"U.S. House of Representatives
Bill HR 644 (2017)
Conscience Protection Act of 2017
Introduction
Original
This bill was referred to the House Committee on Energy and Commerce in January, 2017. It did not progress further.
115th CONGRESS
1st Session
H. R. 644
To amend the Public Health Service Act to prohibit governmental
discrimination against providers of health services that are not involved in
abortion.
IN THE HOUSE OF REPRESENTATIVES
January 24, 2017
A BILL
To amend the Public Health Service Act to prohibit governmental
discrimination against providers of health services that are not involved in
abortion.
Be it enacted by the Senate and House of Representatives of the United
States of America in Congress assembled,
SECTION 1. Short title.
This Act may be cited as the "Conscience Protection
Act of 2017".
SEC. 2. Findings.
Congress finds as follows:
(1) Thomas Jefferson stated a conviction common to
our Nation's founders when he declared in 1809 that "[n]o provision in our
Constitution ought to be dearer to man than that which protects the rights
of conscience against the enterprises of the civil authority".
(2) In 1973, the Supreme Court concluded that the
government must leave the abortion decision "to the medical judgment of the
pregnant woman's attending physician", recognizing that a physician may
choose not to participate in abortion. Roe v. Wade, 410 U.S. 113, 164
(1973). The Court cited with approval a policy that "neither physician,
hospital, nor hospital personnel shall be required to perform any act
violative of personally-held moral principles", 410 U.S. at 143 n. 38, and
cited State laws upholding this principle. Doe v. Bolton, 410 U.S. 179,
197–8 (1973).
(3) Congress's enactments to protect this right of
conscience in health care include the Church amendment of 1973 (42
U.S.C. 300a–7), the Coats/Snowe amendment of 1996 (42
U.S.C. 238n), and the Hyde/Weldon amendment approved by Congresses and
Presidents of both parties every year since 2004.
(4) None of these laws explicitly provides a "private
right of action" so victims of discrimination can defend their conscience
rights in court, and administrative enforcement by the Department of Health
and Human Services Office for Civil Rights has been lax, at times allowing
cases to languish for years without resolution.
(5) Defying the Federal Hyde/Weldon amendment,
California's Department of Managed Health Care has mandated coverage for all
elective abortions in all health plans under its jurisdiction. Other States
such as New York and Washington have taken or considered similar action, and
some States may go farther to require all physicians and hospitals to
provide or facilitate abortions. On June 21, 2016, the Obama
Administration concluded a nearly two-year investigation of this matter by
determining that California’s decision to require insurance plans under the
California Department for Managed Health Care authority to cover all legal
abortion services did not violate the Weldon amendment. Until the new
Administration is able to reverse this finding, individuals will have to
choose between ignoring their conscience or forgoing health care coverage.
(6) The vast majority of medical professionals do not perform abortions,
with 86 percent of ob/gyns unwilling to provide them in a recent study
(Obstetrics & Gynecology, Sept. 2011) and the great majority of hospitals
choosing to do so in rare cases or not at all.
7) A health care provider's decision not to
participate in an abortion, like Congress's decision not to fund most
abortions, erects no new barrier to those seeking to perform or undergo
abortions but leaves each party free to act as he or she wishes.
(8) Such protection poses no conflict with other
Federal laws, such as the law requiring emergency stabilizing treatment for
a pregnant woman and her unborn child when either is in distress (Emergency
Medical Treatment and Active Labor Act). As the previous Administration
has said, these areas of law have operated side by side for many years and
both should be fully enforced (76 Fed. Reg. 9968–77 (2011) at 9973).
(10) Reaffirming longstanding Federal policy on
conscience rights and providing a right of action in cases where it is
violated allows longstanding and widely supported Federal laws to work as
intended.
SEC. 3.
Prohibiting governmental discrimination against providers of
health services that are not involved in abortion.
Title II of the Public Health Service Act (42
U.S.C. 202 et seq.) is amended by inserting after section 245 the
following:
"SEC. 245A.
Prohbiting governmental discrimination against providers of
health services that are not involved in abortion.
"(a) In
general. - Notwithstanding any other law, the Federal Government, and any
State or local government that receives Federal financial assistance, may
not penalize, retaliate against, or otherwise discriminate against a health
care provider on the basis that the provider does not -
"(1) perform, refer for, pay for, or otherwise
participate in abortion;
"(2) provide or sponsor abortion coverage; or
"(3) facilitate or make arrangements for any of the
activities specified in this subsection.
"(b) Rule of
construction. - Nothing in this section shall be construed -
"(1) to prevent any health care provider from
voluntarily electing to participate in abortions or abortion referrals;
"(2) to prevent any health care provider from
voluntarily electing to provide or sponsor abortion coverage or health
benefits coverage that includes abortion;
"(3) to prevent an accrediting agency or a Federal,
State or local government from establishing standards of medical competency
applicable only to those who have knowingly, voluntarily, and specifically
elected to perform abortions, or from enforcing contractual obligations
applicable only to those who, as part of such contract, knowingly,
voluntarily, and specifically elect to provide abortions;
"(4) to affect, or be affected by, section 1867 of
the Social Security Act (42
U.S.C. 1395dd, commonly referred to as the 'Emergency Medical Treatment
and Active Labor Act'); or
"(5) to supersede any law enacted by any State for
the purpose of regulating insurance, except as specified in subsection (a).
"(c)
Administration. - The Secretary shall designate the Director of the Office
for Civil Rights of the Department of Health and Human Services -
"(1) to receive complaints alleging a violation of
this section, section 245 of this Act, or any of subsections (b) through (e)
of section 401 of the Health Programs Extension Act of 1973; and
"(2) to pursue the investigation of such complaints
in coordination with the Attorney General.
"(d)
Definitions. - For purposes of this section:
"(1)
FEDERAL
FINANCIAL ASSISTANCE. - The term 'Federal financial assistance' means
Federal payments to cover the cost of health care services or benefits, or
other Federal payments, grants, or loans to promote or otherwise facilitate
health-related activities.
"(2)
HEALTH
CARE PROVIDER. - The term 'health care provider' means -
"(A) an individual physician or other health
professional;
"(B) a hospital, health system, or other health care
facility or organization (including a party to a proposed merger or other
collaborative arrangement relating to health services, and an entity
resulting therefrom);
"(C) a provider-sponsored organization, an
accountable care organization, or a health maintenance organization;
"(D) a social services provider that provides or
authorizes referrals for health care services;
"(E) a program of training in the health professions
or an applicant to or participant in such a program;
"(F) an issuer of health insurance coverage; or
"(G) a group health plan or student health plan, or a
sponsor or administrator thereof.
"(3)
STATE
OR LOCAL GOVERNMENT THAT RECEIVES FEDERAL FINANCIAL ASSISTANCE. - The
term 'State or local government that receives Federal financial assistance'
includes every agency and other governmental unit and subdivision of a State
or local government, if such State or local government, or any agency or
governmental unit or subdivision thereof, receives Federal financial
assistance.
"SEC. 245B. Civil action for certain violations.
"(a) In
general. - A qualified party may, in a civil action, obtain appropriate
relief with regard to a designated violation.
"(b)
Definitions. - For purposes of this section:
"(1)
QUALIFIED
PARTY. - The term 'qualified party' means -
"(A) the Attorney General of the United States; or
"(B) any person or entity adversely affected by the
designated violation.
"(2)
DESIGNATED
VIOLATION. - The term 'designated violation' means an actual or threatened
violation of -
"(A) section 245 or 245A of this Act; or
"(B) any of subsections (b) through (e) of section
401 of the Health Programs Extension Act of 1973 regarding an objection to
abortion.
"(c)
Administrative remedies not required. - An action under this section
may be commenced, and relief may be granted, without regard to whether the
party commencing the action has sought or exhausted available administrative
remedies.
"(d)
Defendants in actions under this section may include governmental entities
as well as others. -
"(1)
IN
GENERAL. - An action under this section may be maintained against,
among others, a party that is a Federal or State governmental entity. Relief
in an action under this section may include money damages even if the
defendant is such a governmental entity.
"(2)
DEFINITION. - For
the purposes of this subsection, the term 'State governmental entity' means
a State, a local government within a State, and any agency or other
governmental unit or subdivision of a State or of such a local government.
"(e) Nature
of relief. - In an action under this section, the court shall grant -
"(1) all necessary equitable and legal relief,
including, where appropriate, declaratory relief and compensatory damages,
to prevent the occurrence, continuance, or repetition of the designated
violation and to compensate for losses resulting from the designated
violation; and
"(2) to a prevailing plaintiff, reasonable attorneys'
fees and litigation expenses as part of the costs.".