------------------------

             STATE LAW AND CIANA'S PROTECTION OF STATE LAW

    There are currently over 43 states with parental 
involvement statutes on the books.\76\ Of these statutes, the 
large majority are in effect today.\77\ Despite widespread 
support for parental involvement laws and clear public policy 
considerations justifying such laws, there exists substantial 
evidence, outlined above, that they are frequently circumvented 
by adults who transport minors to abortion providers in states 
that do not have parental notification or consent laws. One 
purpose of CIANA is to curb the interstate circumvention of 
these laws, thereby protecting the rights of parents and the 
interests of vulnerable minors.
---------------------------------------------------------------------------
    \76\See Ala. Code Sec. Sec. 26-21-1 to -8 (2003); Alaska Stat. 
Sec. Sec. 18.16.010-030 (Michie 2003); Ariz. Rev. Stat. Sec. 36-2152 
(2004); Ark. Code Ann. Sec. Sec. 20-16-801 to -808 (Michie 2003); Cal. 
Health & Safety Code Sec. 123450 (West 2004); Colo. Rev. Stat. Ann. 
Sec. Sec. 12-37.5-101 to -108 (West 2004); Conn. Gen. Stat. Ann. 
Sec. 19a-601 (West 2003); Del. Code Ann. tit. 24, Sec. Sec. 1780-1789B 
(2003); Fla. Stat. Ann. ch. 390.01115 (Harrison 2004); Ga. Code Ann. 
Sec. Sec. 15-11-110 to -118 (Harrison 2003); Idaho Code Sec. 18-609A 
(2003); 750 Ill. Comp. Stat. Ann. 70/1-99 (West 2004); Ind. Code Ann. 
Sec. Sec. 16-18-2-267, 16-34-2-4 (West 2004); Iowa Code Ann. 
Sec. Sec. 135L.1-.8 (West 2003); Kan. Stat. Ann. Sec. 65-6705 (2003); 
Ky. Rev. Stat. Ann. Sec. 311.732 (Michie 2003); La. Rev. Stat. Ann. 
Sec. 40:1299.35.5 (West 2004); Me. Rev. Stat. Ann. tit. 22, Sec. 1597-A 
(West 2003); Md. Code Ann., Health-Gen. I Sec. 20-103 (2004); Mass. 
Gen. Laws Ann. ch. 112, Sec. 12S (West 2004); Mich. Comp. Laws Ann. 
Sec. Sec. 722.901-.908 (West 2004); Minn. Stat. Ann. Sec. 144.343 (West 
2004); Miss. Code Ann. Sec. Sec. 41-41-51 to -63 (2003); Mo. Ann. Stat. 
Sec. Sec. 188.015, 188.028 (West 2004); Mont. Code Ann. Sec. Sec. 50-
20-201 to -215 (2003); Neb. Rev. Stat. Sec. Sec. 71-6901 to--6909 
(2003); Nev. Rev. Stat. Sec. Sec. 442.255-.257 (2003); N.H. Rev. Stat. 
Ann. Sec. Sec. 132:24-28 (2003); N.J. Stat. Ann. Sec. Sec. 9:17A-1 to -
1.12 (West 2004); N.M. Stat. Ann. Sec. Sec. 30-5-1 to -3 (Michie 2003); 
N.C. Gen. Stat. Sec. Sec. 90-21.6 to .10 (2003); N.D. Cent. Code 
Sec. Sec. 14-02.1-03.1 (2003); Ohio Rev. Code Ann. Sec. Sec. 2919.12, 
2919.121-.122 (West 2004); 18 Pa. Cons. Stat. Ann. Sec. 3206 (West 
2004); R.I. Gen. Laws Sec. 23-4.7-6 (2003); S.C. Code Ann. 
Sec. Sec. 44-41-30 to -37 (Law. Co-op. 2003); S.D. Codified Laws 
Sec. 34-23A-7 (Michie 2004); Tenn. Code Ann. Sec. 37-10-301 to -304 
(2004); Tex. Fam. Code Ann. Sec. Sec. 33.001-.004 (Vernon 2004); Utah 
Code Ann. Sec. 76-7-304 (2003); Va. Code Ann. Sec. 16.1-241 (Michie 
2004); W. Va. Code Sec. Sec. 16-2F-1 to -8 (2004); Wis. Stat. Ann. 
Sec. 48.375 (West 2003); Wyo. Stat. Ann. Sec. 35-6-118 (Michie 2003).
    \77\See Planned Parenthood v. Heed, 390 F.3d 53 (1st Cir. 2004) 
(unconstitutional for lack of health exception); Planned Parenthood of 
Idaho, Inc. v. Wasden, 376 F.3d 908 (9th Cir. 2004) (concluding that 
the Idaho statute's definition of Amedical emergency@ is 
unconstitutionally narrow and that, without an adequate medical 
exception, the parental consent statute is invalid); Glick v. McKay, 
937 F.2d 434 (9th Cir. 1991) (judicial bypass procedure rendered 
statute unconstitutional); Zbaraz v. Ryan, No. 84 CV771, 1996 WL 
33293423 (N.D. Ill. Feb. 8, 1996) (the Illinois Supreme Ct. refused to 
issue rules implementing the Illinois statute); Planned Parenthood of 
Alaska, Inc. v. State, No. 3AN-97-6014 CI (Alaska Super. Ct. Oct. 13, 
2003) (decision on remand from State v. Planned Parenthood of Alaska, 
35 P.3d 30 (Alaska 2001)) (parental consent law with judicial waiver 
violates state constitution); American Acad. of Pediatrics v. Lungren, 
940 P.2d 797, 800 (Cal. 1997) (parental consent statute violated state 
constitutional right to privacy); N. Fla. Women's Health and Counseling 
Services, Inc. v. State, 866 So. 2d 612 (Fla. 2003) (state supreme 
court held that law violated state right to privacy; however, the state 
constitution was amended in November 2004 to allow parental 
notification); Wicklund v. State, No. ADV-97-671 (Mont. Dist. Ct. Feb. 
11, 1999) available at http://www.mtbizlaw.com/1stjd99/
WICKLUND_2_11.htm (parental notification law violated state 
constitution); Planned Parenthood of Central New Jersey v. Farmer, 762 
A.2d 620 (N.J. 2000) (parental notification law with judicial waiver 
violates state constitution); N.M. A.G. Op. No. 90-19 (Oct. 3 1990) 
(State attorney general holds law unenforceable due to lack of judicial 
bypass procedure). In addition, Ohio's parental notification law is in 
effect because a subsequently enacted parental consent statute was 
enjoined. See Cincinnati Women's Services v. Voinovich, No. C-1-98-289 
(S.D. Ohio Apr. 29, 1998) (preliminary injunction preventing 
enforcement of the law).
---------------------------------------------------------------------------
    Parental involvement laws have been in force for decades, 
and there is no case where it has been established that these 
laws led to parental abuse or to self-inflicted injury.\78\ 
Similarly, there is no evidence that these laws have led to an 
increase in illegal abortions.\79\
---------------------------------------------------------------------------
    \78\A 1989 memo prepared by the Minnesota Attorney General 
regarding Minnesota's experience with its parental involvement law 
states that ``after some 5 years of the statute's operation, the 
evidence does not disclose a single instance of abuse or forceful 
obstruction of abortion for any Minnesota minor.'' Testimony before the 
Texas House of Representatives on Massachusetts' experience with its 
parental consent law revealed a similar absence of unintended, but 
harmful, consequences. Ms. Jamie Sabino, chair of the Massachusetts 
Judicial Consent for Minors Lawyer Referral Panel, could identify no 
case of a Massachusetts' minor being abused or abandoned as a result of 
the law. See Hearing on Tex. H.B. 1073 Before the House State Affairs 
Comm., 76th Leg., R.S. 21 (Apr. 19, 1999) (statement by Jamie Sabino).
    \79\See Hearing on Tex. H.B. 1073 Before the House State Affairs 
Comm., 76th Leg., R.S. 21 (Apr. 19, 1999) (statement by Jamie Sabino, 
testifying that there had been no increase in the number of illegal 
abortions in Massachusetts since the enactment of the statute in 1981).
---------------------------------------------------------------------------
    Despite these critical benefits of better-informed 
selection of abortion providers, improved medical histories, 
appropriate post-operative care, and the affirmation of 
parental rights, opponents of CIANA argue that mandatory 
parental involvement results in girls' delaying their decisions 
to obtain abortions, thus increasing the risks attendant to the 
procedure.\80\ There is no evidence, however, that parental 
involvement laws result in medically significant delays in 
obtaining abortions. A study of Minnesota's parental 
notification law found that, ``Regardless [of the reason], the 
claim that the law caused more minors to obtain late abortions 
is unsubstantiated. In fact, the reverse is true. For ages 15-
17, the number of late abortions per 1,000 women decreased 
following the enactment of the law. Therefore, an increased 
medical hazard due to a rising number of late abortions was not 
realized.''\81\
---------------------------------------------------------------------------
    \80\Parental Notification of Abortion: Hearings on H. 218 Before 
the House Comm. on Judiciary, 2001-2002 Legis. (Vt. 2001) (Lori Burris, 
representative of Vermont Academy of Pediatrics).
    \81\Rogers, James L., Boruch, Robert F., Stoms, George B. & DeMoya, 
Dorothy, ``Impact of the Minnesota Parental Notification Law on 
Abortion and Birth,'' 81 Amer. J. Pub. Health 294, 297 (Mar. 1991). Cf. 
Ellertson, Charlotte, ``Mandatory Parental Involvement in Minors' 
Abortions: Effects of the Laws in Minnesota, Missouri, and Indiana,'' 
87 Am. J. Pub. Health 1367, 1372 (August 1997) (``Evidence concerning 
delay is mixed.''). See also id. at 1374 (``During periods of the laws' 
enforcement in Minnesota and Indiana, the two states with gestational 
age at abortion, in-state abortions for minors were probably delayed 
into the second month of pregnancy, although probably not into the 
second trimester.'').
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                     OTHER PARENTAL NOTICE STATUTES

    CIANA will strengthen the effectiveness of state laws 
designed to protect children from the health and safety risks 
associated with abortion.\82\ Across the country, officials 
must obtain parental consent before performing even routine 
medical services such as providing aspirin and before including 
children in certain activities such as field trips and contact 
sports.\83\ Regarding body piercing, states require written 
parental consent,\84\ a parent to be present when a minor is 
pierced,\85\ and written permission or a parent's physical 
presence.\86\ The large majority of states have laws 
prohibiting adolescents from getting tattoos without parental 
consent, and a majority of states have laws against body 
piercing without parental consent and laws that prohibit both 
without parental consent.\87\ Also, in Maryland, for example, 
as the Washington Post reports, eleven school systems require a 
parent's note before sunscreen can be applied to a minor 
student.\88\ Notwithstanding the extensive body of State law 
requiring parental consent before minor children can engage in 
a range of less consequential activity, people other than 
parents can secretly take children across state lines without 
the consent of their parents for abortions.
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    \82\In 2001, 853,485 legal induced abortions were reported to CDC. 
See Lilo T. Strauss, M.A., Joy Herndon, M.S., Jeani Chang, M.P.H., 
Wilda Y. Parker Sonya, V. Bowens, M.S., Suzanne B. Zane, D.V.M., 
Cynthia J. Berg, M.D., ``Abortion Surveillance--United States, 2001,'' 
Centers for Disease Control, Division of Reproductive Health, National 
Center for Chronic Disease Prevention and Health Promotion (November 
26, 2004).
    \83\See, e.g., William D. Valente, 2 Education Law: Public and 
Private Sec. 19.23 at 212 (acknowledging ``[t]he common school practice 
of obtaining written parental consents or waivers . . . for designated 
[school field trip] activities''); Cal. Educ Code Ann Sec. 49302 
(requiring parental consent before pupils can be transported).
    \84\See, e.g., Ala. Code Sec. 22-17A2; Alaska Stat. Sec. 08.13.217; 
Del. Code Ann. tit. 11, Sec. 1114; 720 Ill. Comp. Stat. Ann. 5/12-10.1; 
Kan. Stat. Ann. Sec. 65-1953; Me. Rev. Stat. Ann. tit. 32, Sec. 4323; 
Mich. Comp. Laws Ann. Sec. 333.13102; Mo. Ann. Stat. Sec. 324.520; N.C. 
Gen. Stat. Sec. 14-400; Okla. Stat. Ann. tit. 21, Sec. 842.1; Tenn. 
Code Ann. Sec. 62-38-302; Tex. Health & Safety Code Ann. Sec. 146.012.
    \85\See, e.g., Ariz. Rev. Stat. Ann. Sec. 13-3721; La. Rev. Stat. 
Ann. Sec. 14:93.2; R.I. Gen. Laws Sec. 23-1-39; Utah Code Ann. Sec. 76-
10-2201; Va. Code Ann. Sec. 18.2-371.3.
    \86\See, e.g., Cal. Penal Code Sec. 652; Fla. Stat. Ann. 
Sec. 381.0075(7); Ind. Code Ann. Sec. 35-42-2-7; S.C. Code Ann. 
Sec. 44-32-120.
    \87\Ala. Code 22-17A-2 (prohibits anyone from performing a tattoo, 
brand or body piercing on a minor unless prior written informed consent 
is obtained from the minor's parent or legal guardian); Ariz. Rev. 
Stat. Ann. Sec. 13-3721 (establishes that it is unlawful to either 
tattoo or body pierce anyone under age 18 without the physical presence 
of the parent or legal guardian; violators are guilty of a Class 6 
felony; allows anyone to avoid prosecution if he or she requested the 
ID and relied on the accuracy of the information contained in the ID); 
Ark. Stat. Ann. Sec. 5-27-228 (prohibits anyone from tattooing, body 
piercing or branding a minor without the written consent of one of the 
minor's parents, a guardian or a custodian; violators are guilty of a 
misdemeanor and, upon conviction, will be fined between $20 and $200); 
Cal. Penal Code Sec. 652 (establishes that it is unlawful to tattoo or 
offer to tattoo anyone under age 18; violators are guilty of a 
misdemeanor; prohibits anyone from performing or offering to perform 
body piercing upon anyone under age 18 unless the piercing is performed 
in the presence of a parent or guardian or as directed by and notarized 
by the minor's parent or guardian; does not apply to emancipated minors 
and does not include pierces of the ear); Col. Rev. Stat. Ann. Sec. 25-
4-2103 (prohibits anyone from performing a body art procedure on a 
minor unless the artist has received express consent from the minor's 
parent or guardian; failure to obtain permission before performing the 
procedures on a minor shall constitute a petty offense punishable by a 
fine of $250); Conn. Gen. Stat. Sec. 19a-92g (establishes that it is 
illegal to tattoo an unemancipated minor under age 18 without the 
written consent of the minor's parent or guardian; requires written 
consent of the minor's parent in order to perform body piercing on an 
unemancipated minor under age 18); Del. Code Ann. Title 11, Ch 5 
Sec. 1114(a) (it is illegal for a person to either knowingly or 
negligently tattoo or body pierce a minor without the prior written 
consent of the parent or legal guardian who must be over age 18); Fla. 
Stat. Sec. 381.0075 (requires written, notarized consent of a minor's 
parent or legal guardian in order to tattoo a minor; prohibits body 
piercing of a minor without the written, notarized consent of the 
parent or legal guardian or if he or she is accompanied by a parent or 
legal guardian); Ga. Code Sec. 16-5-71.1 (prohibits the tattooing of 
anyone under age 18 by anyone other than a licensed osteopath or 
technician acting under the direct supervision of a licensed physician 
or osteopath; violators are guilty of a misdemeanor; prohibits anyone 
from body piercing anyone under age 18 without prior written consent of 
the custodial parent or guardian; violators are guilty of a 
misdemeanor); Idaho Chapter No. 127 2004 (effective July 1, 2004) 
(prohibits the tattooing, branding or body piercing of minors under the 
age of 14; prohibits the tattooing, branding or body piercing on anyone 
between the ages of 14 and 18 without the written informed consent of 
the minor's parent or legal guardian; written informed consent must be 
executed in the presence of the person performing the act or an 
employee or agent of that person; violators are guilty of a misdemeanor 
and will be fined up to $500 and subsequent violations within 1 year 
will be fined between $500 and $1,000; piercing of the ear lobes and 
piercing for medical purposes are exempted from this legislation) Ill. 
Compiled Stat. 5/12-10.1 (it is a Class C misdemeanor for anyone, other 
than a person licensed to practice medicine in all branches, to tattoo 
or offer to tattoo a person under age 21; establishes that anyone who 
pierces the body of a minor under age 18 without written consent of the 
parent or legal guardian commits a Class C misdemeanor; does not apply 
to emancipated or married minors; Ind. Code Ann. Sec. 35-42-2-7 
(requires a minor's parent or legal guardian to be present on order to 
either tattoo or perform body piercing on a minor under age 18; 
requires the parent or guardian to also provide written permission for 
the minor to receive the tattoo or body piercing); Iowa Code 
Sec. 135.37 (prohibits anyone from tattooing an unmarried minor under 
age 18; upon conviction, violators are guilty of a serious 
misdemeanor); Ky. Rev. Stat. Sec. 211.760 (prohibits anyone from 
tattooing or body piercing minors without the written, notarized 
consent of a parent or guardian); La. Rev. Stat. Ann. Sec. 14:93.2 (it 
is unlawful for anyone to tattoo or body pierce a minor under age 18 
without the consent of the minor's accompanying parent or legal 
custodian; upon conviction, violators shall be fined between $100 and 
$500 or imprisoned between 30 and 100 days, or both); Me. Rev. Stat. 
Ann. Title 32, Ch. 64 Sec. 4323 (establishes that it is illegal to 
tattoo anyone under age 18; requires prior written consent of a minor's 
parent or legal guardian to perform body piercing on anyone under age 
18); Mich. Comp. Laws Ann. Sec. 333.13102 (prohibits anyone from either 
tattooing or performing body piercing on a minor without prior written, 
informed consent of the minor's parent or legal guardian; requires the 
parent or legal guardian to execute the consent in the presence of 
either the person performing the body piercing or tattooing on the 
minor or in the presence of an employee or agent of the individual; 
does not include emancipated minors); Minn. Stat. Sec. 609.2246 (it is 
unlawful for anyone under age 18 to receive a tattoo without written 
parental consent); Miss. Laws Sec. 73-61-3 (prohibits anyone from 
tattooing or body piercing a minor under age 18; violators are guilty 
of a misdemeanor and will be fined a maximum of $500); Mo. Rev. Stat. 
Sec. 324.520 (prohibits anyone from knowingly tattooing or body 
piercing a minor without prior written, informed consent of the minor's 
parent or legal guardian; requires the parent or legal guardian to 
execute the written consent in the presence of either the person 
performing the tattooing or body piercing or an employee or agent of 
that person; violators are guilty of a misdemeanor and will be fined a 
maximum of $500; subsequent violations within 1 year of the initial 
violation will be subject to a fine of between $500 and $1,000); Mont. 
Code Ann. Sec. 45-5-623 (prohibits anyone from knowingly tattooing a 
child under the age of majority without the explicit in-person consent 
of the child's parent or guardian; upon conviction, violators will be 
either fined a maximum of $500, imprisoned for up to 6 months, or both; 
those convicted of a second offense will either be fined a maximum of 
$1,000, imprisoned for up to 6 months, or both); N.C. Gen. Stat. 
Sec. 14-400 (prohibits anyone from tattooing a minor under age 18; 
violators are guilty of a Class 2 misdemeanor; prohibits anyone from 
piercing any part of a minor under age 18 other than the ears without 
the prior consent of the custodial parent; violators are guilty of a 
Class 2 misdemeanor); Ohio Rev. Code Ann. Sec. 3730.06 (it is illegal 
to tattoo, body pierce or pierce the ears of anyone under age 18 
without the consent of the minor's parent, guardian or custodian; 
requires the consenting individual to appear in person at the business 
at the time the procedure is performed and sign a document that 
provides informed consent); Okla. Stat. Title 21 Sec. Sec. 841 and 
842.1 (prohibits anyone other than a licensed practitioner of the 
healing arts in the course of their practice from tattooing or offering 
to tattoo anyone; it is unlawful for anyone to perform, or offer to 
perform, body piercing on a child under age 18 unless the parent or 
legal guardian gives written consent for and is present during the 
procedure; penalties for violations include imprisonment for up to 90 
days and a fine of up to $500, or both); Pa. Cons. Stat. Title 18 
Sec. 6311 (it is unlawful to provide tattoo services to anyone under 
age 18 without the consent of the parent or guardian; violators are 
guilty of a misdemeanor of the third degree and, upon conviction, will 
be sentenced to either pay a maximum fine of $100 or be imprisoned a 
maximum of 3 years, or both); R.I. General Laws Sec. Sec. 11-9-15; 23-
1-39 (prohibits tattooing or body piercing a minor who is unaccompanied 
by his or her consenting parent or guardian; violators are guilty of a 
misdemeanor and, upon conviction, will either be imprisoned a maximum 
of 1 year or fined a maximum of $300); S.D. Codified Laws Ann. Sec. 26-
10-19 (requires anyone who is tattooing a minor under age 18 to obtain 
a signed consent form from the minor's parents authorizing a tattoo; 
violators are guilty of a Class 2 misdemeanor); Tenn. Code Ann. 
Sec. Sec. 62-38-207; 62-38-305 and 306 (establishes that a minor age 16 
or older may be tattooed with the written consent of the parent or 
legal guardian to cover up an existing tattoo and requires the parent 
or legal guardian to be present during the procedure; it is a Class C 
misdemeanor for anyone to tattoo a person under age 18; allows a minor 
age 18 or younger to undergo body piercing with the written consent of 
the parent, legal guardian or legal custodian and requires them to be 
present during the procedure; they must sign a document that explains 
the procedure and methods for proper care, present proof of age and 
attest in writing that they are the minor's parent, legal guardian or 
legal custodian; violators will be charged with a Class C misdemeanor 
and will be imprisoned for up to 30 days or pay a fine of up to $50); 
Texas Health and Safety Code Ann. Sec. Sec. 146.012; 146.0125 
(prohibits anyone from performing a tattoo on anyone under age 18 
without the consent of a parent or guardian who believes it is in the 
best interest of the minor to cover an obscene of offensive tattoo; 
required consent may be the physical presence of the individual's 
parent or guardian or the provision of evidence that he or she is the 
parent or guardian of the person who is getting the tattoo; prohibits 
anyone from performing body piercing on an individual under age 18 
without the consent of the individual's parent, managing conservator or 
guardian; consent must specify the part of the body to be pierced. 
Required consent is the physical presence of the individual's parent or 
guardian and the provision of evidence stating their parental or 
guardian status); Utah Code Ann. Sec. 76-10-2201 (prohibits anyone from 
performing or offering to perform a tattoo or body piercing upon a 
minor without receiving the consent of the minor's parent or legal 
guardian; establishes that a person is not guilty of a violation if he 
or she (a) had no actual knowledge of the minor's age and (b) reviewed, 
recorded and maintained a personal identification number for the minor 
prior to performing the body piercing or tattoo; violators are guilty 
of a Class C misdemeanor and the owner or operator of the establishment 
where the act takes place is subject to a civil penalty of $750 for 
each violation); Vt. Stat. Ann. Title 26 Sec. 4102 (prohibits anyone 
from tattooing a minor without the written consent of his or her parent 
or guardian); Va. Code Sec. 18.2-371.3 (prohibits anyone from tattooing 
or performing body piercing on a person under age 18, knowing or having 
reason to believe that the person is under 18 except (a) in the 
presence of the person's parent or guardian or (b) when done by or 
under the supervision of a medical doctor, registered nurse, or other 
medical services personnel in the performance of their duties; 
violators are guilty of a Class 2 misdemeanor. A second or subsequent 
violation shall be punished as a Class 1 misdemeanor; excludes ear 
piercing as a form of body piercing); Wash. Rev. Code Sec. 26.28.085 
(applying a tattoo to a minor under age 18 is illegal and violators are 
guilty of a misdemeanor; prohibits anyone from stating that he or she 
did not know the minor's age as a defense to prosecution, unless he or 
she establishes that by a preponderance of evidence he or she made a 
reasonable attempt to determine the true age of the minor by requiring 
a driver's license or other picture ID card and did nor rely solely on 
oral allegations); W. Va. Code Sec. 16-38-3 (requires prior written 
consent from a parent or guardian for the tattooing of a minor); Wis. 
Stat. Sec. 948.70 (prohibits anyone other than a physician in the 
course of his or her professional practice from tattooing or offering 
to tattoo a child; violators are subject to a Class D forfeiture); Wyo. 
Stat. Sec. 14-3-107 Chapter 47 2004 (Effective July 1, 2004) (prohibits 
anyone from tattooing a person under the age of majority, except with 
the consent of the person's parent or legal guardian who is present at 
the time the procedure is performed; violators are guilty of a 
misdemeanor and punishable by imprisonment for a maximum of 6 months, a 
fine of a maximum of $750, or both; prohibits performing body art on 
anyone who had not reached the age of majority without the consent of 
the parent or legal guardian and who is present at the time of the 
procedure; violators are guilty of a misdemeanor and punishable by 
imprisonment for a maximum of 6 months, a fine of a maximum of $750, or 
both; body art is defined as the practice of body piercing, branding 
scarification, sculpting or tattooing).
    \88\See Daniel de Vise, ``Bill Would Legislate Maryland Students' 
Use of Sunscreen,'' The Washington Post (March 29, 2005).
---------------------------------------------------------------------------

                    STATE JUDICIAL BYPASS PROCEDURES

    In Bellotti v. Baird,\89\ a plurality of the United States 
Supreme Court set forth the basic test by which judicial bypass 
proceedings pursuant to a parental consent statute, if judicial 
bypass provisions are enacted at all, must be reviewed. Bypass 
procedures must allow the minor to show that she possesses 
maturity and information to make the abortion decision, in 
consultation with her physician, without regard to her parents' 
wishes; allow the minor to show that, even if she cannot make 
the decision by herself, the ``desired abortion would be in her 
best interests''\90\ ; be confidential; and be conducted ``with 
expedition to allow the minor an effective opportunity to 
obtain the abortion.''\91\
---------------------------------------------------------------------------
    \89\443 U.S. 622 (1979) (Bellotti II).
    \90\Id. at 644.
    \91\Id. Factors that may be considered in determining 
``immaturity'' include work and personal experience, appreciation of 
the gravity of the procedure, and judgment. See Hodgson v. Minnesota, 
497 U.S. 417 (1990). Under the ``best interests'' analysis, judges 
often consider medical risks to the minor as a result of the time, 
place, or type of procedure to be performed, medical risks particular 
to the girl, evidence of physical, sexual, or emotional abuse by 
parents or guardians, and abortion alternatives such as marriage, 
adoption, and single motherhood.
---------------------------------------------------------------------------
    Critics of CIANA claim that the measure endangers the 
health of young girls who are forced to travel out of state to 
obtain abortions because the judges in their home states either 
refuse to hear judicial bypass petitions or deny them 
arbitrarily. In support of this argument, the critics cite 
cases like that of Ms. Billie Lominick, who testified before 
the Constitution Subcommittee regarding her experience with 
South Carolina's judicial bypass procedures. According to Ms. 
Lominick, who assisted her grandson's girlfriend in obtaining 
an out-of-state abortion, only two judges in the state of South 
Carolina would hear a judicial bypass petition, and one of 
those judges, according to Ms. Lominick, would hear petitions 
only from girls residing in his county.\92\
---------------------------------------------------------------------------
    \92\See Child Custody Protection Act: Hearings on H.R. 1218 Before 
the Subcomm. on the Constitution of the House Comm. on the Judiciary, 
106th Cong. (May 27, 1999) (statement of Billie Lominick).
---------------------------------------------------------------------------
    Such examples ignore the fact that CIANA provides 
assistance only in the enforcement of constitutional state 
parental notice and consent laws. If there are only two judges 
in an entire state willing to hear judicial bypass proceedings, 
that state's parental involvement laws are likely 
unconstitutional under Supreme Court precedent, which requires 
the state to provide a minor the opportunity to seek a judicial 
bypass with ``sufficient expedition to provide an effective 
opportunity for an abortion to be obtained.''\93\
---------------------------------------------------------------------------
    \93\Bellotti v. Baird, 443 U.S. 622, 644 (1979) (plurality 
opinion).
---------------------------------------------------------------------------
    This fact is illustrated by the First Circuit's decision in 
Planned Parenthood League v. Bellotti (``Bellotti II'').\94\ In 
that case, the court held that the plaintiffs could 
successfully challenge the state's judicial bypass procedures 
if they could present ``proof of `a systemic failure to provide 
a judicial bypass option in the most expeditious, practical 
manner.'''\95\ The court of appeals remanded the case to the 
lower court so that the plaintiffs could present evidence that, 
among other things, judges were ```defacto unavailable' to hear 
minors' abortion petitions,''\96\ and many judges were avoided 
``for reasons of hostility.''\97\ The Sixth Circuit has also 
recognized that a constitutional challenge may be brought for a 
state's systemic failure to provide an expeditious judicial 
bypass.\98\
---------------------------------------------------------------------------
    \94\868 F.2d 459 (1st Cir. 1989).
    \95\Id. at 469 (quoting Hodgson v. Minnesota, 648 F. Supp. 756, 777 
(D. Minn. 1986)).
    \96\Id. at 463.
    \97\Id. at 461 n.6.
    \98\See Cleveland Surgi-Center, Inc. v. Jones, 2 F.3d 686, 690 (6th 
Cir. 1993).
---------------------------------------------------------------------------
    Not only must states provide access to judges who are 
willing to hear judicial bypass petitions, states must also 
ensure that the judges who do hear bypass petitions render 
their decisions in an expedited fashion. For example, in 
Planned Parenthood v. Lawall,\99\ the Court of Appeals for the 
Ninth Circuit struck down an Arizona parental consent statute 
on the grounds that its judicial bypass provision lacked 
specific time limits and was therefore in violation of the 
Bellotti II expediency requirement. The court reached this 
conclusion even though the Arizona statute stated that such 
proceedings were to be given priority and required that ``the 
court shall reach the decision [on a bypass request] promptly 
and without delay to serve the best interests of a pregnant 
minor.''\100\ The court's rationale in adopting a strict 
interpretation of the Supreme Court's timeliness requirement 
was that ``[o]pen-ended bypass provisions engender substantial 
possibilities of delay for minors seeking abortions.''\101\
---------------------------------------------------------------------------
    \99\Planned Parenthood v. Lawall, 180 F.3d 1022 (9th Cir. 1999).
    \100\Id. at 1027.
    \101\Id. at 1030.
---------------------------------------------------------------------------
    The Fifth Circuit employed essentially identical reasoning 
in striking down a Louisiana judicial bypass procedure having 
indefinite time limits.\102\ The court found that ``not only do 
[the bypass procedures] fail to provide any specific time 
within which a minor's application will be decided, but they 
give no assurances (assurances required by Bellotti II) that 
the proceedings will conclude expeditiously.''\103\
---------------------------------------------------------------------------
    \102\See Causeway Medical Suite v. Ieyoub, 109 F.3d 1096 (5th Cir. 
1997).
    \103\Id. at 1110-11.
---------------------------------------------------------------------------
    As these cases illustrate, judicial bypass procedures must 
be readily accessible and efficient in order to pass 
constitutional muster. CIANA will assist in the enforcement of 
only those State parental involvement laws that meet the 
relevant constitutional criteria.
    In any case, the minority's own witness at a hearing on 
H.R. 1755, the ``Child Custody Protection Act,'' which 
contained the same provision in CIANA regarding judicial bypass 
laws, admitted that ``I am personally not aware of cases where 
[a judicial bypass procedure] hasn't worked.''\104\ 
Furthermore, testimony received by the Constitution 
Subcommittee indicates that, where judicial bypass procedures 
are in place, they are not needed in the overwhelming number of 
cases because a parent's involvement is obtained. In 2002, 852 
girls received abortions in Alabama with a parent's approval 
and 12 with a judge's approval, according to state health 
department records. Idaho similarly reported less than 5 
percent of minors using judicial bypass to avoid that state's 
parental consent law (64 minors with parental consent, 3 with 
judicial bypass) in 2002. South Dakota reported 14 of 76 minors 
obtained judicial bypasses, rather than parental consent. In 
Texas where 3,654 minors obtained abortions, the Texas 
Department of Health paid for assistance in 284 judicial bypass 
proceedings. In Wisconsin, less than 10% of the minors 
obtaining abortions did so with the use of an order obtained 
through judicial bypass (727 with parental involvement, 63 with 
judicial bypass).\105\
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    \104\Child Custody Protection Act: Hearings on H.R. 1755 Before the 
Subcomm. on the Constitution of the House Comm. on the Judiciary, 108th 
Cong., 41 (2004) (testimony of Rev. Lois M. Powell).
    \105\Id. at 37 (statement of Teresa Collett).
---------------------------------------------------------------------------
    And far from being too complicated or too intrusive, the 
judicial bypass procedure has been described as ``remarkably 
simple'' by the Nebraska Supreme Court in Orr v. Knowles.\106\ 
In fact, the average judicial bypass hearing lasts only 12 
minutes, and ``more than 92 percent of the hearings [were] less 
than or equal to 20 minutes.''\107\ The young girl is not 
subjected to an adversarial process. She is not ``on trial.'' A 
young girl must merely present evidence only about her maturity 
level, not intimate details of her personal life, to the court. 
Then the judge will make his decision.
---------------------------------------------------------------------------
    \106\See Orr v. Knowles, 337 N.W.2d 699, 706 (Neb. 1983) (``This 
statute does not provide that the state or anyone else will contest the 
minor's claim that she is mature enough to make the abortion decision 
herself. Rather, she will present evidence, and the judge will then 
make the decision as to her maturity. Since there is no adversarial 
aspect to these proceedings, we find that no petitioning minor, 
indigent or otherwise, is entitled to free court-appointed counsel as a 
matter of right in proceedings under Sec. 28-347(2).''). Accord Joseph 
W. Moylan, ``No Law Can Give Me the Right to Do What Is Wrong,'' in 
Life and Learning V: Proceedings of the Fifth University Faculty for 
Life Conference at 234, 235 (1995) (explaining Judge Moylan's decision 
to resign from a bench in the juvenile court he had occupied for more 
than 20 years) (``When the bill, taken from a Minnesota law, did get 
passed, it stated that at the hearing the pregnant minor is entitled to 
have an attorney appointed for her and even a guardian ad litem. There 
is nobody on the other side, unless a judge takes it on himself. Now I 
know of no other case that is like that, where it is truly one-sided. 
If after that one-sided hearing, the judge finds that the girl is 
mature and can give an informed consent, then the judge is required to 
authorize the abortion physician to perform the abortion.'').
    \107\Id. at 648.
---------------------------------------------------------------------------
    Indeed, judicial bypass procedures are overwhelmingly 
granted by the courts. Judicial bypasses provide a safe and 
effective means of insuring the well-being of young girls 
seeking to abort their pregnancies. A survey of Massachusetts 
cases found that every minor who sought judicial authorization 
to bypass parental consent received it.\108\ Another 
Massachusetts study found that only 1 of 477 girls was refused 
judicial authorization.\109\ A Minnesota study cited that a 
Federal trial court determined that of the 3,573 bypass 
petitions filed, six were withdrawn, nine were denied, and 
3,558 were granted.\110\ A survey of the Virginia statute 
requiring parental notification found that out of 18 requests 
for judicial bypass, ``all but one of the requests were granted 
eventually.''\111\
---------------------------------------------------------------------------
    \108\Robert H. Mnookin, ``Bellotti v. Baird, A Hard Case'' in In 
the Interest of Children: Advocacy, Law Reform, and Public Policy 149, 
239 (Robert H. Mnookin ed., 1985).
    \109\Susanne Yates & Anita J. Pliner, ``Judging Maturity in the 
Courts: the Massachusetts Consent Statute,'' 78 Am. J. Pub. Health 646, 
647 (1988).
    \110\Hodgson v. Minnesota, 648 F.Supp. 756, 765 (D. Minn. 1986).
    \111\See Ellen Nakashima, ``Fewer Teens Receiving Abortions in 
Virginia: Notification Law to Get Court Test,'' Washington Post (March 
3, 1998) at A1 (``In Virginia, since the law took effect, 18 teenagers 
have gone to a judge, who determines whether the girl is mature enough 
to make her own decision about abortion. All but one of the requests 
were granted eventually.'')
---------------------------------------------------------------------------

CIANA IS BASED ON THE PROPOSITION THAT PARENTS SHOULD BE GIVEN A CHANCE 
          TO PLAY A ROLE IN THE LIVES OF THEIR MINOR CHILDREN

    Children's feelings should not trump parental authority. 
Parents are not simply placeholders in a child's life. They are 
the foundational pillars of civilization. The family unit has 
provided the comfort, stability, and safety necessary to 
sustain civilization, and it has done so for millennia. Parents 
must be given a chance to work with their own children through 
difficult situations. There is no guarantee that parents will 
be successful in that endeavor, and unfortunately there will, 
no doubt, be a few parents who will be indifferent when they 
are made aware of their daughter's pregnancy. But that is 
surely the rare case, and even in that rare case nothing in 
this legislation will bar an abortion. What this legislation 
affirms is the proposition that parents deserve a chance. 
Opponents of CIANA must rest their objections on the notion 
that most parents do not deserve that simple chance. But 
parents do deserve that chance, and CIANA would give that 
chance to parents who have not abused or neglected their child. 
Even famously liberal Justice Stevens wrote in his concurring 
opinion in H.L. v. Matheson that ``[t]he possibility that some 
parents will not react with compassion and understanding upon 
being informed of their daughter's predicament or that, even if 
they are receptive, they will incorrectly advise her, does not 
undercut the legitimacy of the State's attempt to establish a 
procedure that will enhance the probability that a pregnant 
young woman exercise as wisely as possible her right to make 
the abortion decision.''\112\
---------------------------------------------------------------------------
    \112\450 U.S. 398, 424 (1981) (Stevens, J., concurring).
---------------------------------------------------------------------------
    Nothing in this bill requires a minor who was abused by her 
parents to notify an abusive parent before having an abortion. 
And all state judicial bypass provisions that are protected by 
this bill are both the product of state law and required to 
conform to the Supreme Court's own standards for judicial 
bypass provisions. Furthermore, all the various additional 
exceptions opponents have proposed be added to CIANA are simply 
legislative excuses to deny parents that chance. Those who 
oppose giving parents a chance claim life is hopelessly 
confusing and therefore Congress should not act to protect 
parental rights. But a sister or a brother, or a minister, or 
some other third party, is not a parent. Sisters and brothers, 
and ministers, can of course provide their own counseling if a 
minor girl seeks it. But parents are special, and parents 
deserve unique protections when it comes to their ability to 
protect the health and safety of their children. That much is 
clear.
    Anyone who is truly interested in the best interests of a 
pregnant girl--be they a minister, a sibling, a friend, or 
anyone else--will encourage her to inform her parents and give 
them the chance of helping her address her situation 
appropriately. It is beyond dispute that it is not in a 
pregnant girl's best interests to allow anyone to assist her in 
circumventing state laws providing for parental involvement or 
to allow anyone to give a pregnant girl who has crossed state 
lines a secret abortion that could have serious medical 
consequences without notifying a parent.
    Unfortunately, during consideration of this legislation, 
some opponents of this legislation have equated parents with 
slave owners.\113\ Parental rights are not those of a slave 
owner. They are the rights of caring people who deserve a 
chance to work with their children through difficult times and 
should be provided a chance to express their love to their 
children in their children's moments of greatest need.
---------------------------------------------------------------------------
    \113\See, e.g., H.R. Rep. No. 107-397 (2002) at 56 (``It seems to 
me what this bill is, is really akin to the Fugitive Slave Act of the 
1850's where you're enabling one State in the South, which had slavery, 
to reach over into another State . . . and say, `We want our slave 
back.''') (remarks of Mr. Nadler D-NY).
---------------------------------------------------------------------------

               THE FUNDAMENTAL NATURE OF PARENTAL RIGHTS

    The United States Supreme Court has described parents' 
right to control the care of their children as ``perhaps the 
oldest of the fundamental liberty interests recognized by this 
Court.''\114\ In addressing the right of parents to direct the 
medical care of their children, the Supreme Court has stated:
---------------------------------------------------------------------------
    \114\Troxel v. Granville, 530 U.S. 57, 65 (2000) (overturning 
Washington visitation statute which unduly interfered with parental 
rights).

        Our jurisprudence historically has reflected Western 
        civilization concepts of the family as a unit with 
        broad parental authority over minor children. Our cases 
        have consistently followed that course; our 
        constitutional system long ago rejected any notion that 
        a child is ``the mere creature of the State'' and, on 
        the contrary, asserted that parents generally ``have 
        the right, coupled with the high duty, to recognize and 
        prepare [their children] for additional obligations.'' 
        Surely, this includes a ``high duty'' to recognize 
        symptoms of illness and to seek and follow medical 
        advice. The law's concept of the family rests on a 
        presumption that parents possess what a child lacks in 
        maturity, experience, and capacity for judgment 
        required for making life's difficult decisions.\115\
---------------------------------------------------------------------------
    \115\Parham v. J.R., 442 U.S. 584, 602 (1979) (emphasis added) 
(citations omitted) (rejecting claim that minors had right to 
adversarial proceeding prior to commitment by parents for treatment 
related to mental health).

    The parents of a minor child have a fundamental right to 
direct the upbringing and education of that child. The Supreme 
Court first recognized the right to ``establish a home and 
bring up children'' as a ``privilege[] long recognized at 
common law as essential to the orderly pursuit of happiness by 
free men'' in the 1923 case of Meyer v. Nebraska in which it 
struck down as unconstitutional a Nebraska law forbidding all 
schools within its boundaries from teaching pupils in any 
language other than English.\116\ Two years later, striking 
down an Oregon statute requiring all children, under compulsory 
education laws, to attend public schools, the Court affirmed 
this principle stating, ``The child is not the mere creature of 
the state; those who nurture him and direct his destiny have 
the right, coupled with the high duty, to recognize and prepare 
him for additional obligations.''\117\
---------------------------------------------------------------------------
    \116\262 U.S. 390, 399 (1923).
    \117\Pierce v. Society of the Sisters, 268 U.S. 510, 535 (1925).
---------------------------------------------------------------------------
    Coupled with this right, however, is the duty of parents to 
provide for the care and safety of their children, including 
their physical and medical well-being. A parent's duty to 
provide medical care to his or her child is a duty arising from 
the relationship of parent and child. Indeed, the Court has 
described the ``care and nurture'' of a child as being a 
``primary function'' of parents.\118\ Ignoring or violating a 
parent's legal right to direct the upbringing of their 
children, including the right to direct the medical care 
received by those children, can result in liability.\119\ In 
Meyer, the Court stated, ``Corresponding to the right of 
control, it is the natural duty of the parent to give his 
children education suitable to their station in life 
[.]''\120\Certainly this duty to educate includes instructing 
one's children on how to best make decisions concerning their 
health.
---------------------------------------------------------------------------
    \118\See Prince v. Massachusetts, 321 U.S. 158, 166 (1944).
    \119\Unauthorized medical examinations of minors have resulted in 
liability. See van Emrik v. Chemung County Dep't of Soc. Servs., 911 
F.2d 863, 867 (2d Cir. 1990) (parental consent required for x-ray); 
Tenebaum v. Williams, 193 F.3d 581, 597-99 (2d Cir. 1999)(parental 
consent required for gynecological exam).
    \120\Meyer, 262 U.S. at 400.
---------------------------------------------------------------------------
    Holding that the State of Georgia's commitment procedures 
for minor children did not violate the due process rights of 
minors, the Court recognized ``the traditional presumption that 
the parents act in the best interests of their child'' and 
warned against discarding ``wholesale those pages of human 
experience that teach that parents generally do act in the 
child's best interests.''\121\ The Court added, ``Surely, this 
includes a `high duty' to recognize symptoms of illness and to 
seek and follow medical advice.''\122\
---------------------------------------------------------------------------
    \121\Parham, 442 U.S. at 602-04. See also Hodgson v. Minnesota, 497 
U.S. 417 (1990) (a parent is ``presumed to act in the minor's best 
interest and thereby assures that the minor's decision to terminate her 
pregnancy is knowing, intelligent, and deliberate'').
    \122\Parharm, 442 U.S. at 602.
---------------------------------------------------------------------------
    The Supreme Court has consistently recognized that parents 
have a legal right to be involved in their minor daughter's 
decision to seek medical care, which includes the abortion 
procedure. Therefore, the Court has consistently affirmed a 
state's right to restrict the circumstances under which a minor 
may obtain an abortion in ways in which adult women seeking 
abortions may not be restricted. Holding that a state may not 
grant to a third party an absolute, and possibly arbitrary, 
veto over a minor's decision to have an abortion in Planned 
Parenthood v. Danforth, the Court added ``the State has 
somewhat broader authority to regulate the activities of 
children than of adults.''\123\ Indeed, ``the status of minors 
under the law is unique in many respects'' and the ``unique 
role in our society of the family, the institution by which `we 
inculcate and pass down many of our most cherished values, 
moral and cultural,' requires that constitutional principles be 
applied with sensitivity and flexibility to the special needs 
of parents and children.''\124\
---------------------------------------------------------------------------
    \123\428 U.S. 52, 74 (1976).
    \124\Bellotti v. Baird, 443 U.S. 622, 633-34 (1979) (Bellotti II).
---------------------------------------------------------------------------

SUPREME COURT PRECEDENT SUPPORTS GIVING PARENTS A CHANCE TO PLAY A ROLE 
                 IN THEIR CHILDREN'S ABORTION DECISIONS

    Supreme Court precedents support CIANA. The Supreme Court 
has observed that ``[t]he medical, emotional, and psychological 
consequences of an abortion are serious and can be 
lasting,''\125\ and that ``[i]t seems unlikely that [the minor] 
will obtain adequate counsel and support from the attending 
physician at an abortion clinic, where abortions for pregnant 
minors frequently take place.''\126\ Parental involvement in 
such a decision will lead to improved medical care for minors 
seeking abortions and provide increased protection for young 
girls against sexual exploitation by adult men.
---------------------------------------------------------------------------
    \125\H.L. v. Matheson, 450 U.S. 398, 411 (1981).
    \126\Planned Parenthood v. Danforth, 428 U.S. 52, 91 (1976).
---------------------------------------------------------------------------
    On an issue as contentious and divisive as abortion, it is 
both remarkable and instructive that there is such firm and 
long-standing support for laws requiring parental involvement. 
Various reasons underlie this broad and consistent support. As 
the Supreme Court, including Justices O'Connor, Kennedy, and 
Souter, observed in Planned Parenthood v. Casey,\127\ parental 
consent and notification laws related to abortions ``are based 
on the quite reasonable assumption that minors will benefit 
from consultation with their parents and that children will 
often not realize that their parents have their best interests 
at heart.''
---------------------------------------------------------------------------
    \127\505 U.S. 833, 895 (1992).
---------------------------------------------------------------------------
    In Planned Parenthood of Central Missouri v. Danforth,\128\ 
noted liberal Justice Stewart wrote, ``There can be little 
doubt that the State furthers a constitutionally permissible 
end by encouraging an unmarried pregnant minor to seek the help 
and advice of her parents in making the very important decision 
whether or not to bear a child.''\129\ Three years later, in 
Bellotti v. Baird,\130\ a plurality of the Court acknowledged 
that parental consultation is critical for minors considering 
abortion because minors often lack the experience, perspective, 
and judgment to avoid choices that could be detrimental to 
them. The Bellotti plurality also observed that parental 
consultation is particularly desirable regarding the abortion 
decision since, for some, the situation raises profound moral 
and religious concerns.\131\
---------------------------------------------------------------------------
    \128\428 U.S. 52 (1976).
    \129\Planned Parenthood v. Danforth, 428 U.S. 52, 91 (1976) 
(Stewart, J., concurring).
    \130\443 U.S. 622, 640 (1979) (Bellotti II) (plurality opinion).
    \131\Id. at 635.
---------------------------------------------------------------------------
    Significantly, the Supreme Court has already concluded that 
notice statutes do not give parents any ``veto power''\132\ 
over the minor's abortion decision. As the Court reiterated in 
Akron II, ``notice statutes are not equivalent to consent 
statutes because they do not give anyone a veto power over a 
minor's abortion decision.''\133\ A one-parent notification law 
such as one containing CIANA's abuse and life-endangerment 
exception does not require a judicial bypass. As the Fourth 
Circuit Court of Appeals recognized in Planned Parenthood of 
the Blue Ridge v. Camblos, ``In contrast to its assessment of 
parental consent statutes, the [Supreme] Court has consistently 
recognized that the same potential for absolute veto over the 
abortion decision that inheres in a parental consent statute 
does not inhere in a parental notice statute, and therefore 
that notice statutes are fundamentally different from--and less 
burdensome than--consent statutes.''\134\
---------------------------------------------------------------------------
    \132\See H.L. v. Matheson, 450 U.S. 398, 411 (1981) (``The Utah 
Statute gives neither parents nor judges a veto power over the minor's 
abortion decision.'').
    \133\Ohio v. Akron Center for Reproductive Health, 497 U.S. 502, 
511 (1992).
    \134\Planned Parenthood of the Blue Ridge v. Camblos, 155 F.3d 352, 
363 (4th Cir. 1998).
---------------------------------------------------------------------------
    Parental involvement in a pregnant minor girl's abortion 
decision is supported by the common-sense realization that 
minors often lack the maturity to fully comprehend the 
significance and consequences of their actions. In 1976, when 
it first addressed Massachusetts' parental consent statute, the 
Supreme Court recognized that with minors, ``there are 
unquestionably greater risks of inability to give an informed 
consent.''\135\ During its second review of Massachusetts' 
parental consent law, the Court stated, ``Viewed together, our 
cases show that although children generally are protected by 
the same constitutional guarantees against governmental 
deprivations as are adults, the State is entitled to adjust its 
legal system to account for children's vulnerability and their 
needs for concern, . . . sympathy, and . . . paternal 
attention.''\136\ The Court continued to describe its previous 
rulings to allow states to ``limit the freedom of children to 
choose for themselves in the making of important, affirmative 
choices with potentially serious consequences'' as being 
``grounded in the recognition that, during the formative years 
of childhood and adolescence, minors often lack the experience, 
perspective, and judgment to recognize and avoid choices that 
could be detrimental to them.''\137\
---------------------------------------------------------------------------
    \135\Bellotti v. Baird, 428 U.S. 132, 147 (1976) (Bellotti I).
    \136\Bellotti II, 443 U.S. at 635 (quotations and citations 
omitted).
    \137\Id. at 635.
---------------------------------------------------------------------------
    The Supreme Court has pointed to the ``guiding role of 
parents in the upbringing of their children'' as the basis for 
its rulings preserving for parents a unique legal authority 
over the conduct of their children.\138\ The Court has reasoned 
that ``parents naturally take an interest in the welfare of 
their children[.]''\139\ This, in the Court's view, creates 
``an important state interest in encouraging a family rather 
than a judicial resolution of a minor's abortion 
decision.''\140\ In H.L. v. Matheson,\141\ the Court upheld a 
Utah statute requiring a physician to notify, if possible, 
parents of a minor upon whom an abortion is to be performed and 
stated:
---------------------------------------------------------------------------
    \138\See id. at 637.
    \139\Id. at 648.
    \140\Id.
    \141\450 U.S. 398 (1981).

        There can be little doubt that the State furthers a 
        constitutionally permissible end by encouraging an 
        unmarried pregnant minor to seek the help and advice of 
        her parents in making the very important decision 
        whether or not to bear a child. That is a grave 
        decision, and a girl of tender years, under emotional 
        stress, may be ill-equipped to make it without mature 
        advice and emotional support. It seems unlikely that 
        she will obtain adequate counsel and support from the 
        attending physician at an abortion clinic, where 
        abortions for pregnant minors frequently take 
        place.\142\
---------------------------------------------------------------------------
    \142\Id. at 409-10.

    In Planned Parenthood v. Casey, the Court upheld the 
parental consent provisions of Pennsylvania's Abortion Control 
Act of 1982, stating that they ``provide the parent or parents 
of a pregnant young woman the opportunity to consult with her 
in private, and to discuss the consequences of her decision in 
the context of the values and moral or religious principles of 
their family.''\143\ It continued, ``The State commonly 
protects its youth from adverse governmental action and from 
their own immaturity by requiring parental consent to or 
involvement in important decisions by minors.''\144\
---------------------------------------------------------------------------
    \143\505 U.S. 833, 899-900 (1992).
    \144\Bellotti, 443 U.S. at 637.
---------------------------------------------------------------------------
    It is instructive that the Court has always held that this 
important duty to ensure and provide for the care and nurture 
of minor children lies only with parents--a conclusion that 
arises from the traditional legal recognition ``that natural 
bonds of affection lead parents to act in the best interests of 
their children.''\145\
---------------------------------------------------------------------------
    \145\Parham v. J.R., 442 U.S. 584, 602 (1979)(emphasis added). See 
also Prince v. Commonwealth of Massachusetts, 321 U.S. 158, 166 (1944) 
(``It is cardinal with us that the custody, care and nurture of the 
child reside first in the parents, whose primary function and freedom 
include preparation for obligations the state can neither supply nor 
hinder.''); Wisconsin v. Yoder, 406 U.S. 205, 232 (1972) (``The history 
and culture of Western civilization reflect a strong tradition of 
parental concern for the nurture and upbringing of their children. This 
primary role of the parents in the upbringing of their children is now 
established beyond debate as an enduring American tradition.'').
---------------------------------------------------------------------------
    Significantly for CIANA, the Court recently struck down a 
Washington State visitation law under which grandparents were 
granted visitation to their grandchildren over the objection of 
the children's mother precisely because it failed to provide 
special protection for the fundamental right of parents to 
control with whom their children associate.\146\ The Court 
concluded that the lower court ``gave no special weight at 
all'' to a mother's conclusion that excessive grandparent 
visitation was not in her minor children's best interests, and 
continued, ``so long as a parent adequately cares for his or 
her children (i.e., is fit), there will normally be no reason 
for the State to inject itself into the private realm of the 
family to further question the ability of that parent to make 
the best decisions concerning the rearing of that parent's 
children.''\147\ This failure, the Court stated, ``directly 
contravened the traditional presumption that a fit parent will 
act in the best interest of his or her child.''\148\
---------------------------------------------------------------------------
    \146\Troxel v. Granville, 530 U.S. 57 (2000).
    \147\Id. at 68-69.
    \148\Id. at 69.
---------------------------------------------------------------------------

                CIANA PROTECTS THE HEALTH OF MINOR GIRLS

    Young girls face serious risks to their health and well-
being when they are secretly taken for abortions without their 
parents' knowledge. When an abortion is performed on a girl 
without the physician having full knowledge of her medical 
history--which is usually available only from a parent--the 
risks greatly increase. Moreover, minor girls who do not 
involve their parents usually do not return for follow-up 
treatment, which can lead to dangerous complications. In many 
cases, only a girl's parents know of her prior psychological 
and medical history, including allergies to medication and 
anesthesia. Also, parents are usually the only people who can 
provide authorization for post-abortion medical procedures or 
the release of pertinent data from family physicians. None of 
these precautions can be taken when a pregnant girl is taken to 
have an abortion without her parents' knowledge. Consequently, 
when parents are not involved, the risks to the minor girl's 
health significantly increase. CIANA is designed to safeguard 
minor girls' physical and emotional health by helping to ensure 
parental involvement in their interstate abortion decisions.
    The medical care that minors seeking abortions receive is 
improved when their parents are involved in three ways.
    First, parental involvement allows parents to assist their 
daughter in the selection of a competent abortion provider. 
With all medical procedures, one of the most reliable means of 
guaranteeing patient safety is the professional competence of 
the physician performing the procedure. In Bellotti v. Baird, 
the United States Supreme Court acknowledged that parents 
possess a much greater ability to evaluate and select competent 
healthcare providers than their minor children often do:

        In this case . . . we are concerned only with minors 
        who, according to the record, range in age from 
        children of 12 years to 17-year-old teenagers. Even the 
        latter are less likely than adults to know or be able 
        to recognize ethical, qualified physicians, or to have 
        the means to engage such professionals. Many minors who 
        bypass their parents probably will resort to an 
        abortion clinic, without being able to distinguish the 
        competent and ethical from those that are incompetent 
        or unethical.\149\
---------------------------------------------------------------------------
    \149\Bellotti v. Baird, 443 U.S. 622, 641 n.21 (1979) (Bellotti 
II).

    The Supreme Court's concern for that ability of minors to 
distinguish competent and ethical abortion providers is 
particularly justified in states where non-physicians are 
allowed, by statute, to perform abortions. The National 
Abortion and Reproductive Rights Action League recommends that 
patients seeking an abortion confirm that the abortion will be 
performed by a licensed physician in good standing with the 
state Board of Medical Examiners, and that he or she have 
admitting privileges at a local hospital not more than 20 
minutes away from the location where the abortion is to 
occur.\150\ A well-informed parent seeking to guide her child 
is more likely to inquire into the qualifications of the person 
performing the abortion, and the availability of a physician 
with local admitting privileges, than an emotionally vulnerable 
young girl faced with pregnancy.
---------------------------------------------------------------------------
    \150\See National Abortion and Reproductive Rights Action League, 
Minors' Issues: Reproductive Choice Issues, at http://www.naral.org/
issues/issues_minors.html (last visited Aug. 30, 2001).
---------------------------------------------------------------------------
    Second, parental involvement will ensure that parents have 
the opportunity to provide additional medical history and 
information to abortion providers prior to performance of the 
abortion. As the Supreme Court has stated:

        The medical, emotional, and psychological consequences 
        of an abortion are serious and can be lasting . . . An 
        adequate medical and psychological case history is 
        important to the physician. Parents can provide medical 
        and psychological data, refer the physician to other 
        sources of medical history, such as family physicians, 
        and authorize family physicians to give relevant 
        data.\151\
---------------------------------------------------------------------------
    \151\H.L. v. Matheson, 450 U.S. 398, 411 (1981). Accord Ohio v. 
Akron Ctr. for Reproductive Health, 497 U.S. 502, 518-19 (1990).

    Take, for example, the story of Sandra, a 14-year-old girl 
who committed suicide shortly after obtaining an abortion.\152\ 
Sandra's mother, who learned of her daughter's abortion only 
after her suicide, sued the abortion provider at which Sandra's 
abortion was performed, asserting that her daughter's death was 
due to the failure of the abortion provider to obtain a 
psychiatric history or monitor Sandra's mental health.\153\ The 
court concluded that Sandra was not insane at the time she 
committed suicide and, therefore, her actions broke the chain 
of causation required for recovery.\154\ Yet evidence was 
presented that Sandra had a history of psychological illness 
and that her behavior was noticeably different after the 
abortion.\155\ If Sandra's mother had been aware of her 
daughter's abortion, she would have had the opportunity to 
notify the abortion provider of Sandra's psychological history, 
and steps could have been taken to minimize the psychological 
effect of the abortion on Sandra's already fragile mental 
state.
---------------------------------------------------------------------------
    \152\See Edison v. Reproductive Health Services, 863 S.W.2d 621 
(Mo. App. E.D. 1993).
    \153\See id. at 624.
    \154\See id. at 628.
    \155\Edison v. Reproductive Health Services, 863 S.W.2d 621 (Mo. 
App. E.D. 1993).
---------------------------------------------------------------------------
    A more complete and thus more accurate medical history of 
the patient will enable abortion providers to disclose not only 
medical risks that ordinarily accompany abortions but also 
those risks that may be specific to a pregnant minor. Parental 
involvement provides adults with the opportunity to advise and 
assist the girl in giving her informed consent to the 
procedure.
    Third, parental involvement will improve medical treatment 
of pregnant minors by ensuring that parents have adequate 
knowledge to recognize and respond to any post-abortion 
complications that may develop.\156\ The rate of many of the 
complications associated with abortion are unknown. As a 
clinician's guide states, ``The abortion reporting systems of 
some counties and states in the United States include entries 
about complications, but these systems are generally considered 
to underreport infections and other problems that appear some 
time after the procedure was performed.''\157\ Furthermore, 
women typically have no pre-existing relationship with an 
abortion provider,\158\ which likely accounts for the fact that 
only about one-third return to the provider for their post-
operative exam.\159\ Teenagers are even less likely to return 
for follow-up appointments.\160\ This failure to return for 
post-operative exams precludes discovery of post-abortion 
complications by abortion providers and subsequent reporting of 
these complications. Other healthcare providers may be 
reluctant to report any complications for fear of compromising 
the secrecy that often surrounds abortions.
---------------------------------------------------------------------------
    \156\See Ohio v. Akron Ctr. for Reproductive Health, 497 U.S. 502, 
519 (1990).
    \157\Stanley K. Henshaw, ``Unintended Pregnancy and Abortion: A 
Public Health Perspective,'' in A Clinician's Guide to Medical and 
Surgical Abortions 20 (Maureen Paul et al., eds. 1999).
    \158\See Florida Dep't of Health v. North Florida Women's Health 
and Counseling Service, 852 So.2d 254, 264 n.3 (Fla. App. 1 Dist., 
2001): [E]vidence at trial showed, the physician-patient relationship 
is often attenuated in the abortion context, almost to the point of 
non-existence. Cf. Planned Parenthood v. Danforth, 428 U.S. 52, 91, 96 
S.Ct. 2831, 49 L.Ed.2d 788 (1976) (``It seems unlikely that [the minor] 
will obtain adequate counsel and support from the attending physician 
at an abortion clinic, where abortions for pregnant minors frequently 
take place.''). Abortion patients ordinarily see their physicians only 
once or twice, very briefly. Most of their interaction is with the 
clinic's staff. Physicians performing abortions often perform several 
in the space of a single hour. Id.
    \159\Stanley K. Henshaw, ``Unintended Pregnancy and Abortion: A 
Public Health Perspective,'' in A Clinician's Guide to Medical and 
Surgical Abortions 20 (Maureen Paul et al., eds. 1999). Cf. Richard S. 
Moon, Why I Don't Do Abortions Anymore, Medical Economics 61(Mar. 4, 
1985).
    \160\Parental Notification of Abortion: Hearings on H. 218 Before 
the House Comm. on Health and Welfare, 2001-2002 Legis. (Vt. 2001) 
(Nancy Mosher, President and CEO of Planned Parenthood of Northern New 
England on April 16, 2001) (estimating that two-thirds of Vermont women 
keep their follow up appointments, although ``teenagers are notorious 
for `no-showing''').
---------------------------------------------------------------------------
    At least one American court has held that a perforated 
uterus is a ``normal risk'' associated with abortion.\161\ 
Untreated, a perforated uterus may result in an infection, 
complicated by fever, endometritis, and parametritis. According 
to one study, ``[t]he risk of death from post-abortion sepsis 
[infection] is highest for young women, those who are 
unmarried, and those who undergo procedures that do not 
directly evacuate the contents of the uterus . . . A delay in 
treatment allows the infection to progress to bacteremia, 
pelvic abscess, septic pelvic thrombophlebitis, disseminated 
intravascular coagulophy, septic shock, renal failure, and 
death.''\162\ Evidence about these dangers presented at trial 
persuaded a Florida appellate court to uphold that State's 
parental notification law:
---------------------------------------------------------------------------
    \161\Reynier v. Delta Women's Clinic, 359 So.2d 733, 738 (La. Ct. 
App. 1978) (``All the medical testimony was to the effect that a 
perforated uterus was a normal risk, but the statistics given by the 
experts indicated that it was an infrequent occurrence and it was rare 
for a major blood vessel to be damaged.''). Frequent injuries from 
incomplete abortions are discussed in Swate v. Schiffers, 975 S.W.2d 70 
(Tex. App.-San Antonio 1998) (abortionist's unsuccessful claim of libel 
against journalist for reports based in part upon one disciplinary 
order that doctor had failed to complete abortions performed on several 
patients and had failed to repair lacerations which occurred during 
abortion procedures). Cf. Sherman v. District of Columbia Bd. of 
Medicine, 557 A.2d 943, 944 (D.C. 1989) (``Dr. Sherman placed his 
patients' lives at risk by using unsterile instruments in surgical 
procedures and by intentionally doing incomplete abortions (using 
septic instruments) to increase his fees by making later surgical 
procedures necessary. His practices made very serious infections (and 
perhaps death) virtually certain to occur. Dr. Sherman does not 
challenge our findings that his misconduct was willful nor that he 
risked serious infections in his patients for money.'').
    \162\Phillip G. Stubblefield and David A. Grimes, ``Current 
Concepts: Septic Abortions,'' New Eng. J. Med. 310 (August 4, 1994).

        The State proved that appropriate aftercare is critical 
        in avoiding or responding to post-abortion 
        complications. Abortion is ordinarily an invasive 
        surgical procedure attended by many of the risks 
        accompanying surgical procedures generally. If post-
        abortion nausea, tenderness, swelling, bleeding, or 
        cramping persists or suddenly worsens, a minor (like an 
        adult) may need medical attention. A guardian unaware 
        that her ward or a parent unaware that his minor 
        daughter has undergone an abortion will be at a serious 
        disadvantage in caring for her if complications 
        develop. An adult who has been kept in the dark cannot, 
        moreover, assist the minor in following the abortion 
        provider's instructions for post-surgical care. Failure 
        to follow such instructions can increase the risk of 
        complications. As the plaintiffs' medical experts 
        conceded, the risks are significant in the best of 
        circumstances. While abortion is less risky than some 
        surgical procedures, abortion complications can result 
        in serious injury, infertility, and even death.\163\
---------------------------------------------------------------------------
    \163\Florida Dep't of Health v. North Florida Women's Health and 
Counseling Service, 852 So.2d 254, 262-63 (Fla. App. 1 Dist. 2001), 
quashed by North Florida Women's Health and Counseling Services, Inc. 
v. State, 866 So.2d 612 (Fla. 2003) (striking down state law under 
state constitution's ``right to privacy''). The Florida Constitution 
was subsequently amended to state ``Notwithstanding a minor's right to 
privacy . . . the Legislature is authorized to require by general law 
for notification to a parent or guardian of a minor before the 
termination of the minor's pregnancy.'' Fla. Stat. Ann. Const. Art. 10 
Sec. 22.

    Young adolescent girls are particularly at risk of certain 
adverse medical consequences from an abortion. For instance, 
there is a greater risk of cervical injury associated with 
suction-curettage abortions (at 12 weeks' gestation or earlier) 
performed on girls 17 years old or younger.\164\ Cervical 
injury is of serious concern because it may predispose the 
young girl to adverse outcomes in future pregnancies. Girls 17 
years old or younger also face a two and a half times greater 
risk of acquiring endometriosis following an abortion than do 
women 20-29 years old.\165\
---------------------------------------------------------------------------
    \164\See Willard Cates, Jr., M.D., M.P.H., Kenneth F. Schulz, 
M.B.A. & David A. Grimes, M.D., The Risks Associated With Teenage 
Abortion, New Eng. J. of Med., Sept. 15, 1983, at 621-24.
    \165\See Burkman et al., Morbidity Risk Among Young Adolescents 
Undergoing Elective Abortion, Contraception, vol. 30 (1984), at 99-105.
---------------------------------------------------------------------------
    The particular risks faced by minors upon whom abortions 
are performed were articulated by Dr. Bruce A. Lucero. Dr. 
Lucero, who supported the Child Custody Protection Act (federal 
legislation similar to CIANA) in 1998, wrote in The New York 
Times about his own experience with minor girls seeking 
abortions. ``In almost all cases,'' Dr. Lucero wrote, ``the 
only reason that a teen-age girl doesn't want to tell her 
parents about her pregnancy is that she feels ashamed and 
doesn't want to let her parents down.''\166\ However, according 
to Dr. Lucero, ``parents are usually the ones who can best help 
their teen-ager consider her options. And whatever the girl's 
decision, parents can provide the necessary emotional support 
and financial assistance.''\167\ Moreover, Dr. Lucero explained 
that ``patients who receive abortions at out-of-state clinics 
frequently do not return for follow-up care, which can lead to 
dangerous complications. And a teen-ager who has an abortion 
across state lines without her parents' knowledge is even more 
unlikely to tell them that she is having complications.''\168\
---------------------------------------------------------------------------
    \166\Bruce A. Lucero, M.D., ``Parental Guidance Needed,'' The New 
York Times (July 12, 1998), section 4, at 1.
    \167\Id.
    \168\Id.
---------------------------------------------------------------------------
    Opponents also argue that the bill needs a broader ``health 
exception.'' It does not. CIANA specifically provides that its 
notification requirements would not apply if ``the abortion is 
necessary to save the life of the minor because her life was 
endangered by a physical disorder, physical injury, or physical 
illness, including a life-endangering physical condition caused 
by or arising from the pregnancy itself.'' If the concern is 
about health risks of a non life-threatening nature, then the 
best course of action, of course, is involving the parents. 
Finally, the Supreme Court has upheld as constitutional a state 
parental notification statute that did not contain a health 
exception. That state statute provided only for a ``judicial 
bypass'' exception, which would of course take some time for a 
minor to utilize, and an exception for cases in which emergency 
treatment prior to notice ``is necessary to prevent the woman's 
death.''\169\
---------------------------------------------------------------------------
    \169\Hodsgon v. Minnesota, 497 U.S. 417, 426 n.7 (1990) (citing 
Minnesota statute Sec. 144.343, subd. 4(a)).
---------------------------------------------------------------------------
    Without the knowledge that their daughters have had 
abortions, parents are incapable of ensuring that their 
children obtain routine post-operative care or of providing an 
adequate medical history to physicians called upon to treat any 
complications that may arise. The first omission may allow 
complications such as infection, perforation, or depression, to 
continue untreated. The second omission may be lethal. When 
parents do not know that their daughter had an abortion, 
ignorance prevents swift and appropriate intervention by 
emergency room professionals responding to a life-threatening 
condition.
    In short, the physical and psychological risks of abortions 
to minors are great, and laws requiring parental involvement in 
such abortions reduce that risk. The widespread practice of 
evading such laws by transporting minors across State lines 
through interstate commerce may be prevented only through 
Federal legislation.

             CIANA PROTECTS MINOR GIRLS FROM SEXUAL ASSAULT

    In addition to improving the medical care received by young 
girls dealing with an unplanned pregnancy, parental involvement 
will provide increased protection against sexual exploitation 
of minors by adult men. National studies reveal that ``[a]lmost 
two thirds of adolescent mothers have partners older than 20 
years of age.''\170\ In a study of over 46,000 pregnancies by 
school-age girls in California, researchers found that ``71%, 
or over 33,000, were fathered by adult post-high-school men 
whose mean age was 22.6 years, an average of 5 years older than 
the mothers . . . Even among junior high school mothers aged 15 
or younger, most births are fathered by adult men 6-7 years 
their senior. Men aged 25 or older father more births among 
California school-age girls than do boys under age 18.''\171\ 
Other studies have found that most teenage pregnancies are the 
result of predatory practices by men who are substantially 
older.\172\
---------------------------------------------------------------------------
    \170\American Academy of Pediatrics Committee on Adolescence, 
``Adolescent Pregnancy--Current Trends and Issues: 1998,'' 103 
Pediatrics 516, 519 (1999).
    \171\Mike A. Males, ``Adult Involvement in Teenage Childbearing and 
STD,'' 346 Lancet 64 (July 8,1995) (emphasis added).
    \172\See id. (citing HP Boyer and D. Fine, ``Sexual Abuse as a 
Factor in Adolescent Pregnancy and Child Maltreatment,'' 24 Fam. Plan. 
Perspectives 4 (1992)); See also HP Gershenson, et al. ``The Prevalence 
of Coercive Experience Among Teenage Mothers,'' 24 J. Interpersonal 
Violence 4 (1989); American Academy of Pediatrics Committee on 
Adolescence, ``Adolescent Pregnancy--Current Trends and Issues: 1998,'' 
103 Pediatrics 516, 516 (1999) (``Younger teenagers are especially 
vulnerable to coercive and nonconsensual sex. Involuntary sexual 
activity has been reported in 74% of sexually active girls younger than 
14 years and 60% of those younger than 15 years.'').
---------------------------------------------------------------------------
    A 1989 study of coercive sexual experiences among teenage 
mothers found that of the pregnant teens who had unwanted 
sexual experiences, only 18% of the perpetrators were within 
the victim's age group. Another 18% were three to 5 years older 
than the victim. Seventeen percent were six to 10 years older, 
and 40% were more than 10 years older than their victims.\173\ 
Another study reports that when a minor's parents have not been 
told about her pregnancy, 58 percent of the time it is the 
girl's boyfriend who accompanies her for an abortion, and the 
minor's boyfriend helped pay for the abortion 76 percent of the 
time.\174\
---------------------------------------------------------------------------
    \173\See Gershenson, et al. ``The Prevalence of Coercive Experience 
Among Teenage Mothers,'' 24 J. Interpersonal Violence 4 (1989).
    \174\See Stanley Henshaw & Kathryn Post, Parental Involvement in 
Minors' Abortion Decisions, Family Planning Perspectives, Sept./Oct. 
1992, at 206.
---------------------------------------------------------------------------
    As Professor Teresa Stanton Collett testified before the 
House Constitution Subcommittee:

        [A]s this Congress learned through a congressional 
        report from the Center for Disease Control, two-thirds 
        of the fathers of teenage mothers are age 20 years or 
        older, suggesting that there is in fact differences in 
        power and status between the sexual partners.\175\ In 
        addition to that, a survey of 1,500 unmarried minors 
        having abortions revealed that among the minors who 
        reported that neither parent knew of the abortion, 89 
        percent said that a boyfriend was involved in deciding 
        or arranging the abortion, and 93 percent of those 15 
        and under said that the boyfriend was involved.\176\
---------------------------------------------------------------------------
    \175\See Department of Health and Human Services, ``Report to 
Congress on Out-of-Wedlock Childbearing'' (September 1995) at x 
(``Evidence also indicates that among unmarried teenage mothers, two-
thirds of the fathers are age 20 or older, suggesting that differences 
in power and status exist between many sexual partners.'').
    \176\Child Custody Protection Act: Hearings on H.R. 1755 Before the 
Subcomm. on the Constitution of the House Comm. on the Judiciary, 108th 
Cong., 22 (July 20, 2004) (statement of Teresa Collett).

    Experience suggests that sexual predators recognize the 
advantage of their victims' obtaining an abortion.\177\ Not 
only does an abortion eliminate a critical piece of evidence of 
the criminal conduct,\178\ but it also allows the abuse to 
continue undetected.\179\ As a recent presentation given at a 
U.S. Department of Health and Human Services Conference on the 
Sexual Exploitation of Teens showed, of minor girls' first 
sexual experiences, 13% constitute statutory rape.\180\ 
Further, the younger a sexually experienced teen is, the more 
likely they are to experience statutory rape. Of sexually 
experienced teens age 13 or younger, 65% experienced statutory 
rape. Of those age 14, 53% experienced statutory rape. And of 
those age 15, 41% experienced statutory rape.\181\ And young 
girls who are younger at their first sexual experience are more 
likely to say their first sexual experience was non-
voluntary.\182\ Also, blacks and Hispanics are more likely to 
experience statutory rape.\183\ Parental involvement laws help 
ensure that parents have the opportunity to protect their 
daughters from those who would victimize them further. Secret 
abortions protect and perpetuate the illegal conduct of these 
adult male predators.
---------------------------------------------------------------------------
    \177\On June 14, 2000, a 36-year-old Omaha man who impersonated the 
father of his teen-age victim in order to assist her in obtaining an 
abortion was sentenced to 1\1/2\-2 years in prison for felony child 
abuse. See Angie Brunkow, ``Man Who Said He Was Girl's Dad Sentenced,'' 
Omaha World-Herald (June 14, 2000) at 20. A similar attempt to hide the 
consequences of statutory rape is reflected in the testimony of Joyce 
Farley before the United States House of Representatives, Committee on 
the Judiciary, Subcommittee on the Constitution. See, e.g., Child 
Custody Protection Act: Hearings on H.R. 3682 Before the Subcomm. on 
the Constitution of the House Comm. on the Judiciary, 105th Congress, 
May 21, 1998 (statement of Joyce Farley). http://www.house.gov/
judiciary/222460.htm.
    \178\See Commonwealth v. Sasville, 616 N.E.2d 476 (Mass. 1993) 
(destruction of aborted fetus precluded prosecution for forcible rape 
of a child under the age of sixteen). Compare Smith v. Commonwealth, 
432 S.E.2d 2 (Va. App. 1993) (prosecution for rape of 14-year-old 
girl), with Hampton v. State, 1987 WL. 28223 (Ark. App. 1987) 
(prosecution for incest), and State v. Khong, 502 N.E.2d 682 (Ohio App. 
1985) (prosecutor subject to contempt order for failure to comply with 
discovery orders).
    \179\Dee Dee Alonzo testified before the Texas Senate Human 
Services Committee in support of Senate Bill 30, the bill enacting the 
Texas Parental Notification Act. At age sixteen, she was seduced by her 
high school teacher. When she became pregnant, he persuaded her to have 
a secret abortion. She went to the clinic alone, obtained the abortion 
her abuser had paid for, and returned to continue the abusive 
relationship for another year. Ms. Alonzo testified ``No matter what 
their reaction would have been, they were my parents and they were 
adults, and they did love me, it would not have been a secret and the 
man would have been exposed.'' Testimony of Dee Dee Alonzo, Hearing on 
Tex. S.B. 30 Before the Senate Human Servs. Comm., 76th Leg., R.S. 4-5 
(Mar. 10, 1999) (tapes available from the Senate Staff Servs. Office 
and content is from private transcripts of those tapes). A similar 
incident involved another high school student impregnated by her 
teacher. This is revealed in the settlement related to injuries she 
suffered during the abortion of her pregnancy. See Clement v. Riston, 
No.B-131,033, settlement reported in Jury Verdict Research, Research, 
LRP Pub. No. 65904 available on Lexis-Nexis; cf. Patterson v. Planned 
Parenthood, 971 S.W.2d 439, 447 (Tex. 1998) (Gonzales, J., concurring) 
(describing the sexual abuse of a young girl that resulted in two 
pregnancies and two secret abortions).
    \180\Kristin Moore, Ph.D. and Jennifer Manlove, Ph.D., ``A 
Demographic Portrait of Statutory Rape,'' Presentation given at the 
United States Department of Health and Human Services' Conference on 
the Sexual Exploitation of Teens (March 23-24, 2005) (defining 
statutory rape as occurring when teens aged 15 or younger have sex with 
a partner 3 or more years older).
    \181\Id.
    \182\Id. (of those younger than 14, 18%; of those age 15-16, 10%; 
and of those age 17-19, 5%).
    \183\Id. (Hispanic, 17%, black, 16%, white, 11%).
---------------------------------------------------------------------------

       CONGRESS HAS CLEAR CONSTITUTIONAL AUTHORITY TO ENACT CIANA

    CIANA is a regulation of commerce among the several 
states.\184\ Commerce, as that term is used in the 
Constitution, includes travel whether or not that travel is for 
reasons of business.\185\ To transport another person across 
state lines is to engage in commerce among the states.\186\ 
Under current Supreme Court precedents, Congress can enact 
legislation concerning interstate commerce, such as CIANA, for 
reasons related primarily to local activity rather than 
commerce itself.\187\
---------------------------------------------------------------------------
    \184\See, e.g., Heart of Atlanta Motel, Inc. v. United States, 379 
U.S. 241 (1964) (upholding enactment of Title II of the Civil Rights 
Act under Congress' commerce clause power).
    \185\See, e.g., Caminetti v. United States, 242 U.S. 470 (1917).
    \186\There is therefore no need to address the scope of Congress' 
power to regulate activity that is not, but that affects, commerce 
among the States. See, e.g., A.L.A. Schechter Poultry Corp. v. United 
States, 295 U.S. 495 (1935); Wickard v. Filburn, 317 U.S. 111 (1942); 
Katzenbach v. McClung, 379 U.S. 294 (1964); United States v. Lopez, 514 
U.S. 549 (1995).
    \187\See United States v. Darby, 312 U.S. 100 (1941).
---------------------------------------------------------------------------
    The interstate transportation of minors for the purpose of 
securing an abortion is clearly a form of interstate commerce 
which the Constitution expressly empowers Congress to 
regulate.\188\ CIANA regulates only conduct which involves 
interstate movement, activity which the national government 
alone is expressly authorized by the Constitution to address.
---------------------------------------------------------------------------
    \188\U.S. Const., art. I, Sec. 8, cl. 3.
---------------------------------------------------------------------------
    The Federal Government has long exercised its interstate 
commerce authority to prohibit interstate activity harmful to 
minors and their families. In 1910, Congress used its Commerce 
Clause power to enact the Mann Act,\189\ which, before its 
amendment in 1986, prohibited the interstate transportation of 
women or minors for purposes of ``prostitution or debauchery, 
or for any other immoral purpose.'' The Supreme Court upheld 
the enactment of this law as a constitutional exercise of 
Congress' power over transportation among the several states. 
The Court reasoned that if men and women employ interstate 
transportation to facilitate a wrong, then their right to 
interstate travel can be restricted.\190\ That statute was 
upheld as applied to the transportation of a person to Nevada 
for purposes of engaging in prostitution, even though 
prostitution was legal in Nevada.\191\ The Mann Act flatly 
prohibited the interstate transportation of women for 
``prostitution'' or for ``any other immoral purpose.'' In 
upholding the law as a valid exercise of Congress' commerce 
power, the Court stated:
---------------------------------------------------------------------------
    \189\18 U.S.C. Sec. 2421 (1970). As amended, the statute prohibits 
the knowing transportation of any individual across state lines ``with 
intent that such individual engage in prostitution, or in any sexual 
activity for which any person can be charged with a criminal offense, 
or attempts to do so . . .'' 18 U.S.C. Sec. 2421 (1999).
    \190\See Hoke v. United States, 227 U.S. 308, 323 (1913) (noting, 
in upholding the constitutionality of the Mann Act, ``that Congress has 
power over transportation `among the several states;' that the power is 
complete in itself, and that Congress, as an incident to it, may adopt 
not only means necessary but convenient to its exercise, and the means 
may have the quality of police regulations.'').
    \191\See United States v. Pelton, 578 F.2d 701 (8th Cir. 1978).

        The transportation of passengers in interstate 
        commerce, it has long been settled, is within the 
        regulatory power of Congress, under the commerce clause 
        of the Constitution, and the authority of Congress to 
        keep the channels of interstate commerce free from 
        immoral and injurious uses has been frequently 
        sustained, and is no longer open to question.\192\
---------------------------------------------------------------------------
    \192\Caminetti, 242 U.S. at 491.

    Just as it was appropriate for Congress to use its 
constitutional authority to keep the channels of interstate 
commerce free from ``immoral'' conduct, so it is also 
appropriate for Congress to exercise that authority to keep the 
channels of interstate commerce free from those who transport 
minors across state lines in order to circumvent state parental 
involvement laws, or from physicians who might not otherwise 
notify a minor's parents.
    The Mann Act is not the only example of a Federal law that 
prohibit interstate activities that might be legal in the state 
to which the activity is directed. Indeed, as long ago as 1876, 
Congress ``made it a crime to deposit in the mails any letters 
or circulars concerning lotteries, whether illegal or chartered 
by state legislatures.''\193\ A statute to this effect is still 
in force.\194\ Congress later prohibited the transportation of 
lottery tickets in interstate commerce, whether or not 
lotteries are legal in the state to which the tickets are 
transported.\195\ That provision was upheld by the Supreme 
Court in Champion v. Ames\196\ and is still in effect.
---------------------------------------------------------------------------
    \193\United States v. Edge Broadcasting Co., 509 U.S. 418, 421 
(1993).
    \194\See 18 U.S.C.A. Sec. 1302 (prohibiting the mailing of lottery 
tickets or letters, circulars, and other materials regarding a 
lottery).
    \195\See 18 U.S.C. Sec. 1301.
    \196\188 U.S. 321 (1903).
---------------------------------------------------------------------------
    CIANA does not supercede, override, or alter existing state 
laws regarding minors' abortions. Rather, CIANA is predicated 
on Congress' authority to regulate interstate activity. The 
bill does nothing to regulate purely local activity, and it 
does not impose any new rules regarding conduct that occurs 
solely within one state. CIANA embodies rules to regulate 
interstate activities that involve two or more states, as is 
entirely appropriate under the Commerce Clause. In short, CIANA 
does not encroach on state powers.

            CIANA IS CONSISTENT WITH SUPREME COURT PRECEDENT

    In Roe v. Wade,\197\ a majority of the Supreme Court found 
that the Fourteenth Amendment's Due Process Clause, which 
provides that no state shall deprive any person of ``life, 
liberty, or property'' without due process of law, includes 
within it a ``substantive'' component that bars a state from 
prohibiting abortions under some circumstances. This 
substantive component of the Due Process Clause, also described 
in that case as including a ``right to privacy,'' was construed 
to forbid virtually all state prohibitions on abortion during 
the first trimester of pregnancy.\198\ In Planned Parenthood v. 
Casey,\199\ the scope of permissible state regulation of 
abortion and the standards to be applied in evaluating the 
constitutionality of the regulation were significantly changed. 
Instead of declaring that the right to seek an abortion was a 
``fundamental right'' requiring a ``compelling state interest'' 
in order to be regulated, the new holding was that state 
regulation of abortion was permissible so long as such 
regulation did not place an ``undue burden'' on a woman's 
exercise of her constitutional rights with regard to 
abortion.\200\
---------------------------------------------------------------------------
    \197\410 U.S. 113 (1973).
    \198\See Planned Parenthood v. Casey, 505 U.S. 833, 985 (1992) 
(Scalia, J., dissenting).
    \199\505 U.S. 833 (1992).
    \200\For the articulation of the ``undue burden'' standard in 
Casey, see id. at 874-80. While the ``undue burden'' standard as 
expressed in Casey appeared only to be the views of the three-person 
plurality, Justice Scalia predicted that ``undue burden'' would 
henceforward be the relevant standard, see id. at 984-95 (Scalia, J., 
dissenting). It now appears that the lower Federal courts understand 
that the ``undue burden'' standard is the correct one to be applied in 
abortion cases involving babies that are not viable. See, e.g., Manning 
v. Hunt, 119 F.3d 254, 260 (4th Cir. 1997) (``The trend does appear to 
be a move away from the strict scrutiny standard toward the so-called 
`undue burden' standard of review.'').
---------------------------------------------------------------------------
    CIANA does not place an undue burden upon a woman's right 
to an abortion. To the extent that a state rule is inconsistent 
with the Court's doctrine, that rule is ineffective and CIANA 
would not make it effective. Regarding the bill's provisions 
that govern interstate abortions conducted in States without 
parental involvement laws, a requirement that a parent simply 
be notified is not an undue burden.
    Following the Court's decision in Roe v. Wade,\201\ many 
states enacted parental notice or consent statutes requiring 
minors to notify or seek the consent of their parents before 
undergoing an abortion. Parental consent laws generally require 
one or both parents to give actual consent to the minor's 
decision to have an abortion. Parental notification laws 
typically require the physician, or in some statutes another 
health care provider, to notify one or both of the parents of 
the minor female at some time prior to the abortion.
---------------------------------------------------------------------------
    \201\410 U.S. 113 (1973).
---------------------------------------------------------------------------
    The Court first considered parental involvement in a minor 
daughter's abortion in Planned Parenthood of Central Missouri 
v. Danforth.\202\ The Missouri statute gave a minor girl's 
parent an absolute veto over her decision to have an abortion. 
The majority, led by Justice Blackmun, concluded that such a 
veto power was unconstitutional.\203\ The majority noted, 
however, that the Court ``long has recognized that the State 
has somewhat broader authority to regulate the activities of 
children than of adults'' and ``emphasized'' that its holding 
in the case ``does not suggest that every minor, regardless of 
age . . . may give effective consent for termination of her 
pregnancy.''\204\
---------------------------------------------------------------------------
    \202\428 U.S. 52 (1976).
    \203\Id. at 74.
    \204\Id. at 74, 75.
---------------------------------------------------------------------------
    The Court next addressed state parental involvement laws in 
Bellotti v. Baird,\205\ remanding a parental consent statute 
that was unclear as to whether the parents had authority to 
veto the abortion and as to the availability of a judicial 
bypass procedure.\206\ The statute returned to the Supreme 
Court in Bellotti v. Baird (Bellotti II).\207\ The statute in 
Bellotti II required a minor to obtain the consent of her 
parents or circumvent this requirement through a judicial 
bypass proceeding that did not take into account whether the 
minor was sufficiently mature to make an informed decision 
regarding the abortion. The Supreme Court invalidated the 
statute without a majority opinion.
---------------------------------------------------------------------------
    \205\428 U.S. 132 (1976).
    \206\In doing so the Court recognized minors bear ``unquestionably 
greater risks of inability to give an informed consent.'' Id. at 147.
    \207\443 U.S. 622 (1979).
---------------------------------------------------------------------------
    Justice Powell stated in his plurality opinion, 
``constitutional interpretation has consistently recognized 
that the parents' claim to authority in their own household to 
direct the rearing of their children is basic in the structure 
of our society'' and that ``[p]roperly understood, then, the 
tradition of parental authority is not inconsistent with our 
tradition of individual liberty; rather, the former is one of 
the basic presuppositions of the latter.''\208\ This has become 
the de facto constitutional standard for parental consent and 
notification laws. In upholding parental involvement laws, the 
plurality found three reasons why the constitutional rights of 
minors were not identical to the constitutional rights of 
adults: ``[t]he peculiar vulnerability of children; their 
inability to make critical decisions in an informed, mature 
manner; and the importance of the parental role in child 
rearing.''\209\ Thus, the plurality sought to design guidelines 
for a judicial bypass proceeding that allowed states to address 
these interests in a parental consent statute.
---------------------------------------------------------------------------
    \208\Id. at 638.
    \209\Id. at 634.
---------------------------------------------------------------------------
    In H.L. v. Matheson,\210\ a minor girl challenged the 
constitutional validity of a state statute that required a 
physician to give notice to the parents of a minor girl 
whenever possible before performing an abortion on her. By a 
vote of six to three, the statute was held constitutional. The 
Court held that a state could require notification of the 
parents of a minor girl because the notification ``furthers a 
constitutionally permissible end by encouraging an unmarried 
pregnant minor to seek the help and advice of her parents in 
making the very important decision whether or not to bear a 
child.''\211\
---------------------------------------------------------------------------
    \210\450 U.S. 398 (1981).
    \211\Id. at 409-10.
---------------------------------------------------------------------------
    In Planned Parenthood Association of Kansas City, Missouri, 
Inc. v. Ashcroft,\212\ the Court upheld the constitutionality 
of a State law that required a minor to obtain the consent of 
one of her parents before obtaining an abortion or, in the 
alternative, to obtain the consent of a juvenile court judge. 
While there was no majority opinion, this case marked the first 
time the Court directly upheld a parental consent requirement.
---------------------------------------------------------------------------
    \212\462 U.S. 476 (1983).
---------------------------------------------------------------------------
    In Ohio v. Akron Center for Reproductive Health,\213\ the 
Supreme Court upheld a statute that required a physician to 
give notice to one of the minor's parents or, under some 
circumstances, another relative, before performing an abortion 
on the minor. The statute permitted the physician and the minor 
to avoid the requirement by a judicial bypass. Justice Kennedy, 
writing for the majority, held that the bypass proceeding did 
not unconstitutionally impair a minor's rights by the creation 
of unnecessary delay.\214\ The Court established in this case 
that it will not invalidate state procedures so long as they 
seem to be reasonably designed to provide the minor with an 
expedited process.
---------------------------------------------------------------------------
    \213\497 U.S. 502 (1990).
    \214\See id. at 514-15.
---------------------------------------------------------------------------
    In Hodgson v. Minnesota,\215\ the Court invalidated a state 
statute that required notification of both parents prior to a 
minor girl's abortion without the option of a judicial bypass. 
The Court, however, upheld statutory requirements that both 
parents be notified of the abortion and a 48 hour waiting 
period between notification and the performance of the 
abortion, if such requirements were accompanied by a judicial 
bypass procedure that met constitutional standards.
---------------------------------------------------------------------------
    \215\497 U.S. 417 (1990).
---------------------------------------------------------------------------
    CIANA, consistent with these Supreme Court precedents, 
requires--in cases in which a minor from one state seeks to 
obtain an abortion in another state without a parental 
involvement law--that before an abortion can be obtained, 
either (1) the physician is presented with documentation 
showing with a reasonable degree of certainty that a court in 
the minor's state of residence has waived any parental 
notification required by the laws of that state, or has 
otherwise authorized that the minor be allowed to procure an 
abortion; (2) the minor declares in a signed written statement 
that she is the victim of sexual abuse, neglect, or physical 
abuse by a parent, and, before an abortion is performed on the 
minor, the physician notifies the authorities specified to 
receive reports of child abuse or neglect by the law of the 
State in which the minor resides of the known or suspected 
abuse or neglect; or (3) the abortion is necessary to save the 
life of the minor because her life was endangered by a physical 
disorder, physical injury, or physical illness, including a 
life endangering physical condition caused by or arising from 
the pregnancy itself.
    In Planned Parenthood of Central Missouri v. Danforth,\216\ 
the first of a series of Supreme Court cases dealing with 
parental consent or notification laws, noted liberal Justice 
Stewart wrote, ``There can be little doubt that the State 
furthers a constitutionally permissible end by encouraging an 
unmarried pregnant minor to seek the help and advice of her 
parents in making the very important decision of whether or not 
to bear a child.''\217\
---------------------------------------------------------------------------
    \216\428 U.S. 52 (1976).
    \217\Planned Parenthood v. Danforth, 428 U.S. 52, 91 (1976) 
(Stewart, J., concurring).
---------------------------------------------------------------------------
    While the Supreme Court has, to date, ``declined to decide 
whether a parental notification statute must include some sort 
of bypass provision to be constitutional,''\218\ it is of note 
that even famously liberal Justice Stevens wrote in his 
concurring opinion in H.L. v. Matheson, that ``[t]he fact that 
certain members of the class of unmarried minor women who are 
suffering unwanted pregnancies and desire to terminate the 
pregnancies may actually be emancipated or sufficiently mature 
to make a well-reasoned abortion decision does not, in my view, 
undercut the validity of the [state] statute [in question] . . 
. [A] state legislature has constitutional power to utilize, 
for purposes of implementing a parental-notice requirement, a 
yardstick based upon the chronological age of unmarried 
pregnant women. That this yardstick will be imprecise or even 
unjust in particular cases does not render its use by a state 
legislature impermissible under the Federal 
Constitution.''\219\
---------------------------------------------------------------------------
    \218\Lambert v. Wicklund, 520 U.S. 292, 295 (1997).
    \219\H.L. v. Matheson, 450 U.S. 398, 424-25 (1981) (Stevens, J., 
concurring) (citations and quotations omitted).
---------------------------------------------------------------------------
    Furthermore, the Court in Hodgson v. Minnesota,\220\ wrote 
that:
---------------------------------------------------------------------------
    \220\497 U.S. 417 (1990).

        We think it is clear that a requirement that a minor 
        wait 48 hours after notifying a single parent of her 
        intention to get an abortion would reasonably further 
        the legitimate state interest in ensuring that the 
        minor's decision is knowing and intelligent . . . The 
        brief waiting period provides the parent the 
        opportunity to consult with his or her spouse and a 
        family physician, and it permits the parent to inquire 
        into the competency of the doctor performing the 
        abortion, discuss the religious or moral implications 
        of the abortion decision, and provide the daughter 
        needed guidance and counsel in evaluating the impact of 
        the decision on her future.''\221\
---------------------------------------------------------------------------
    \221\Hodgson v. Minnesota, 497 U.S. 417, 448-49 (1990).

    The Supreme Court has clearly indicated that a parental 
notification requirement does not impose an undue burden on a 
minor's ability to obtain an abortion, finding that ``[a] 48-
hour delay imposes only a minimal burden on the right of the 
minor to decide whether or not to terminate her 
pregnancy.''\222\
---------------------------------------------------------------------------
    \222\Id. at 449 (emphasis added).
---------------------------------------------------------------------------
    The Court then stated in Planned Parenthood v. Casey that:

        Numerous forms of state regulation might have the 
        incidental effect of increasing the cost or decreasing 
        the availability of medical care, whether for abortion 
        or any other medical procedure. The fact that a law 
        which serves a valid purpose, one not designed to 
        strike at the right itself, has the incidental effect 
        of making it more difficult or more expensive to 
        procure an abortion cannot be enough to invalidate it. 
        Only where state regulation imposes an undue burden on 
        a woman's ability to make this decision does the power 
        of the State reach into the heart of the liberty 
        protected by the Due Process Clause.\223\
---------------------------------------------------------------------------
    \223\Planned Parenthood v. Casey, 505 U.S. 833, 874 (1992).

    The Court continued that ``[a] finding of an undue burden 
is a shorthand for the conclusion that a state regulation has 
the purpose or effect of placing a substantial obstacle in the 
path of a woman seeking an abortion of a nonviable 
fetus.''\224\ A parental notice requirement, which the Supreme 
Court has described as a ``minimal burden''\225\ is clearly not 
a ``substantial obstacle''\226\ to receiving an abortion.
---------------------------------------------------------------------------
    \224\Id. at 877 (1992) (emphasis added).
    \225\Hodgson v. Minnesota, 497 U.S. 417, 449 (1990) (emphasis 
added).
    \226\The Supreme Court elaborated that ``Some guiding principles 
should emerge. What is at stake is the woman's right to make the 
ultimate decision, not a right to be insulated from all others in doing 
so. Regulations which do no more than create a structural mechanism by 
which the State, or the parent or guardian of a minor, may express 
profound respect for the life of the unborn are permitted, if they are 
not a substantial obstacle to the woman's exercise of the right to 
choose.'' Planned Parenthood v. Casey, 505 U.S. 833, 877 (1992).
---------------------------------------------------------------------------
    The Supreme Court continued: ``We reject the rigid 
trimester framework of Roe v. Wade. To promote the State's 
profound interest in potential life, throughout pregnancy the 
State may take measures to ensure that the woman's choice is 
informed, and measures designed to advance this interest will 
not be invalidated as long as their purpose is to persuade the 
woman to choose childbirth over abortion. These measures must 
not be an undue burden on the right . . . As with any medical 
procedure, the State may enact regulations to further the 
health or safety of a woman seeking an abortion . . . 
[P]arental notification or consent requirements . . . and our 
judgment that they are constitutional, are based on the quite 
reasonable assumption that minors will benefit from 
consultation with their parents and that children will often 
not realize that their parents have their best interests at 
heart.''\227\
---------------------------------------------------------------------------
    \227\Planned Parenthood v. Casey, 505 U.S. 833, 878, 895 (1992).
---------------------------------------------------------------------------
    Even famously liberal Justice Stevens wrote in his 
concurring opinion in H.L. v. Matheson,\228\ that:
---------------------------------------------------------------------------
    \228\450 U.S. 398 (1981).

        In my opinion, the special importance of a young 
        woman's abortion decision . . . provides a special 
        justification for reasonable state efforts intended to 
        ensure that the decision be wisely made. Such 
        reasonable efforts surely may include a requirement 
        that an abortion be procured only after consultation 
        with a licensed physician. And, because the most 
        significant consequences of the [abortion] decision are 
        not medical in character, the State unquestionably has 
        an interest in ensuring that a young woman receive 
        other appropriate consultation as well. In my opinion, 
        the quality of that interest is plainly sufficient to 
        support a state legislature's determination that such 
        appropriate consultation should include parental advice 
        . . . [T]he State may legitimately decide that such 
        consultation should be made more probable by ensuring 
        that parents are informed of their daughter's decision: 
        If there is no parental-[notice] requirement, many 
        minors will submit to the abortion procedure without 
        ever informing their parents. An assumption that the 
        parental reaction will be hostile, disparaging, or 
        violent no doubt persuades many children simply to 
        bypass parental counsel which would in fact be loving, 
        supportive, and, indeed, for some indispensable. It is 
        unrealistic, in my judgment, to assume that every 
        parent-child relationship is either (a) so perfect that 
        communication and accord will take place routinely or 
        (b) so imperfect that the absence of communication 
        reflects the child's correct prediction that the parent 
        will . . . [act] arbitrarily to further a selfish 
        interest rather than the child's interest. A state 
        legislature may conclude that most parents will be 
        primarily interested in the welfare of their children, 
        and further, that the imposition of a parental-[notice] 
        requirement is an appropriate method of giving the 
        parents an opportunity to foster that welfare by 
        helping a pregnant distressed child to make and to 
        implement a correct decision.\229\
---------------------------------------------------------------------------
    \229\H.L. v. Matheson, 450 U.S. 398, 422-24 (1981) (Stevens, J., 
concurring) (citations and quotations omitted).

    Even earlier, the Court stated in H.L. v. Matheson that 
``[t]he Constitution does not compel a state to fine-tune its 
statutes so as to encourage or facilitate abortions. To the 
contrary, state action encouraging childbirth except in the 
most urgent circumstances is rationally related to the 
legitimate governmental objective of protecting potential 
life.''\230\
---------------------------------------------------------------------------
    \230\Id. at 413 (citations and quotations omitted).
---------------------------------------------------------------------------

              THE RIGHT TO TRAVEL IS PRESERVED UNDER CIANA

    Opponents also argue that CIANA violates the rights of 
residents of each of the United States and of the District of 
Columbia to travel to and from any state of the Union for 
lawful purposes. Those opposed to CIANA on these grounds argue 
that the legislation will hold a pregnant minor ``hostage'' to 
the laws of her home state.
    As an initial matter, it does not appear that the Supreme 
Court has ever held that Congress' power to regulate interstate 
commerce is ever limited by the ``right to travel.'' Even 
assuming, however, that Congress' authority under the Commerce 
Clause is limited by the right to travel doctrine,\231\ the 
Supreme Court has recognized that the right to travel is ``not 
absolute,'' and is not violated so long as there is a 
``substantial reason for the discrimination beyond the mere 
fact that they are citizens of other States.''\232\ Congress 
obviously has a substantial interest in protecting the health 
and well-being of minor girls and in protecting the rights of 
parents to raise their children.
---------------------------------------------------------------------------
    \231\Contrary to claims by some opponents of CIANA, Saenz v. Roe, 
526 U.S. 489 (1999) does not in any way impugn the constitutionality of 
CIANA. In Saenz, the Supreme Court addressed ``the citizen's right to 
be treated equally in her new State of residence.'' Id. at 505 
(emphasis added). A minor who is a resident of one state and who 
crosses state lines to obtain an abortion in another state is by 
definition not a resident of the state in which such abortion is 
performed. Both operative sections of CIANA specifically restrict its 
applications to situations in which a minor resides in one state and 
seeks an abortion in another state.
    \232\Saenz v. Roe, 526 U.S. 489, 502 (1999).
---------------------------------------------------------------------------
    However, the notion that CIANA is inconsistent with the 
constitutional right to travel is not supportable under the 
Supreme Court's jurisprudence. Neither a state nor the Federal 
Government can interfere with a citizen's ability to leave a 
state for the purpose of visiting another State or prevent its 
citizens from returning; either would violate ``the right of a 
citizen of one State to enter and to leave another 
State.''\233\ CIANA does not even implicate this limitation, 
for it does not preclude the minor from traveling. The minor's 
right to travel to another state is wholly unimpeded by CIANA.
---------------------------------------------------------------------------
    \233\See id. at 500.
---------------------------------------------------------------------------
    In addition, the Court has recognized that the right to 
interstate travel ``may be regulated or controlled by the 
exercise of a State's police power'' and by the Federal 
Government as well.\234\ Protecting the health and well-being 
of minor girls and the rights of parents to raise their 
children are substantial, indeed compelling, reasons for 
restricting minors from obtaining an abortion without parental 
involvement. First, young adolescent girls who undergo 
abortions face a heightened risk of suffering from long-term 
physical and psychological complications. Second, 
``[c]onstitutional interpretation has consistently recognized 
that the parents' claim to authority in their own household to 
direct the rearing of their children is basic in the structure 
of our society,'' and that ``[p]roperly understood, then, the 
tradition of parental authority is not inconsistent with our 
tradition of individual liberty; rather, the former is one of 
the basic presuppositions of the latter.''\235\ Thus, ``[u]nder 
the Constitution, the State can properly conclude that parents 
. . . who have [the] primary responsibility for children's 
well-being are entitled to the support of laws designed to aid 
discharge of that responsibility.''\236\ Third, the fundamental 
rights of minors, including the right to travel, are not equal 
to those of adults. Although the Court has previously concluded 
that the fundamental rights of a child are ``virtually 
coextensive with that of an adult,''\237\ it also has 
recognized that ``[t]hese rulings have not been made on the 
uncritical assumption that the constitutional rights of 
children are indistinguishable from those of adults.''\238\ 
Thus, ``the State is entitled to adjust its legal system to 
account for children's vulnerability and their needs for 
`concern, . . . sympathy, and . . . paternal attention.'''\239\
---------------------------------------------------------------------------
    \234\United States v. Guest, 383 U.S. 745, 759 n.17 (1966).
    \235\Bellotti v. Baird, 443 U.S. 622, 638 (1979) (Bellotti II).
    \236\Id. at 639.
    \237\Id. at 634.
    \238\Id. at 635.
    \239\Id.
---------------------------------------------------------------------------
    Based upon this reasoning, the Court has allowed States to 
enact laws that ``account for children's vulnerability'' and 
that protect the unique role of parents:

        [T]he Court has held that the States validly may limit 
        the freedom of children to choose for themselves in the 
        making of important, affirmative choices with 
        potentially serious consequences. These rulings have 
        been grounded in the recognition that, during the 
        formative years of childhood and adolescence, minors 
        often lack the experience, perspective, and judgment to 
        recognize and avoid choices that could be detrimental 
        to them.\240\
---------------------------------------------------------------------------
    \240\Id.

    Therefore, ``[l]egal restrictions on minors, especially 
those supportive of the parental role, may be important to the 
child's chances for the full growth and maturity that make 
eventual participation in a free society meaningful and 
rewarding.''\241\ Consequently, a State may properly subject 
minors to more stringent limitations than are permissible with 
respect to adults. Examples include laws that prohibit the sale 
of cigarettes and alcoholic beverages to minors, laws that 
prohibit the sale of firearms and deadly weapons to minors 
without parental consent, and laws that prohibit third parties 
from exposing minors to certain types of literature. Similarly, 
Congress may restrict the right of minors to travel across 
state lines to a greater extent than it may adults.
---------------------------------------------------------------------------
    \241\Id. at 638-39.
---------------------------------------------------------------------------
    CIANA's opponents sometimes also argue that CIANA violates 
the rights of states to enact and enforce their own laws 
governing conduct within their territorial boundaries. This 
contention is clearly specious because CIANA does not attempt 
to regulate conduct occurring solely within the territorial 
boundaries of a state. Rather, CIANA regulates interstate 
commerce, and Congress has the exclusive authority to regulate 
such activity.

                                Hearings

    The Committee's Subcommittee on the Constitution held 1 day 
of hearings on H.R. 2299 on March 8, 2012. Testimony was 
received from Professor Teresa Collett, Professor of Law, 
University of St. Thomas School of Law; The Very Rev. Dr. 
Katherine Hancock Ragsdale, President and Dean, Episcopal 
Divinity School; and Dr. Michael New, Department of Social 
Sciences, University of Michigan--Dearborn.

                        Committee Consideration

    On March 27, 2012, the Committee met in open session and 
ordered the bill H.R. 2299 favorably reported without 
amendment, by a rollcall vote of 20 to 13, a quorum being 
present.

                            Committee Votes

    In compliance with clause 3(b) of rule XIII of the Rules of 
the House of Representatives, the Committee advises that the 
following rollcall votes occurred during the Committee's 
consideration of H.R. 2299.
    1. An amendment offered by Mr. Nadler that provides an 
exemption for grandparents and adult siblings, provided that 
such grandparent or adult sibling did not have sexual contact 
with the minor. Failed by a vote of 7-16.

                             ROLLCALL NO. 1
------------------------------------------------------------------------
                                                 Ayes     Nays   Present
------------------------------------------------------------------------
Mr. Smith, Chairman..........................                X
Mr. Sensenbrenner, Jr........................                X
Mr. Coble....................................                X
Mr. Gallegly.................................
Mr. Goodlatte................................                X
Mr. Lungren..................................                X
Mr. Chabot...................................                X
Mr. Issa.....................................                X
Mr. Pence....................................
Mr. Forbes...................................
Mr. King.....................................                X
Mr. Franks...................................                X
Mr. Gohmert..................................                X
Mr. Jordan...................................                X
Mr. Poe......................................                X
Mr. Chaffetz.................................
Mr. Griffin..................................                X
Mr. Marino...................................
Mr. Gowdy....................................                X
Mr. Ross.....................................
Ms. Adams....................................
Mr. Quayle...................................                X
Mr. Amodei...................................                X

Mr. Conyers, Jr., Ranking Member.............
Mr. Berman...................................       X
Mr. Nadler...................................       X
Mr. Scott....................................       X
Mr. Watt.....................................
Ms. Lofgren..................................
Ms. Jackson Lee..............................
Ms. Waters...................................
Mr. Cohen....................................
Mr. Johnson, Jr..............................       X
Mr. Pierluisi................................       X
Mr. Quigley..................................       X
Ms. Chu......................................
Mr. Deutch...................................       X
Ms. Sanchez..................................
Mr. Polis....................................
                                              --------------------------
    Total....................................       7       16
------------------------------------------------------------------------

    2. An amendment offered by Mr. Scott that provides an 
exemption for taxicab drivers, and others in the business of 
professional transport, unless the individual had sexual 
contact with the minor. Failed by a vote of 10-14.

                             ROLLCALL NO. 2
------------------------------------------------------------------------
                                                 Ayes     Nays   Present
------------------------------------------------------------------------
Mr. Smith, Chairman..........................                X
Mr. Sensenbrenner, Jr........................                X
Mr. Coble....................................                X
Mr. Gallegly.................................                X
Mr. Goodlatte................................                X
Mr. Lungren..................................                X
Mr. Chabot...................................                X
Mr. Issa.....................................
Mr. Pence....................................
Mr. Forbes...................................
Mr. King.....................................
Mr. Franks...................................                X
Mr. Gohmert..................................
Mr. Jordan...................................
Mr. Poe......................................                X
Mr. Chaffetz.................................                X
Mr. Griffin..................................                X
Mr. Marino...................................                X
Mr. Gowdy....................................                X
Mr. Ross.....................................
Ms. Adams....................................
Mr. Quayle...................................
Mr. Amodei...................................                X

Mr. Conyers, Jr., Ranking Member.............
Mr. Berman...................................       X
Mr. Nadler...................................       X
Mr. Scott....................................       X
Mr. Watt.....................................       X
Ms. Lofgren..................................       X
Ms. Jackson Lee..............................
Ms. Waters...................................
Mr. Cohen....................................
Mr. Johnson, Jr..............................       X
Mr. Pierluisi................................       X
Mr. Quigley..................................       X
Ms. Chu......................................
Mr. Deutch...................................       X
Ms. Sanchez..................................       X
Mr. Polis....................................
                                              --------------------------
    Total....................................      10       14
------------------------------------------------------------------------

    3. An amendment offered by Mr. Watt that provides an 
exemption for persons transporting a minor if delay endangers 
the physical health of the minor seeking the abortion. Failed 
by a vote of 11-13.

                             ROLLCALL NO. 3
------------------------------------------------------------------------
                                                 Ayes     Nays   Present
------------------------------------------------------------------------
Mr. Smith, Chairman..........................                X
Mr. Sensenbrenner, Jr........................                X
Mr. Coble....................................                X
Mr. Gallegly.................................                X
Mr. Goodlatte................................                X
Mr. Lungren..................................                X
Mr. Chabot...................................                X
Mr. Issa.....................................
Mr. Pence....................................
Mr. Forbes...................................
Mr. King.....................................
Mr. Franks...................................                X
Mr. Gohmert..................................
Mr. Jordan...................................
Mr. Poe......................................
Mr. Chaffetz.................................                X
Mr. Griffin..................................                X
Mr. Marino...................................                X
Mr. Gowdy....................................                X
Mr. Ross.....................................
Ms. Adams....................................
Mr. Quayle...................................
Mr. Amodei...................................                X

Mr. Conyers, Jr., Ranking Member.............
Mr. Berman...................................       X
Mr. Nadler...................................       X
Mr. Scott....................................       X
Mr. Watt.....................................       X
Ms. Lofgren..................................       X
Ms. Jackson Lee..............................       X
Ms. Waters...................................
Mr. Cohen....................................
Mr. Johnson, Jr..............................       X
Mr. Pierluisi................................       X
Mr. Quigley..................................       X
Ms. Chu......................................
Mr. Deutch...................................       X
Ms. Sanchez..................................       X
Mr. Polis....................................
                                              --------------------------
    Total....................................      11       13
------------------------------------------------------------------------

    4. An amendment offered by Mr. Watt that provides an 
exemption for cases where the abortion is necessary to protect 
the health or save the life of the abortion-seeking minor. 
Failed by a vote of 12-15.

                             ROLLCALL NO. 4
------------------------------------------------------------------------
                                                 Ayes     Nays   Present
------------------------------------------------------------------------
Mr. Smith, Chairman..........................                X
Mr. Sensenbrenner, Jr........................                X
Mr. Coble....................................                X
Mr. Gallegly.................................                X
Mr. Goodlatte................................                X
Mr. Lungren..................................                X
Mr. Chabot...................................                X
Mr. Issa.....................................
Mr. Pence....................................
Mr. Forbes...................................
Mr. King.....................................
Mr. Franks...................................                X
Mr. Gohmert..................................
Mr. Jordan...................................
Mr. Poe......................................                X
Mr. Chaffetz.................................                X
Mr. Griffin..................................                X
Mr. Marino...................................                X
Mr. Gowdy....................................                X
Mr. Ross.....................................
Ms. Adams....................................
Mr. Quayle...................................                X
Mr. Amodei...................................                X

Mr. Conyers, Jr., Ranking Member.............
Mr. Berman...................................       X
Mr. Nadler...................................       X
Mr. Scott....................................       X
Mr. Watt.....................................       X
Ms. Lofgren..................................       X
Ms. Jackson Lee..............................       X
Ms. Waters...................................
Mr. Cohen....................................       X
Mr. Johnson, Jr..............................       X
Mr. Pierluisi................................       X
Mr. Quigley..................................       X
Ms. Chu......................................
Mr. Deutch...................................       X
Ms. Sanchez..................................       X
Mr. Polis....................................
                                              --------------------------
    Total....................................      12       15
------------------------------------------------------------------------

    5. An amendment offered by Ms. Jackson Lee that provides an 
exemption for clergy, godparents, aunts, uncles, or first 
cousins, unless the individual had sexual contact with the 
minor. Failed by a vote of 11-16.

                             ROLLCALL NO. 5
------------------------------------------------------------------------
                                                 Ayes     Nays   Present
------------------------------------------------------------------------
Mr. Smith, Chairman..........................                X
Mr. Sensenbrenner, Jr........................                X
Mr. Coble....................................                X
Mr. Gallegly.................................                X
Mr. Goodlatte................................                X
Mr. Lungren..................................                X
Mr. Chabot...................................                X
Mr. Issa.....................................
Mr. Pence....................................
Mr. Forbes...................................
Mr. King.....................................
Mr. Franks...................................                X
Mr. Gohmert..................................
Mr. Jordan...................................
Mr. Poe......................................                X
Mr. Chaffetz.................................                X
Mr. Griffin..................................                X
Mr. Marino...................................                X
Mr. Gowdy....................................                X
Mr. Ross.....................................
Ms. Adams....................................
Mr. Quayle...................................                X
Mr. Amodei...................................                X

Mr. Conyers, Jr., Ranking Member.............
Mr. Berman...................................       X
Mr. Nadler...................................       X
Mr. Scott....................................       X
Mr. Watt.....................................       X
Ms. Lofgren..................................       X
Ms. Jackson Lee..............................       X
Ms. Waters...................................
Mr. Cohen....................................       X
Mr. Johnson, Jr..............................       X
Mr. Pierluisi................................                X
Mr. Quigley..................................       X
Ms. Chu......................................
Mr. Deutch...................................       X
Ms. Sanchez..................................       X
Mr. Polis....................................
                                              --------------------------
    Total....................................      11       16
------------------------------------------------------------------------

    6. An amendment offered by Ms. Jackson Lee that provides an 
exemption for cases where pregnancy is a result of sexual 
contact with parent, guardian, or other household member. 
Failed by a vote of 11-17.

                             ROLLCALL NO. 6
------------------------------------------------------------------------
                                                 Ayes     Nays   Present
------------------------------------------------------------------------
Mr. Smith, Chairman..........................                X
Mr. Sensenbrenner, Jr........................                X
Mr. Coble....................................                X
Mr. Gallegly.................................                X
Mr. Goodlatte................................                X
Mr. Lungren..................................                X
Mr. Chabot...................................                X
Mr. Issa.....................................                X
Mr. Pence....................................
Mr. Forbes...................................
Mr. King.....................................
Mr. Franks...................................                X
Mr. Gohmert..................................                X
Mr. Jordan...................................
Mr. Poe......................................                X
Mr. Chaffetz.................................                X
Mr. Griffin..................................                X
Mr. Marino...................................                X
Mr. Gowdy....................................                X
Mr. Ross.....................................
Ms. Adams....................................
Mr. Quayle...................................                X
Mr. Amodei...................................                X

Mr. Conyers, Jr., Ranking Member.............
Mr. Berman...................................       X
Mr. Nadler...................................       X
Mr. Scott....................................       X
Mr. Watt.....................................       X
Ms. Lofgren..................................       X
Ms. Jackson Lee..............................       X
Ms. Waters...................................
Mr. Cohen....................................
Mr. Johnson, Jr..............................       X
Mr. Pierluisi................................       X
Mr. Quigley..................................       X
Ms. Chu......................................
Mr. Deutch...................................       X
Ms. Sanchez..................................       X
Mr. Polis....................................
                                              --------------------------
    Total....................................      11       17
------------------------------------------------------------------------

    7. An amendment offered by Ms. Jackson Lee that changes the 
effective date from 45 days to 120 days after enactment. Failed 
by a vote of 11-17.

                             ROLLCALL NO. 7
------------------------------------------------------------------------
                                                 Ayes     Nays   Present
------------------------------------------------------------------------
Mr. Smith, Chairman..........................                X
Mr. Sensenbrenner, Jr........................                X
Mr. Coble....................................                X
Mr. Gallegly.................................                X
Mr. Goodlatte................................                X
Mr. Lungren..................................                X
Mr. Chabot...................................                X
Mr. Issa.....................................                X
Mr. Pence....................................
Mr. Forbes...................................
Mr. King.....................................
Mr. Franks...................................                X
Mr. Gohmert..................................                X
Mr. Jordan...................................
Mr. Poe......................................                X
Mr. Chaffetz.................................                X
Mr. Griffin..................................                X
Mr. Marino...................................                X
Mr. Gowdy....................................                X
Mr. Ross.....................................
Ms. Adams....................................
Mr. Quayle...................................                X
Mr. Amodei...................................                X

Mr. Conyers, Jr., Ranking Member.............
Mr. Berman...................................       X
Mr. Nadler...................................       X
Mr. Scott....................................       X
Mr. Watt.....................................       X
Ms. Lofgren..................................       X
Ms. Jackson Lee..............................       X
Ms. Waters...................................
Mr. Cohen....................................
Mr. Johnson, Jr..............................       X
Mr. Pierluisi................................       X
Mr. Quigley..................................       X
Ms. Chu......................................
Mr. Deutch...................................       X
Ms. Sanchez..................................       X
Mr. Polis....................................
                                              --------------------------
    Total....................................      11       17
------------------------------------------------------------------------

    8. An amendment by Mr. Johnson that provides an exception 
to the disclosure requirement if the minor's home poses a 
threat to physical safety. Failed by a vote of 11-18.

                             ROLLCALL NO. 8
------------------------------------------------------------------------
                                                 Ayes     Nays   Present
------------------------------------------------------------------------
Mr. Smith, Chairman..........................                X
Mr. Sensenbrenner, Jr........................                X
Mr. Coble....................................                X
Mr. Gallegly.................................                X
Mr. Goodlatte................................                X
Mr. Lungren..................................                X
Mr. Chabot...................................                X
Mr. Issa.....................................                X
Mr. Pence....................................
Mr. Forbes...................................
Mr. King.....................................                X
Mr. Franks...................................                X
Mr. Gohmert..................................                X
Mr. Jordan...................................
Mr. Poe......................................                X
Mr. Chaffetz.................................                X
Mr. Griffin..................................                X
Mr. Marino...................................                X
Mr. Gowdy....................................                X
Mr. Ross.....................................
Ms. Adams....................................
Mr. Quayle...................................                X
Mr. Amodei...................................                X

Mr. Conyers, Jr., Ranking Member.............
Mr. Berman...................................       X
Mr. Nadler...................................       X
Mr. Scott....................................       X
Mr. Watt.....................................       X
Ms. Lofgren..................................       X
Ms. Jackson Lee..............................
Ms. Waters...................................
Mr. Cohen....................................
Mr. Johnson, Jr..............................       X
Mr. Pierluisi................................       X
Mr. Quigley..................................       X
Ms. Chu......................................       X
Mr. Deutch...................................       X
Ms. Sanchez..................................       X
Mr. Polis....................................
                                              --------------------------
    Total....................................      11       18
------------------------------------------------------------------------

    9. An amendment offered by Mr. Quigley that provides an 
exemption for cases of rape or incest. Failed by a vote of 11-
15.

                             ROLLCALL NO. 9
------------------------------------------------------------------------
                                                 Ayes     Nays   Present
------------------------------------------------------------------------
Mr. Smith, Chairman..........................                X
Mr. Sensenbrenner, Jr........................                X
Mr. Coble....................................                X
Mr. Gallegly.................................                X
Mr. Goodlatte................................                X
Mr. Lungren..................................                X
Mr. Chabot...................................                X
Mr. Issa.....................................                X
Mr. Pence....................................
Mr. Forbes...................................
Mr. King.....................................                X
Mr. Franks...................................                X
Mr. Gohmert..................................
Mr. Jordan...................................
Mr. Poe......................................                X
Mr. Chaffetz.................................                X
Mr. Griffin..................................
Mr. Marino...................................                X
Mr. Gowdy....................................
Mr. Ross.....................................
Ms. Adams....................................
Mr. Quayle...................................                X
Mr. Amodei...................................                X

Mr. Conyers, Jr., Ranking Member.............
Mr. Berman...................................       X
Mr. Nadler...................................       X
Mr. Scott....................................       X
Mr. Watt.....................................       X
Ms. Lofgren..................................       X
Ms. Jackson Lee..............................
Ms. Waters...................................
Mr. Cohen....................................
Mr. Johnson, Jr..............................       X
Mr. Pierluisi................................       X
Mr. Quigley..................................       X
Ms. Chu......................................       X
Mr. Deutch...................................       X
Ms. Sanchez..................................       X
Mr. Polis....................................
                                              --------------------------
    Total....................................      11       15
------------------------------------------------------------------------

    10. An amendment offered by Ms. Chu that provides an 
exemption in Section 2 of the bill for those who have 
transported a minor in order to protect the life and health of 
the minor. Failed by a vote of 9-15.

                             ROLLCALL NO. 10
------------------------------------------------------------------------
                                                 Ayes     Nays   Present
------------------------------------------------------------------------
Mr. Smith, Chairman..........................                X
Mr. Sensenbrenner, Jr........................                X
Mr. Coble....................................                X
Mr. Gallegly.................................                X
Mr. Goodlatte................................                X
Mr. Lungren..................................                X
Mr. Chabot...................................                X
Mr. Issa.....................................                X
Mr. Pence....................................
Mr. Forbes...................................
Mr. King.....................................
Mr. Franks...................................                X
Mr. Gohmert..................................
Mr. Jordan...................................
Mr. Poe......................................                X
Mr. Chaffetz.................................                X
Mr. Griffin..................................                X
Mr. Marino...................................                X
Mr. Gowdy....................................
Mr. Ross.....................................
Ms. Adams....................................
Mr. Quayle...................................                X
Mr. Amodei...................................                X

Mr. Conyers, Jr., Ranking Member.............
Mr. Berman...................................
Mr. Nadler...................................       X
Mr. Scott....................................       X
Mr. Watt.....................................       X
Ms. Lofgren..................................
Ms. Jackson Lee..............................
Ms. Waters...................................
Mr. Cohen....................................
Mr. Johnson, Jr..............................       X
Mr. Pierluisi................................       X
Mr. Quigley..................................       X
Ms. Chu......................................       X
Mr. Deutch...................................       X
Ms. Sanchez..................................       X
Mr. Polis....................................
                                              --------------------------
    Total....................................       9       15
------------------------------------------------------------------------

    11. An amendment offered by Mr. Nadler that provides for a 
Federal judicial bypass. Failed by a vote of 8-16.

                             ROLLCALL NO. 11
------------------------------------------------------------------------
                                                 Ayes     Nays   Present
------------------------------------------------------------------------
Mr. Smith, Chairman..........................                X
Mr. Sensenbrenner, Jr........................                X
Mr. Coble....................................                X
Mr. Gallegly.................................                X
Mr. Goodlatte................................                X
Mr. Lungren..................................                X
Mr. Chabot...................................                X
Mr. Issa.....................................                X
Mr. Pence....................................
Mr. Forbes...................................
Mr. King.....................................
Mr. Franks...................................                X
Mr. Gohmert..................................
Mr. Jordan...................................
Mr. Poe......................................                X
Mr. Chaffetz.................................                X
Mr. Griffin..................................                X
Mr. Marino...................................                X
Mr. Gowdy....................................
Mr. Ross.....................................
Ms. Adams....................................                X
Mr. Quayle...................................                X
Mr. Amodei...................................                X

Mr. Conyers, Jr., Ranking Member.............
Mr. Berman...................................
Mr. Nadler...................................       X
Mr. Scott....................................       X
Mr. Watt.....................................       X
Ms. Lofgren..................................
Ms. Jackson Lee..............................
Ms. Waters...................................
Mr. Cohen....................................
Mr. Johnson, Jr..............................       X
Mr. Pierluisi................................       X
Mr. Quigley..................................
Ms. Chu......................................       X
Mr. Deutch...................................       X
Ms. Sanchez..................................       X
Mr. Polis....................................
                                              --------------------------
    Total....................................       8       16
------------------------------------------------------------------------

    12. An en bloc amendment offered by Mr. Scott that 
restricts prosecution to offenders in the first degree and 
provides that no Federal notification is required if both the 
minor's home state, and the state in which she is seeking an 
abortion, do not require parental involvement in the minor's 
decision. Failed by a vote of 14-17.

                             ROLLCALL NO. 12
------------------------------------------------------------------------
                                                 Ayes     Nays   Present
------------------------------------------------------------------------
Mr. Smith, Chairman..........................                X
Mr. Sensenbrenner, Jr........................                X
Mr. Coble....................................                X
Mr. Gallegly.................................                X
Mr. Goodlatte................................                X
Mr. Lungren..................................                X
Mr. Chabot...................................                X
Mr. Issa.....................................
Mr. Pence....................................
Mr. Forbes...................................
Mr. King.....................................                X
Mr. Franks...................................                X
Mr. Gohmert..................................
Mr. Jordan...................................                X
Mr. Poe......................................                X
Mr. Chaffetz.................................                X
Mr. Griffin..................................                X
Mr. Marino...................................                X
Mr. Gowdy....................................
Mr. Ross.....................................                X
Ms. Adams....................................
Mr. Quayle...................................                X
Mr. Amodei...................................                X

Mr. Conyers, Jr., Ranking Member.............       X
Mr. Berman...................................       X
Mr. Nadler...................................       X
Mr. Scott....................................       X
Mr. Watt.....................................       X
Ms. Lofgren..................................       X
Ms. Jackson Lee..............................
Ms. Waters...................................       X
Mr. Cohen....................................
Mr. Johnson, Jr..............................       X
Mr. Pierluisi................................       X
Mr. Quigley..................................       X
Ms. Chu......................................       X
Mr. Deutch...................................       X
Ms. Sanchez..................................       X
Mr. Polis....................................       X
                                              --------------------------
    Total....................................      14       17
------------------------------------------------------------------------

    13. H.R. 2299 was favorably reported without amendment, by 
a rollcall vote of 20 to 13, a quorum being present.

                             ROLLCALL NO. 13
------------------------------------------------------------------------
                                                 Ayes     Nays   Present
------------------------------------------------------------------------
Mr. Smith, Chairman..........................       X
Mr. Sensenbrenner, Jr........................       X
Mr. Coble....................................       X
Mr. Gallegly.................................       X
Mr. Goodlatte................................       X
Mr. Lungren..................................       X
Mr. Chabot...................................       X
Mr. Issa.....................................       X
Mr. Pence....................................
Mr. Forbes...................................       X
Mr. King.....................................       X
Mr. Franks...................................       X
Mr. Gohmert..................................
Mr. Jordan...................................       X
Mr. Poe......................................       X
Mr. Chaffetz.................................       X
Mr. Griffin..................................       X
Mr. Marino...................................       X
Mr. Gowdy....................................
Mr. Ross.....................................       X
Ms. Adams....................................
Mr. Quayle...................................       X
Mr. Amodei...................................       X

Mr. Conyers, Jr., Ranking Member.............                X
Mr. Berman...................................                X
Mr. Nadler...................................                X
Mr. Scott....................................                X
Mr. Watt.....................................                X
Ms. Lofgren..................................                X
Ms. Jackson Lee..............................
Ms. Waters...................................                X
Mr. Cohen....................................
Mr. Johnson, Jr..............................                X
Mr. Pierluisi................................       X
Mr. Quigley..................................                X
Ms. Chu......................................                X
Mr. Deutch...................................                X
Ms. Sanchez..................................                X
Mr. Polis....................................                X
                                              --------------------------
    Total....................................      20       13
------------------------------------------------------------------------

                      Committee Oversight Findings

    In compliance with clause 3(c)(1) of rule XIII of the Rules 
of the House of Representatives, the Committee advises that the 
findings and recommendations of the Committee, based on 
oversight activities under clause 2(b)(1) of rule X of the 
Rules of the House of Representatives, are incorporated in the 
descriptive portions of this report.

               New Budget Authority and Tax Expenditures

    Clause 3(c)(2) of rule XIII of the Rules of the House of 
Representatives is inapplicable because this legislation does 
not provide new budgetary authority or increased tax 
expenditures.

               Congressional Budget Office Cost Estimate

    In compliance with clause 3(c)(3) of rule XIII of the Rules 
of the House of Representatives, the Committee sets forth, with 
respect to the bill, H.R. 2299, the following estimate and 
comparison prepared by the Director of the Congressional Budget 
Office under section 402 of the Congressional Budget Act of 
1974:

                                     U.S. Congress,
                               Congressional Budget Office,
                                     Washington, DC, April 9, 2012.
Hon. Lamar Smith, Chairman,
Committee on the Judiciary,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 2299, the ``Child 
Interstate Abortion Notification Act.''
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Mark 
Grabowicz, who can be reached at 226-2860.
            Sincerely,
                                      Douglas W. Elmendorf,
                                                  Director.

Enclosure

cc:
        Honorable John Conyers, Jr.
        Ranking Member




         H.R. 2299--Child Interstate Abortion Notification Act.

    As ordered reported by the House Committee on the Judiciary on 
                             April 9, 2012.




    CBO estimates that implementing H.R. 2299 would have no 
significant cost to the Federal Government. Enacting the bill 
could affect direct spending and revenues; therefore, pay-as-
you-go procedures apply. However, CBO estimates that any 
effects would be insignificant for each year.
    H.R. 2299 would establish new Federal crimes relating to 
the transporting of minors across State lines without parental 
notification to obtain abortions. Because the legislation would 
establish new offenses, the government would be able to pursue 
cases that it otherwise would not be able to prosecute. We 
expect that H.R. 2299 would apply to a relatively small number 
of offenders, so any increase in costs for law enforcement, 
court proceedings, or prison operations would not be 
significant. Any such costs would be subject to the 
availability of appropriated funds.
    Because those prosecuted and convicted under H.R. 2299 
could be subject to criminal fines, the Federal Government 
might collect additional fines if the legislation is enacted. 
Criminal fines are recorded as revenues, deposited in the Crime 
Victims Fund, and later spent. CBO expects that any additional 
revenues and direct spending would not be significant because 
of the small number of cases likely to be affected.
    H.R. 2299 contains an intergovernmental and a private-
sector mandate as defined in the Unfunded Mandates Reform Act 
(UMRA) by requiring doctors, in certain cases, to provide 
parental notification in person or by certified mail before 
performing an abortion on a minor who is not a resident of the 
State in which the abortion would be performed. CBO estimates 
the cost for doctors in publicly owned or private medical 
facilities to comply with that mandate would be minimal. The 
bill also contains a private-sector mandate by prohibiting the 
transport of a minor across State lines with the intent to 
obtain an abortion in a State that does not require parental 
notification or consent. CBO estimates that the aggregate costs 
of the intergovernmental and private-sector mandates would be 
small and well below the annual thresholds established in UMRA 
($73 million for intergovernmental mandates and $146 million 
for private-sector mandates in 2012, adjusted annually for 
inflation).
    The CBO staff contacts for this estimate are Mark Grabowicz 
(for Federal costs) and Melissa Merrell and Marin Randall (for 
mandates). The estimate was approved by Peter H. Fontaine, 
Assistant Director for Budget Analysis.

                    Performance Goals and Objectives

    The Committee states that pursuant to clause 3(c)(4) of 
rule XIII of the Rules of the House of Representatives, H.R. 
2299 is designed to prohibit taking minors across State lines 
in circumventions of laws requiring the involvement of parents 
in abortion decisions.

                          Advisory on Earmarks

    In accordance with clause 9 of rule XXI of the Rules of the 
House of Representatives, H.R. 2299 does not contain any 
congressional earmarks, limited tax benefits, or limited tariff 
benefits as defined in clause 9(e), 9(f), or 9(g) of Rule XXI.

                      Section-by-Section Analysis

    The following discussion describes the bill as reported by 
the Committee.
Sec. 1. Short title.
    Section 1 provides this Act may be cited as the ``Child 
Interstate Abortion Notification Act.''
Sec. 2. Transportation of Minors in Circumvention of Certain Laws 
        Relating to Abortion.
    Subsection (a) of Section 2 provides that, unless one of 
the exceptions listed below is met, whoever knowingly 
transports a minor across a State line, with the intent that 
such minor obtain an abortion, and thereby abridges the right 
of a parent under a law (in force in the minor's state of 
residence) requiring parental involvement in a minor's abortion 
decision, shall be fined or imprisoned not more than 1 year, or 
both. An abridgement of a parent's right occurs if an abortion 
is performed or induced on the minor, in a State other than the 
State where the minor resides, without the parental consent or 
notification, or the judicial authorization, that would have 
been required by that law had the abortion been performed in 
the State where the minor resides.
    Subsection (b) of Section 2 provides for the following 
exceptions to prosecuting or suing someone under this section: 
(1) the prohibition does not apply if the abortion was 
necessary to save the life of the minor because her life was 
endangered by a physical disorder, physical injury, or physical 
illness, including a life endangering physical condition caused 
by or arising from the pregnancy itself; (2) the bill exempts 
from prosecution or suit the minor herself (the girl being 
transported) and any parent of that minor.
    Subsection (c) of Section 2 provides that a defendant can 
present an affirmative defense to a prosecution for an offense, 
or to a lawsuit, based on a violation of this section if the 
defendant: (1) reasonably believed, based on information the 
defendant obtained directly from a parent of the minor, that 
before the minor obtained the abortion, the parental consent or 
notification took place that was required under State law had 
the abortion been performed in the State where the minor 
resides; or (2) was presented with documentation showing with a 
reasonable degree of certainty that a court in the minor's 
State of residence waived any parental notification required by 
the laws of that State, or otherwise authorized that the minor 
be allowed to obtain an abortion.
    Subsection (d) of Section 2 provides that any parent who 
suffers harm from a violation of subsection (a) may obtain 
appropriate relief in a civil action.
    Subsection (e) of Section 2 provides, among other, the 
following definitions. The term a ``law requiring parental 
involvement in a minor's abortion decision'' means a law 
requiring, before an abortion is performed on a minor, either: 
(1) notification to, or consent of, a parent of that minor; or 
(2) proceedings in a State court. A ``law requiring parental 
involvement in a minor's abortion decision'' does not include a 
law that allows notification or consent to be given by anyone 
other than a ``parent'' as defined in the bill. The term 
``minor'' means an individual who is not older than the maximum 
age requiring parental notification or consent, or proceedings 
in a State court, under the State law requiring parental 
involvement in a minor's abortion decision. The term ``parent'' 
means: (1) a parent or guardian; (1) a legal custodian; or (3) 
a person with the requisite legal status to have care and 
control of the minor, and with whom the minor regularly 
resides, who is designated by the law requiring parental 
involvement in the minor's abortion decision as a person to 
whom notification, or from whom consent, is required.
Sec. 3. Child Interstate Abortion Notification.
    Subsection (a) of Section 3 provides that a physician who 
knowingly performs or induces an abortion on a minor in 
violation of the requirements of this section shall be fined 
under this title or imprisoned not more than 1 year, or both. 
Subsection (a) further provides that, unless one of the 
exceptions described below is met, a physician who knowingly 
performs or induces an abortion on a minor who is a resident of 
a State other than the State in which the abortion is performed 
must provide at least 24 hours actual notice to a parent of the 
minor before performing the abortion. If actual notice to such 
parent is not possible after a reasonable effort has been made, 
24 hours constructive notice must be given to a parent.
    Subsection (b) of Section 3 provides that subsection (a) 
does not apply if: (1) the abortion is performed or induced in 
a State that has a law in force requiring parental involvement 
in a minor's abortion decision and the physician complies with 
the requirements of that law; (2) the physician is presented 
with documentation showing with a reasonable degree of 
certainty that a court in the minor's State of residence has 
waived any parental notification required by the laws of that 
State, or has otherwise authorized that the minor be allowed to 
procure an abortion; (3) the minor declares in a signed written 
statement that she is the victim of sexual abuse, neglect, or 
physical abuse by a parent, and, before an abortion is 
performed on the minor, the physician notifies the authorities 
specified to receive reports of child abuse or neglect by the 
law of the State in which the minor resides of the known or 
suspected abuse or neglect; (4) the abortion is necessary to 
save the life of the minor because her life was endangered by a 
physical disorder, physical injury, or physical illness, 
including a life endangering physical condition caused by or 
arising from the pregnancy itself; or (5) the minor is 
physically accompanied by a person who presents the physician 
or his agent with documentation showing with a reasonable 
degree of certainty that he or she is in fact the parent of 
that minor.
    Subsection (c) of Section 3 provides that any parent who 
suffers harm from a violation of subsection (a) may obtain 
appropriate relief in a civil action.
    Subsection (d) of Section 3 defines the following terms, 
among others. The term ``actual notice'' means the giving of 
written notice directly, in person. The term ``constructive 
notice'' means notice that is given by certified mail, return 
receipt requested, restricted delivery to the last known 
address of the person being notified, with delivery deemed to 
have occurred 48 hours following noon on the next day 
subsequent to mailing on which regular mail delivery takes 
place, days on which mail is not delivered excluded. The term a 
``law requiring parental involvement in a minor's abortion 
decision'' is given the same meaning as in Section 2. The term 
``minor'' means an individual who is not older than 18 years 
and who is not emancipated under State law. The term ``parent'' 
means a parent or guardian; a legal custodian; or a person 
standing in loco parentis who has care and control of the 
minor, and with whom the minor regularly resides, as determined 
by State law. The term ``physician'' means a doctor of medicine 
legally authorized to practice medicine by the State in which 
such doctor practices medicine, or any other person legally 
empowered under State law to perform an abortion.
Sec. 4. Severability and Effective Date.
    Subsection (a) of Section 4 provides that if any provision 
of this Act, or any application thereof, is found 
unconstitutional, that finding shall not affect any provision 
or application of the Act not so adjudicated.
    Subsection (b) of Section 4 provides that the provisions of 
this Act shall take effect upon enactment.

         Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (new matter is 
printed in italics and existing law in which no change is 
proposed is shown in roman):

                      TITLE 18, UNITED STATES CODE



           *       *       *       *       *       *       *
                             PART I--CRIMES

Chapter.                                                            Sec.
      General Provisions...............................................1
     * * * * * * *
117A. Transportation of minors in circumvention of certain laws 
              relating to abortion................................  2431
117B. Child interstate abortion notification......................  2435
     * * * * * * *

CHAPTER 117A--TRANSPORTATIONOF MINORS IN CIRCUMVENTION OF CERTAIN LAWS 
                          RELATING TO ABORTION

Sec.
2431. Transportation of minors in circumvention of certain laws relating 
          to abortion.
2432. Transportation of minors in circumvention of certain laws relating 
          to abortion.

Sec. 2431. Transportation of minors in circumvention of certain laws 
                    relating to abortion

    (a) Offense.--
            (1) Generally.--Except as provided in subsection 
        (b), whoever knowingly transports a minor across a 
        State line, with the intent that such minor obtain an 
        abortion, and thereby in fact abridges the right of a 
        parent under a law requiring parental involvement in a 
        minor's abortion decision, in force in the State where 
        the minor resides, shall be fined under this title or 
        imprisoned not more than one year, or both.
            (2) Definition.--For the purposes of this 
        subsection, an abridgement of the right of a parent 
        occurs if an abortion is performed or induced on the 
        minor, in a State or a foreign nation other than the 
        State where the minor resides, without the parental 
        consent or notification, or the judicial authorization, 
        that would have been required by that law had the 
        abortion been performed in the State where the minor 
        resides.
    (b) Exceptions.--
            (1) The prohibition of subsection (a) does not 
        apply if the abortion was necessary to save the life of 
        the minor because her life was endangered by a physical 
        disorder, physical injury, or physical illness, 
        including a life endangering physical condition caused 
        by or arising from the pregnancy itself.
            (2) A minor transported in violation of this 
        section, and any parent of that minor, may not be 
        prosecuted or sued for a violation of this section, a 
        conspiracy to violate this section, or an offense under 
        section 2 or 3 of this title based on a violation of 
        this section.
    (c) Affirmative Defense.--It is an affirmative defense to a 
prosecution for an offense, or to a civil action, based on a 
violation of this section that the defendant--
            (1) reasonably believed, based on information the 
        defendant obtained directly from a parent of the minor, 
        that before the minor obtained the abortion, the 
        parental consent or notification took place that would 
        have been required by the law requiring parental 
        involvement in a minor's abortion decision, had the 
        abortion been performed in the State where the minor 
        resides; or
            (2) was presented with documentation showing with a 
        reasonable degree of certainty that a court in the 
        minor's State of residence waived any parental 
        notification required by the laws of that State, or 
        otherwise authorized that the minor be allowed to 
        procure an abortion.
    (d) Civil Action.--Any parent who suffers harm from a 
violation of subsection (a) may obtain appropriate relief in a 
civil action unless the parent has committed an act of incest 
with the minor subject to subsection (a).
    (e) Definitions.--For the purposes of this section--
            (1) the term ``abortion'' means the use or 
        prescription of any instrument, medicine, drug, or any 
        other substance or device intentionally to terminate 
        the pregnancy of a female known to be pregnant, with an 
        intention other than to increase the probability of a 
        live birth, to preserve the life or health of the child 
        after live birth, to terminate an ectopic pregnancy, or 
        to remove a dead unborn child who died as the result of 
        a spontaneous abortion, accidental trauma or a criminal 
        assault on the pregnant female or her unborn child;
            (2) the term a ``law requiring parental involvement 
        in a minor's abortion decision'' means a law--
                    (A) requiring, before an abortion is 
                performed on a minor, either--
                            (i) the notification to, or consent 
                        of, a parent of that minor; or
                            (ii) proceedings in a State court; 
                        and
                    (B) that does not provide as an alternative 
                to the requirements described in subparagraph 
                (A) notification to or consent of any person or 
                entity who is not described in that 
                subparagraph;
            (3) the term ``minor'' means an individual who is 
        not older than the maximum age requiring parental 
        notification or consent, or proceedings in a State 
        court, under the law requiring parental involvement in 
        a minor's abortion decision;
            (4) the term ``parent'' means--
                    (A) a parent or guardian;
                    (B) a legal custodian; or
                    (C) a person standing in loco parentis who 
                has care and control of the minor, and with 
                whom the minor regularly resides, who is 
                designated by the law requiring parental 
                involvement in the minor's abortion decision as 
                a person to whom notification, or from whom 
                consent, is required; and
            (5) the term ``State'' includes the District of 
        Columbia and any commonwealth, possession, or other 
        territory of the United States, and any Indian tribe or 
        reservation.

Sec. 2432. Transportation of minors in circumvention of certain laws 
                    relating to abortion

    Notwithstanding section 2431(b)(2), whoever has committed 
an act of incest with a minor and knowingly transports the 
minor across a State line with the intent that such minor 
obtain an abortion, shall be fined under this title or 
imprisoned not more than one year, or both. For the purposes of 
this section, the terms ``State'', ``minor'', and ``abortion'' 
have, respectively, the definitions given those terms in 
section 2435.

          CHAPTER 117B--CHILDINTERSTATE ABORTION NOTIFICATION

Sec.
2435. Child interstate abortion notification.

Sec. 2435. Child interstate abortion notification

    (a) Offense.--
            (1) Generally.--A physician who knowingly performs 
        or induces an abortion on a minor in violation of the 
        requirements of this section shall be fined under this 
        title or imprisoned not more than one year, or both.
            (2) Parental notification.--A physician who 
        performs or induces an abortion on a minor who is a 
        resident of a State other than the State in which the 
        abortion is performed must provide, or cause his or her 
        agent to provide, at least 24 hours actual notice to a 
        parent of the minor before performing the abortion. If 
        actual notice to such parent is not possible after a 
        reasonable effort has been made, at least 24 hours 
        constructive notice must be given to a parent before 
        the abortion is performed.
    (b) Exceptions.--The notification requirement of subsection 
(a)(2) does not apply if--
            (1) the abortion is performed or induced in a State 
        that has, in force, a law requiring parental 
        involvement in a minor's abortion decision and the 
        physician complies with the requirements of that law;
            (2) the physician is presented with documentation 
        showing with a reasonable degree of certainty that a 
        court in the minor's State of residence has waived any 
        parental notification required by the laws of that 
        State, or has otherwise authorized that the minor be 
        allowed to procure an abortion;
            (3) the minor declares in a signed written 
        statement that she is the victim of sexual abuse, 
        neglect, or physical abuse by a parent, and, before an 
        abortion is performed on the minor, the physician 
        notifies the authorities specified to receive reports 
        of child abuse or neglect by the law of the State in 
        which the minor resides of the known or suspected abuse 
        or neglect;
            (4) the abortion is necessary to save the life of 
        the minor because her life was endangered by a physical 
        disorder, physical injury, or physical illness, 
        including a life endangering physical condition caused 
        by or arising from the pregnancy itself, but an 
        exception under this paragraph does not apply unless 
        the attending physician or an agent of such physician, 
        within 24 hours after completion of the abortion, 
        notifies a parent in writing that an abortion was 
        performed on the minor and of the circumstances that 
        warranted invocation of this paragraph; or
            (5) the minor is physically accompanied by a person 
        who presents the physician or his agent with 
        documentation showing with a reasonable degree of 
        certainty that he or she is in fact the parent of that 
        minor.
    (c) Civil Action.--Any parent who suffers harm from a 
violation of subsection (a) may obtain appropriate relief in a 
civil action unless the parent has committed an act of incest 
with the minor subject to subsection (a).
    (d) Definitions.--For the purposes of this section--
            (1) the term ``abortion'' means the use or 
        prescription of any instrument, medicine, drug, or any 
        other substance or device intentionally to terminate 
        the pregnancy of a female known to be pregnant, with an 
        intention other than to increase the probability of a 
        live birth, to preserve the life or health of the child 
        after live birth, to terminate an ectopic pregnancy, or 
        to remove a dead unborn child who died as the result of 
        a spontaneous abortion, accidental trauma, or a 
        criminal assault on the pregnant female or her unborn 
        child;
            (2) the term ``actual notice'' means the giving of 
        written notice directly, in person, by the physician or 
        any agent of the physician;
            (3) the term ``constructive notice'' means notice 
        that is given by certified mail, return receipt 
        requested, restricted delivery to the last known 
        address of the person being notified, with delivery 
        deemed to have occurred 48 hours following noon on the 
        next day subsequent to mailing on which regular mail 
        delivery takes place, days on which mail is not 
        delivered excluded;
            (4) the term a ``law requiring parental involvement 
        in a minor's abortion decision'' means a law--
                    (A) requiring, before an abortion is 
                performed on a minor, either--
                            (i) the notification to, or consent 
                        of, a parent of that minor; or
                            (ii) proceedings in a State court;
                    (B) that does not provide as an alternative 
                to the requirements described in subparagraph 
                (A) notification to or consent of any person or 
                entity who is not described in that 
                subparagraph;
            (5) the term ``minor'' means an individual who is 
        not older than 18 years and who is not emancipated 
        under the law of the State in which the minor resides;
            (6) the term ``parent'' means--
                    (A) a parent or guardian;
                    (B) a legal custodian; or
                    (C) a person standing in loco parentis who 
                has care and control of the minor, and with 
                whom the minor regularly resides;
        as determined by State law;
            (7) the term ``physician'' means a doctor of 
        medicine legally authorized to practice medicine by the 
        State in which such doctor practices medicine, or any 
        other person legally empowered under State law to 
        perform an abortion; and
            (8) the term ``State'' includes the District of 
        Columbia and any commonwealth, possession, or other 
        territory of the United States, and any Indian tribe or 
        reservation.
                            Dissenting Views

    H.R. 2299, the ``Child Interstate Abortion Notification 
Act,'' (CIANA) imposes draconian criminal penalties on a vast 
array of individuals--including the clergy, grandparents, and 
health care professionals--arising from their involvement in 
assisting a minor in obtaining an abortion. This measure is yet 
another attack by the Majority against women's reproductive 
freedom.\1\ For example, the House Judiciary Committee has, to 
date, met on 12 occasions during this Congress to consider 
various measures intended to restrict women's reproductive 
freedom.\2\
---------------------------------------------------------------------------
    \1\See, e.g., Jessica Valenti, Republicans Wage War on Women: 
Latest Paternalistic Efforts 
to Control Female Sexuality Are Part of a Long Pattern, Baltimore Sun, 
Feb. 28, 2012, available at http://articles.baltimoresun.com/2012-02-
28/news/bs-ed-war-on-women-20120228_1_
democratic-women-republicans-contraception.
    \2\No Taxpayer funding for Abortion Act: Hearing on H.R. 3 Before 
the Subcomm. on the Const. of the H. Comm. on the Judiciary, 112th 
Cong. (2011); Markup of H.R. 3, the No Taxpayer Funding for Abortion 
Act, by the H. Comm. on the Judiciary, 112th Cong. (Mar. 3, 2011); The 
State of Religious Liberty in the United States: Hearing Before the 
Subcomm. on the Const. of the H. Comm. on the Judiciary, 112th Cong. 
(2011); Susan B. Anthony and Frederick Douglass Prenatal 
Nondiscrimination Act (PRENDA) of 2011: Hearing on H.R. 3541 Before the 
Subcomm. on the Const. of the H. Comm. on the Judiciary, 112th Cong. 
(2011); Markup of H.R. 3541, the Susan B. Anthony and Frederick 
Douglass Prenatal Nondiscrimination Act of 2011 by the H. Comm. on the 
Judiciary, 112th Cong. (Feb. 7, 8, 16, 2012); Child Interstate Abortion 
Notification Act: Hearing on H.R. 2299 Before the Subcomm. on the 
Const. of the H. Comm. on the Judiciary, 112th Cong. (2012) 
[hereinafter CIANA Hearing]; Markup of H.R. 3803, the District of 
Columbia Pain-Capable Unborn Child Protection Act, by the H. Comm. on 
the Judiciary, 112th Cong. (July 18, 2012); Markup of H.R. 2299, the 
Child Interstate Abortion Notification Act, by the H. Comm. on the 
Judiciary, 112th Cong. (Mar. 27, 2012); The District of Columbia Pain-
Capable Unborn Child Protection Act: Hearing on H.R. 3803 Before the H. 
Subcomm on the Const. of the H. Comm. on the Judiciary, 112th Cong. 
(2012); The Obama Administration's Abuse of Power: Hearing Before the 
H. Comm. on the Judiciary, 112th Cong. (2012).
---------------------------------------------------------------------------
    While, in most instances, young women\3\ should and do turn 
to their parents when facing difficult decisions regarding 
their pregnancy, not all circumstances are ideal. In some 
cases, it is impossible or even dangerous for a young woman to 
involve her parents in that decision, or even to inform them of 
the pregnancy. Where, for example, the parent, close relative, 
or family friend may have caused the pregnancy, it may become 
necessary for the young woman to turn to a sibling, a 
grandparent, a clergyperson, or other trusted adult for 
assistance and guidance. CIANA, however, would turn that 
responsible adult into a criminal and thereby effectively force 
this young woman to face one of the most difficult situations 
in her life alone.
---------------------------------------------------------------------------
    \3\H.R. 2299 defines a ``minor'' as ``an individual who is not 
older than the maximum age requiring parental notification or consent, 
or proceedings in a State court, under the law requiring parental 
involvement in a minor's abortion decision.'' H.R. 2299, 112th Cong. 
Sec. 2 (2011).
---------------------------------------------------------------------------
    CIANA also imposes criminal penalties on health care 
professionals who fail to comply with the bill's unreasonable 
notification requirements. Under the bill, health care 
professionals would be forced to be knowledgeable of and to 
comply with the laws of all 50 states, the District of 
Columbia, Puerto Rico, territories, possessions, and Indian 
tribes and reservations. Such professionals would also be 
forced under CIANA to comply with a new Federal parental 
notification requirement, which is unconstitutionally 
restrictive. Health care professionals would be subject to 
criminal sanction under the bill if they fail to comply with 
these requirements. As a result, CIANA would criminalize the 
otherwise lawful practice of medicine and dangerously undermine 
the doctor-patient relationship.
    Finally, CIANA violates fundamental principles of 
federalism. The bill would effectively force a young woman to 
carry the laws of her state on her back whenever she traveled 
across state lines. And, it would impose laws enacted in one 
state on the citizens of another state, even in those states 
that have no comparable statutes and states that specifically 
rejected such measures.
    Not surprisingly, H.R. 2299 is opposed by the American 
Academy of Pediatrics, the American Congress of Obstetricians 
and Gynecologists, and the Society for Adolescent Health and 
Medicine;\4\ the National Latina Institute for Reproductive 
Health;\5\ Physicians for Reproductive Choice and Health;\6\ 
the National Partnership for Women and Families;\7\ the 
Reproductive Health Technologies Project;\8\ the National 
Abortion Federation;\9\ the American Civil Liberties Union;\10\ 
the Center for Reproductive Rights;\11\ a coalition of 26 
women's health and civil liberties organizations;\12\ and a 
coalition of 17 religious and faith based organizations and 
communities.\13\
---------------------------------------------------------------------------
    \4\CIANA Hearing (letter from the American Academy of Pediatrics, 
the American Congress of Obstetricians and Gynecologists, & the Society 
for Adolescent Health and Medicine to Rep. Trent Franks (R-AZ), Chair, 
& Rep. Jerrold Nadler (D-NY), Ranking Member, Subcomm. on the Const. of 
the H. Comm. on the Judiciary (Mar. 7, 2012)) (on file with the H. 
Comm. on the Judiciary, Democratic staff).
    \5\Id. at 104 (testimony of the National Latina Institute for 
Reproductive Health).
    \6\Id. at 145 (testimony of Michelle Forcier, Board Member, 
Physicians for Reproductive Choice and Health).
    \7\Id. at 140 (testimony of Debra Ness, President, & Andrea 
Friedman, Director of Reproductive Health Programs, National 
Partnership for Women and Families).
    \8\Id. at 149 (testimony of Kirsten Moore, President & CEO, 
Reproductive Health Technologies Project).
    \9\Id. at 137 (testimony of the National Abortion Federation).
    \10\Id. at 109 (testimony of Laura W. Murphy, Director, Washington 
Legislative Office, et al. American Civil Liberties Union).
    \11\Id. at 117 (testimony of the Center for Reproductive Rights).
    \12\Id. at 134 (letter from Abortion Care Network, Advocates for 
Youth, American Association of University Women, American Civil 
Liberties Union, American Medical Student Association, Association of 
Reproductive Health Professionals, Black Women's Health Imperative, 
Break the Cycle, Center for Reproductive Rights, DC For Democracy, 
JACPAC, National Abortion Federation, National Asian Pacific American 
Women's Forum, National Council of Jewish Women, National Latina 
Institute for Reproductive Health, National Family Planning & 
Reproductive Health, National Network of Abortion Funds, National 
Partnership for Women & Families, National Women's Health Network, 
National Women's Law Center, National Organization for Women, NARAL 
Pro-Choice America, People For the American Way, Physicians for 
Reproductive Choice and Health, Planned Parenthood Federation of 
America, and Population Connection to Rep. Trent Franks (R-AZ), Chair, 
& Rep. Jerrold Nadler (D-NY), Ranking Member, Subcomm. on the Const. of 
the H. Comm. on the Judiciary (Mar. 8, 2012).
    \13\Letter from Anti-Defamation League, Catholics for Choice, 
Concerned Clergy for Choice, Hadassah, Jewish Reconstructionist 
Federation, Jewish Women International, Methodist Federation for Social 
Action, National Council of Jewish Women, Presbyterian Voices for 
Justice, Religious Coalition for Reproductive Choice, Religious 
Institute, Spiritual Youth for Reproductive Freedom, Union for Reform 
Judaism, Unitarian Universalist Association of Congregations, Unitarian 
Universalist Women's Federation, Women's Alliance for Theology, Ethics 
and Ritual, Women of Reform Judaism to Rep. Trent Franks (R-AZ), Chair, 
& Rep. Jerrold Nadler (D-NY), Ranking Member, Subcomm. on the Const. of 
the H. Comm. on the Judiciary (Mar. 27, 2012) (on file with the H. 
Comm. on the Judiciary, Democratic staff).
---------------------------------------------------------------------------
    For these reasons, and those described below, we 
respectfully dissent and we urge our colleagues to reject this 
seriously flawed bill.

                       DESCRIPTION AND BACKGROUND

    CIANA is old wine in a new bottle. Similar legislation has 
been introduced in at least five prior Congresses under 
Republican leadership.\14\ The bill provides both criminal 
penalties for, and a civil cause of action against, a person 
who takes an unemancipated minor across state or international 
boundaries for the purpose of obtaining an abortion in 
circumvention of the minor's home state's parental involvement 
laws. It also imposes criminal penalties on, and provides for a 
civil cause of action against, any physician who performs such 
an abortion.
---------------------------------------------------------------------------
    \14\See, e.g., Child Interstate Abortion Notification Act, H.R. 
748, 109th Cong. (2005); Child Custody Protection Act, S. 403, 109th 
Cong. (2005); Child Custody Protection Act, H.R. 1755, 108th Cong. 
(2003); Child Custody Protection Act, S. 851, 108th Cong. (2003); Child 
Custody Protection Act, H.R. 476, 107th Cong. (2001); Child Custody 
Protection Act, H.R. 1218, 106th Cong. (1999); Child Custody Protection 
Act, S. 661, 106th Cong. (1999); Child Custody Protection Act, H.R. 
3682, 105th Cong. (1998); Child Custody Protection Act, S. 1645, 105th 
Cong. (1998).
---------------------------------------------------------------------------
    A summary of the principal substantive provisions of H.R. 
2299 follows. The bill amends title 18 of the United States 
Code to add two new chapters 117A and 117B. As added by the 
bill, chapter 117A consists of sections 2431 and 2432.\15\ New 
section 2431(a)(1), in turn, makes it a crime, punishable by a 
fine or imprisonment of up to 1 year for anyone who ``knowingly 
transports a minor across a State line, with the intent that 
such minor obtain an abortion, and thereby in fact abridges the 
right of a parent under a law requiring parental involvement in 
a minor's abortion decision, in force in the State where the 
minor resides.'' The prohibition is triggered if ``an abortion 
is performed or induced on the minor, in a State or a foreign 
nation other than the State where the minor resides, without 
the parental consent or notification, or the judicial 
authorization, that would have been required by that law had 
the abortion been performed in the State where the minor 
resides.'' Subsection 2431(a)(2) makes this prohibition 
applicable to an individual who takes the minor across an 
international boundary.
---------------------------------------------------------------------------
    \15\For reasons that are not entirely clear, both sections 2331 and 
2332 are entitled ``Transportation of minors in circumvention of 
certain laws relating to abortion.''
---------------------------------------------------------------------------
    Section 2431(b) specifies an unconstitutionally narrow 
exception to the bill's prohibition. The exception applies only 
``if the abortion was necessary to save the life of the minor 
because her life was endangered by a physical disorder, 
physical injury, or physical illness, including a life 
endangering physical condition caused by or arising from the 
pregnancy itself.''
    Section 2431(c) sets forth two affirmative defenses. It 
provides that it is an affirmative defense to a prosecution for 
an offense, or to a civil action, based on a violation of new 
section 2431, if the defendant:

        (1) reasonably believed, based on information the 
        defendant obtained directly from a parent of the minor, 
        that before the minor obtained the abortion, the 
        parental consent or notification took place that would 
        have been required by the law requiring parental 
        involvement in a minor's abortion decision, had the 
        abortion been performed in the State where the minor 
        resides; or

        (2) was presented with documentation showing with a 
        reasonable degree of certainty that a court in the 
        minor's State of residence waived any parental 
        notification required by the laws of that State, or 
        otherwise authorized that the minor be allowed to 
        procure an abortion.

    Section 2431(d) provides a cause of action to a parent 
``who suffers harm from a violation'' of section 2431(a), 
unless the parent committed an act of incest with the minor.
    Section 2431(e) sets forth various definitions.
    New section 2432 specifies that an individual who has had 
incest with a minor and transports that minor across state 
lines with the intention that the minor obtain an abortion 
would be subject to a fine or imprisonment of not more than 1 
year.
    New chapter 117B, as added to title 18 of the United States 
Code, consists solely of section 2435, which does not impose 
any legal duties or penalties on the minor. Rather, the focus 
of this provision is on the health care profession.
    Section 2435(a) mandates that a physician give 24 hours 
``actual notice'' to a parent before performing an abortion on 
a minor who is from out-of-state. This provision applies even 
if the minor came from a state that does not have a parental 
consent or notification law. Note that section 2435(d)(2) 
defines ``actual notice'' as ``the giving of a written notice 
directly, in person.'' Section 2435(a)(2), in turn, authorizes 
the physician to give at least 24 hours ``constructive notice'' 
to the patient's parents if it is not possible to provide them 
with ``actual notice'' after the abortion provider has made a 
reasonable effort to do so. Although section 2435(d)(3) defines 
``constructive notice'' as ``notice that is given by certified 
mail, return receipt requested, restricted delivery to the last 
known address of the person being notified,'' the bill fails to 
define ``reasonable effort.''
    Section 2435(b) specifies five exceptions to section 
2435(a):

        (1) the abortion is performed or induced in a State 
        that has, in force, a law requiring parental 
        involvement in a minor's abortion decision and the 
        physician complies with the requirements of that law;

        (2) the physician is presented with documentation 
        showing with a reasonable degree of certainty that a 
        court in the minor's State of residence has waived any 
        parental notification required by the laws of that 
        State, or has otherwise authorized that the minor be 
        allowed to procure an abortion;

        (3) the minor declares in a signed written statement 
        that she is the victim of sexual abuse, neglect, or 
        physical abuse by a parent, and, before an abortion is 
        performed on the minor, the physician notifies the 
        authorities specified to receive reports of child abuse 
        or neglect by the law of the State in which the minor 
        resides of the known or suspected abuse or neglect;

        (4) the abortion is necessary to save the life of the 
        minor because her life was endangered by a physical 
        disorder, physical injury, or physical illness, 
        including a life endangering physical condition caused 
        by or arising from the pregnancy itself, but an 
        exception under this paragraph does not apply unless 
        the attending physician or an agent of such physician, 
        within 24 hours after completion of the abortion, 
        notifies a parent in writing that an abortion was 
        performed on the minor and of the circumstances that 
        warranted invocation of this paragraph; or

        (5) the minor is physically accompanied by a person who 
        presents the physician or his agent with documentation 
        showing with a reasonable degree of certainty that he 
        or she is in fact the parent of that minor.

It should be noted that the bill fails to include any exception 
for an instance where the parent cannot be located or where it 
is otherwise impossible to provide timely written notice. The 
bill's exception for a minor accompanied by an individual who 
``presents the physician or his agent with documentation 
showing with a reasonable degree of certainty that he or she is 
in fact the parent of that minor,'' fails to specify what would 
qualify as sufficient documentation. Also, the narrowness of 
the exception for the minor's medical condition would prohibit 
a physician from performing an abortion where the minor is from 
out of state and the minor has a non-life threatening medical 
emergency.
    Section 2435's requirements, as set forth in subsection 
(a), and limited exceptions, as set forth in subsection (b), 
create some very convoluted requirements for physicians and 
their patients. If a minor from a state with no parental 
consent or notice laws traveled to a state also with no 
parental consent or notification laws, the bill requires the 
physician to provide ``actual notice'' directly in person to 
the patient's parents without the minor having the option of a 
judicial bypass. The bill's failure to provide for this option 
directly violates prior Supreme Court rulings.\16\ Also, in 
order for the exceptions to apply in cases where the minor is 
the victim of sexual abuse, the doctor must report any sexual 
abuse to the proper authorities where the minor resides. This 
exception only comes into play if one of the abusers was a 
parent pursuant to section 2435(b)(3). H.R. 2299, however, 
fails to define the term ``proper authorities.''
---------------------------------------------------------------------------
    \16\Bellotti v. Baird, 443 U.S. 622, 643-44 (1979).
---------------------------------------------------------------------------
    Other problems presented by the provisions include the 
following. If a minor from a state with a strict parental 
consent or notification law went to another state with a strict 
parental consent or notice law, the minor is required to abide 
by her own state law in order for an adult to transport her 
across state lines. H.R. 2299 requires the physician to comply 
with the laws of the state in which her practice is located as 
well. Minors who live in very rural states may find that cities 
in adjoining states are closer than cities in other states. 
Additionally, the minor's own jurisdiction may not have a 
provider of abortion services.
    If a minor who comes from a state with a strict parental 
consent or notification law seeks an abortion in a state with 
no parental consent or notice law, then the minor must still 
abide by her state law in order for an adult to transport her 
across state lines. And, the physician must provide ``actual 
notice'' to the patient's parents. As a result, a physician 
would be required to know: (1) the requirements of this 
legislation; (2) the laws of all 50 states, the District of 
Columbia, Puerto Rico, territories, possessions, Indian tribes 
and reservations concerning parental consent or notice; and (3) 
the place of residence of the minor in order for her to comply 
with this bill.
    Section 2435(c) authorizes a parent who ``suffers harm'' 
from a violation of section 2435(a) to file a civil action 
unless the parent had committed an act of incest with the 
minor. And, section 2435(d) sets forth various definitions.

                        CONCERNS WITH H.R. 2299

      I. H.R. 2299 ENDANGERS THE HEALTH AND SAFETY OF YOUNG WOMEN

    Every young woman should be able to turn to her parents 
when faced with a pregnancy and receive the counsel and support 
she needs. Fortunately, that occurs in the overwhelming 
majority of cases, and this bill would be inapplicable under 
such circumstances.
    Unfortunately, there are many reasons why some pregnant 
young women cannot turn to their parents for support and 
guidance. CIANA simply ignores this very real fact and fails to 
take into account those instances where a minor may need 
immediate treatment or where the minor's parents themselves 
pose a direct threat to the young woman.
    A major flaw of CIANA is that it would render responsible 
adults--including well-intentioned siblings, grandparents, and 
members of the clergy--subject to criminal prosecution and 
civil suit. The bill would make it impossible for a pregnant 
minor to seek the assistance of any other adult no matter what 
the situation is at home.
    We attempted to address this serious defect of the bill by 
offering amendments to exempt persons to whom a young woman 
might turn for assistance in a difficult situation. For 
example, Rep. Jerrold Nadler (D-NY) offered an amendment to 
exempt a grandparent or adult sibling of the minor unless the 
grandparent or adult sibling had sexual contact with the minor. 
Rep. Robert C. ``Bobby'' Scott (D-VA) offered an amendment that 
would have exempted taxicab drivers, bus drivers, or other 
persons in the business of professional transport who might 
unwittingly be subject to this legislation, unless that person 
had sexual conduct with the minor or is a registered sex 
offender. Rep. Scott also offered an amendment that would have 
added siblings to the minor and the parents of the minor as 
persons who could not be sued or prosecuted under the bill. 
Rep. Sheila Jackson Lee (D-TX) offered an amendment creating an 
exception for clergy, godparents, aunts, uncles, or first 
cousins of the minor unless that person had sexual contact with 
the minor. Each of these amendments was rejected.
    Another equally serious flaw of CIANA is that it ignores 
the kinds of problems young people face. An estimated 772,000 
children were found to be victims of abuse or neglect in 
2008.\17\ Young women considering abortion are particularly 
vulnerable because family violence is often at its worst during 
a family member's pregnancy.\18\
---------------------------------------------------------------------------
    \17\U.S. Department of Health and Human Services, Administration of 
Children, Youth and Families, Children's Bureau, Child Maltreatment 
2008 (2010).
    \18\See, e.g., H. Amaro et al., Violence During Pregnancy and 
Substance Abuse, 80 Am. J. of Pub. Health 575-579 (1990); University of 
Pittsburgh Medical Center, Information for Patients, Abuse During 
Pregnancy, ED/JAW Rev. (Mar. 2003).
---------------------------------------------------------------------------
    Nearly half of pregnant teens who have a history of abuse 
report being assaulted during their pregnancy, most often by a 
family member.\19\ For example, at the hearing on this 
legislation, The Very Reverend Dr. Katherine Hancock Ragsdale 
discussed some of these problems that young women face.\20\ She 
movingly described a 15-year-old who had been made pregnant 
during a date rape and sought to obtain an abortion on her own 
because she feared violence if her father found out about the 
pregnancy.
---------------------------------------------------------------------------
    \19\American Psychological Association, Parental Consent Laws for 
Adolescent Reproductive Health Care: What Does the Psychological 
Research Say? (Feb. 2000), citing A.B. Berenson, et al., Prevalence of 
Physical and Sexual Assault in Pregnant Adolescents, 13 J. of 
Adolescent Health 466-69 (1992).
    \20\CIANA Hearing at 43 (testimony of the Very Reverend Kathleen 
Ragsdale).
---------------------------------------------------------------------------
    Among minors who did not tell a parent of their abortion, 
30 percent had experienced violence in their family or feared 
violence or being forced to leave home.\21\ As one young woman 
explained, ``[m]y older sister got pregnant when she was 
seventeen. My mother pushed her against the wall, slapped her 
across the face and then grabbed her by the hair, pulled her 
through the living room out the front door and threw her off 
the porch. We don't know where she is now.''\22\ In Idaho, a 
13-year-old student named Spring Adams was shot to death by her 
father after he learned she was to terminate a pregnancy caused 
by his acts of incest.\23\
---------------------------------------------------------------------------
    \21\Martin Donohoe, Parental Notification and Consent Laws for Teen 
Abortions: Overview and 2006 Ballot Measures MEDSCAPE Ob/Gyn & Women's 
Health, Feb. 9, 2007, available at http://www.medscape.com/viewarticle/
549316 (last visited Oct. 20, 2010); Stanley K. Henshaw & Kathryn Kost, 
Parental Involvement in Minors' Abortion Decisions, 24 Family Planning 
Perspectives 197, 199-200 (1992).
    \22\Helena Silverstein, Girls on the Stand: How Courts Fail 
Pregnant Minors (2007) (quoting Melissa Jacobs). Are Courts Prepared to 
Handle Judicial Bypass Proceedings? 32 Human Rights 4 (Winter 2005).
    \23\Margie Boule, An American Tragedy, Sunday Oregonian, Aug. 27, 
1989.
---------------------------------------------------------------------------
    As the Supreme Court has recognized, ``[m]ere notification 
of pregnancy is frequently a flashpoint for battering and 
violence within the family. The number of battering incidents 
is high during the pregnancy and often the worst abuse can be 
associated with pregnancy.''\24\
---------------------------------------------------------------------------
    \24\Planned Parenthood of Southeastern Pennsylvania v. Casey, 505 
U.S. 833, 889 (1992) (citing expert witness testimony).
---------------------------------------------------------------------------
    To address this very real danger, Rep. Hank Johnson (D-GA) 
offered an amendment that would have created an exception to 
the bill if the disclosure of the pregnancy or the decision to 
terminate the pregnancy to one or both of the minor's parents 
would endanger the physical safety of the minor. Similarly, 
Rep. Jackson Lee offered an amendment that would have created 
an exception where the pregnancy was the result of sexual 
contact with a parent or any other person who has permanent or 
temporary care or custody or responsibility for the supervision 
of the minor, or by any household or family member. Both 
amendments were rejected.

                   II. H.R. 2299 IS UNCONSTITUTIONAL

A. LH.R. 2299 Lacks an Adequate Exception To Protect the Life of a 
        Young Woman and Fails To Include Any Exception To Protect Her 
        Health
    H.R. 2299 has an unconstitutionally narrow exception to 
protect the life of the woman, and no health exception. These 
exceptions are especially important in light of the tremendous 
uncertainty and onerous civil and criminal penalties 
responsible adults and health care providers would face under 
the bill. In particular, the delay that the bill's notice 
requirements would impose under section 2432 could be fatal or 
dangerous to a young woman's health and future fertility.
    The narrowness of the ``life'' exception in both sections--
applying only ``if the abortion was necessary to save the life 
of the minor because her life was endangered by a physical 
disorder, physical injury, or physical illness, including a 
life endangering physical condition caused by or arising from 
the pregnancy itself''--would also place health care providers 
in an impossible position. Just how severe must a physical 
threat to a woman's health be before a physician could feel 
confident that a life exception may be invoked? How much could 
a court second-guess a medical decision of this type in a 
future court proceeding? What would be the cost of defending 
such a case even if a physician ultimately prevailed in a civil 
or criminal case, or both?
    As the Supreme Court has long-recognized, laws containing 
life exceptions cannot pick and choose among life-threatening 
circumstances.\25\ The Court requires any restriction on 
abortion to include an exception ``where it is necessary, in 
appropriate medical judgment, for the preservation of the life 
or the health of the mother.''\26\ In Ayotte v. Planned 
Parenthood of Northern New England, the Court expressly 
reiterated its prior holdings in Roe and Casey that a state may 
not restrict access to an abortion that is necessary to 
preserve the life or health of the pregnant woman.\27\ The 
Court also stated the factual proposition that in a small 
number of cases a pregnant minor requires an immediate abortion 
to prevent serious health consequences, something proponents of 
this legislation still incorrectly assert is not the case.\28\ 
Therefore, a state statute that restricts a pregnant minor's 
access to an abortion must include an exception for medical 
emergencies involving the minor's health or life.
---------------------------------------------------------------------------
    \25\Casey, 505 U.S. at 879.
    \26\Id.
    \27\126 S. Ct. 961, 967 (2006). In Doe v. Bolton, 410 U.S. 179 
(1973), the Court held that, to determine whether an abortion is 
necessary to protect a woman's ``health,'' a doctor may exercise his or 
her judgment based on various factors, such as a woman's physical, 
emotional, psychological, and familial well-being, as well as her age.
    \28\Ayotte, 126 S. Ct. at 967 (``New Hampshire has not taken real 
issue with the factual basis of this litigation: In some very small 
percentage of cases, pregnant minors, like adult women, need immediate 
abortions to avert serious and often irreversible damage to their 
health.'').
---------------------------------------------------------------------------
    In recognition of the fact that CIANA fails to include any 
health exception whatsoever in clear violation of Supreme Court 
precedent,\29\ Rep. Judy Chu (D-CA) offered an amendment that 
would have expanded the exception to save the life of the young 
woman to include protecting her health as required by the 
Constitution. Rep. Melvin Watt (D-NC) offered an amendment that 
would have created an exception for a person who has a good 
faith belief that the minor's life or health would be 
endangered by the delay necessary to comply with the law 
requiring parental involvement in a minor's abortion decision 
in the state where the minor resides, including any proceedings 
in state court. Rep. Watt also offered an amendment to create 
an exception to protect the life and health of the minor. Rep. 
Mike Quigley (D-IL) offered an amendment to create an exception 
of the minor's pregnancy was the result of rape or incest. All 
of these amendments were rejected.
---------------------------------------------------------------------------
    \29\Roe v. Wade, 410 U.S. 113, 164-65 (1973) (holding that a state 
may regulate or proscribe post-viability abortions with the exception 
where it is necessary for the preservation of the life or health of the 
woman).
---------------------------------------------------------------------------
B. LH.R. 2299 Fails To Include the Constitutionally-Mandated Judicial 
        Bypass for Parental Notification and Consent Laws
    The Supreme Court has held that a state may not impose a 
blanket parental-consent requirement that would empower a 
parent to veto a young woman's decision to have an 
abortion.\30\ If a state requires a minor to obtain consent 
from one or both of the minor's parents, it must also give her 
the opportunity to bypass that mandate by seeking a judicial 
determination that she is either sufficiently mature to make 
her own decision or that, even if she is ``immature,'' the 
proposed abortion is in her ``best interests.''\31\ As the 
Supreme Court has recognized, ``Any independent interest the 
parent may have in the termination of the minor daughter's 
pregnancy is no more weighty than the right of privacy of the 
competent minor mature enough to become pregnant.''\32\ 
Consistent with this holding, the courts have made it clear 
that reasonable alternatives to parental consent are necessary 
for these laws to pass constitutional scrutiny.
---------------------------------------------------------------------------
    \30\Planned Parenthood v. Danforth, 428 U.S. 52, 74 (1976).
    \31\Bellotti, 443 U.S. at 643-44.
    \32\Danforth, 428 U.S. at 75.
---------------------------------------------------------------------------
    The Court has also invalidated state parental consent laws 
that do not include judicial bypass procedures. In Ohio v. 
Akron Center for Reproductive Health, the Court, in holding 
that the Ohio parental notification statute at issue was 
constitutional, appeared to suggest that the statute's judicial 
bypass procedure adequately protected a pregnant minor's right 
to obtain an abortion.\33\ The Court expressly declined, 
however, to decide whether a state parental notification law 
that did not include a judicial bypass procedure would per se 
violate the Constitution. In Lambert v. Wicklund, the Court 
similarly declined to reach the question of whether a state 
parental notification law must contain a judicial bypass 
procedure.\34\ Rather, the Court held narrowly that the Montana 
parental notification law at issue, which contained a judicial 
bypass procedure, did not place an undue burden on a pregnant 
minor's right to obtain an abortion.\35\
---------------------------------------------------------------------------
    \33\497 U.S. 502 (1990).
    \34\520 U.S. 292 (1997).
    \35\Id. at 295.
---------------------------------------------------------------------------
    A parental notification law would be unconstitutional if it 
did not provide a pregnant minor with some alternative to 
parental notification. In H.L. v. Matheson, the Court upheld as 
constitutional a state statute that requires an unemancipated 
minor who lives with her parents to notify them, ``if 
possible,'' before she obtains an abortion, but includes 
exceptions for a minor who demonstrates that notification is 
not in her best interests.\36\ Moreover, in Belotti v. Baird, 
the Court indicated that a parental notification law would be 
unconstitutional if it did not provide an alternative to 
notification for a ``mature'' minor or when notification would 
not be in a minor's best interests.\37\ In that case, the Court 
observed:
---------------------------------------------------------------------------
    \36\450 U.S. 398 (1981).
    \37\Belotti v. Baird, 443 U.S. 622 (1979).

        [U]nder state regulation such as that undertaken by 
        Massachusetts, every minor must have the opportunity--
        if she so desires--to go directly to a court without 
        first consulting or notifying her parents. If she 
        satisfies the court that she is mature and well enough 
        informed to make intelligently the abortion decision on 
        her own, the court must authorize her to act without 
        parental consultation or consent.\38\
---------------------------------------------------------------------------
    \38\Id. at 647.

    The Court has yet to establish specific parameters for the 
adequacy of judicial bypass procedures in the context of state 
parental involvement laws. In writing for the majority in 
Akron, Justice Kennedy rejected the dissenting opinion's call 
to articulate specific procedural thresholds for the 
constitutionality of a judicial bypass alternative, such as 
whether it must be anonymous or only confidential, or how 
quickly a state must provide a pregnant minor with the 
opportunity for a court proceeding. He stated only that the 
Ohio judicial bypass procedure contained ``reasonable steps'' 
to protect the identity of pregnant minors seeking a judicial 
bypass and that the procedure included adequate provisions to 
expedite a pregnant minor's request for a proceeding.\39\ The 
Court's majority also held that a state may validly require a 
pregnant minor to establish ``by clear and convincing 
evidence'' during a judicial bypass hearing that she is mature 
enough to make an abortion decision without parental 
involvement.\40\
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    \39\Akron, 497 U.S. at 513.
    \40\Id. at 515.
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    To address this defect, Rep. Nadler offered an amendment 
that would have allowed an adult who had a reasonable belief 
that compliance with the judicial bypass procedure of the 
minor's state of residence would either compromise the minor's 
intent to maintain confidentiality with respect to the choice 
to terminate the pregnancy, or would be futile or ineffective 
in the minor's home state, could apply to a Federal district 
court in the district in which the minor resides for a waiver 
of the application of the Act. The amendment was rejected.
C. LH.R. 2299 Imposes an Unconstitutional Undue Burden on a Young 
        Woman's Right To Obtain an Abortion
    The Supreme Court has ruled that the constitutional right 
to privacy includes a minor's decision to terminate her 
pregnancy.\41\ In addition, the Court has held that any 
restriction that has the purpose or effect of placing an 
``undue burden'' on a woman's right to choose to have an 
abortion prior to viability is unconstitutional.\42\ H.R. 2299 
is in conflict with this longstanding precedent.
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    \41\Danforth, 428 U.S. at 74.
    \42\Casey, 505 U.S. at 874.
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    The bill's Federal parental notification provision--which 
is imposed where neither the state in which the procedure is 
performed nor the young woman's home state have their own 
parental notification schemes--does not include any judicial 
bypass.\43\ Accordingly, the young woman will not be able to 
obtain an abortion until the physician provides notice of the 
abortion to one of her parents.\44\ CIANA's Federal 
notification provision thus makes parental notification 
mandatory for these young women with absolutely no option for a 
court bypass. As a result, this provision directly violates the 
Supreme Court's holdings that a statute requiring parental 
involvement, in order to be constitutional, must offer an 
alternative such as a judicial bypass.\45\
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    \43\The following states do not have enforceable parental 
involvement laws and would likely be subject to CIANA's Federal 
notification provisions: Alaska, California, Connecticut, Florida, 
Hawaii, Idaho, Illinois, Montana, Nevada, New Hampshire, New Jersey, 
New Mexico, New York, Oklahoma, Oregon, Vermont, Washington, and the 
District of Columbia. NARAL Pro-Choice America Foundation, Who Decides? 
The Status of Women's Reproductive Rights in the United States (21th 
ed. 2012), available at www.WhoDecides.org.
    \44\The bill provides two exceptions: the narrow exception to 
preserve the life, but not the health of the young woman; and the 
exception for a young woman who ``declares in a signed written 
statement that she is the victim of sexual abuse, neglect, or physical 
abuse by a parent, and, before an abortion in performed on the minor, 
the physician notifies the authorities specified to receive reports of 
child abuse or neglect by the law of the State in which the minor 
resides of the known or suspected abuse or neglect.'' H.R. 2299, 112th 
Cong. Sec. 2435(a)(4)-(5) (2011) (emphasis added).
    \45\Hodgson v. Minnesota, 497 U.S. 417, 420 (1990); Akron 497 U.S. 
at 510.
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    Moreover, the requirement that the doctor must provide 24 
hours actual notice, or at least 48 hours of constructive 
notice to the parents of the minor before providing the 
abortion care, would also impose an undue burden on a woman's 
right to choose.\46\ In contrast, the Supreme Court in Casey 
upheld a 24-hour delay precisely because there was an exception 
for the preservation of the life and health of the woman.\47\
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    \46\Id.
    \47\Casey, 505 U.S. at 886.
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    Without these exceptions, CIANA's Federal notification 
provision would likely be held unconstitutional because these 
delays will place a woman's health at risk and impose an 
``undue burden'' on a woman's right to choose.

      III. H.R. 2299 VIOLATES FUNDAMENTAL PRINCIPLES OF FEDERALISM

    H.R. 2299 would require young women to carry their own 
state laws with them when they travel to other states.\48\ As 
Professors Laurence Tribe of Harvard Law School and Peter Rubin 
of Georgetown University Law Center have explained, the 
predecessor version of this legislation ``amounts to a 
statutory attempt to force this most vulnerable class of young 
women to carry the restrictive laws of their home states 
strapped to their backs, bearing the great weight of those laws 
like the bars of a prison that follows them wherever they 
go.''\49\
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    \48\Memorandum from Professors Laurence H. Tribe, Harvard 
University School of Law, & Peter J. Rubin, Georgetown University Law 
Center, to the H. Comm. on the Judiciary, at 2 (Sept. 2, 2001) (on file 
with the H. Comm. on the Judiciary, Democratic staff).
    \49\Id.
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    It would, moreover, impose on the people of one state who 
have specifically considered and rejected parental notification 
laws, the laws of another state requiring such notification. It 
would nullify the right of a state, within its own borders, to 
set its own policies in this very difficult area.
    To address this defect, Rep. Scott offered an amendment 
creating an exception if neither the minor's state of 
residence, nor the state in which the abortion is performed, 
have a parental notification law in effect. The amendment was 
rejected.
    This bill would also treat a young woman who travels to a 
state, or who resides in a state temporarily (such as a college 
student), differently than a minor living in that state. For 
example, New York does not have a parental notification or 
consent law. Nevertheless, a young woman who travels into New 
York, or who temporarily resides in New York, would be subject 
under H.R. 2299 to an entirely different legal scheme. She 
would either have to obtain a court bypass from her home state 
or, if no bypass is available, be subject to the bill's Federal 
mandatory notice requirements. CIANA would thus discriminate 
against young women within the same state on the basis of their 
state of origin and would deprive them of their right to travel 
to engage in conduct legal in another state in violation of 
constitutionally protected rights to equal protection and 
interstate travel.

                               CONCLUSION

    Without question, promoting the involvement of parents in 
decisions concerning the pregnancy of a minor is a laudable and 
desirable goal. H.R. 2299, however, ignores the real 
circumstances that often affect young pregnant women and, by 
doing so, places these women at mortal risk. These young people 
must not be forced to risk their lives and health if they seek 
the protection of responsible adults in those circumstances 
where their parents have or will precipitate a dangerous 
situation for their child. This bill violates these basic 
principles of humanity and regard for human dimension of these 
problems. It also violates the Constitution in significant 
respects and tramples upon fundamental principles of 
federalism.
    For these reasons, we respectfully dissent, and we urge our 
colleagues to oppose this seriously flawed and unconstitutional 
legislation.

                                   John Conyers, Jr.
                                   Howard L. Berman.
                                   Jerrold Nadler.
                                   Robert C. ``Bobby'' Scott.
                                   Melvin L. Watt.
                                   Zoe Lofgren.
                                   Sheila Jackson Lee.
                                   Steve Cohen.
                                   Henry C. ``Hank'' Johnson, Jr.
                                   Mike Quigley.
                                   Judy Chu.
                                   Ted Deutch.
                                   Linda T. Sanchez.
                                   Jared Polis.

                                  
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