Women’s Health Protection Act of 2019

I 116TH CONGRESS 1ST SESSION H. R. 2975 To protect a woman’s ability to determine whether and when to bear a child or end a pregnancy, and to protect a health care provider’s ability to provide reproductive health care services, including abortion services. IN THE HOUSE OF REPRESENTATIVES MAY 23, 2019 Ms. JUDY CHU of California (for herself, Mr. VELA, Ms. VELA´ZQUEZ, Ms. WASSERMAN SCHULTZ, Mrs. WATSON COLEMAN, Mr. WELCH, Ms. WEXTON, Ms. WILD, Ms. WILSON of Florida, Mr. KENNEDY, Mr. LOEBSACK, Ms. SEWELL of Alabama, Mr. SHERMAN, Mr. YARMUTH, Mr. EVANS, Mr. SCOTT of Virginia, Mr. THOMPSON of Mississippi, Mrs. BUSTOS, Mr. BUTTERFIELD, Mr. NEGUSE, Mr. ALLRED, Ms. ADAMS, Mr. AGUILAR, Ms. BARRAGA´N, Ms. BASS, Mrs. BEATTY, Mr. BERA, Mr. BEYER, Mr. BLUMENAUER, Ms. BLUNT ROCHESTER, Ms. BONAMICI, Mr. BROWN of Maryland, Ms. BROWNLEY of California, Mr. CARBAJAL, Mr. CA´RDENAS, Mr. CARSON of Indiana, Mr. CASTEN of Illinois, Ms. CASTOR of Florida, Mr. CISNEROS, Ms. CLARK of Massachusetts, Ms. CLARKE of New York, Mr. CLAY, Mr. COHEN, Mr. CONNOLLY, Mr. COOPER, Mr. COX of California, Mr. CRIST, Mr. CROW, Mr. SUOZZI, Mr. CUMMINGS, Mr. MORELLE, Mrs. DAVIS of California, Mr. DANNY K. DAVIS of Illi- nois, Ms. DEAN, Mr. DEFAZIO, Ms. DEGETTE, Ms. DELAURO, Ms. DELBENE, Mr. DELGADO, Mrs. DEMINGS, Mr. DEUTCH, Mrs. DINGELL, Mr. DOGGETT, Mr. ENGEL, Ms. ESCOBAR, Mr. ESPAILLAT, Mrs. FLETCHER, Mr. FOSTER, Ms. FRANKEL, Ms. FUDGE, Ms. GARCIA of Texas, Ms. SCANLON, Mr. GOMEZ, Mr. GREEN of Texas, Mr. GRIJALVA, Ms. HAALAND, Mr. HASTINGS, Mrs. HAYES, Mr. HECK, Mr. HIGGINS of New York, Ms. HILL of California, Mr. HIMES, Ms. NORTON, Mr. HORSFORD, Ms. HOULAHAN, Ms. JACKSON LEE, Ms. JAYAPAL, Mr. JOHNSON of Georgia, Ms. JOHNSON of Texas, Ms. KAPTUR, Ms. KELLY of Illinois, Mr. KHANNA, Mr. KILMER, Mr. KIND, Mrs. KIRKPATRICK, Mr. KRISHNAMOORTHI, Ms. KUSTER of New Hampshire, Mr. LARSEN of Washington, Mrs. LAWRENCE, Mr. LAWSON of Florida, Ms. LEE of Cali- fornia, Mrs. LEE of Nevada, Mr. LEVIN of Michigan, Mr. LEWIS, Mr. TED LIEU of California, Ms. LOFGREN, Mr. LOWENTHAL, Mrs. LOWEY, Mr. LUJA´N, Mrs. CAROLYN B. MALONEY of New York, Mr. SEAN PAT- RICK MALONEY of New York, Ms. MATSUI, Mrs. MCBATH, Ms. MCCOL- LUM, Mr. MCEACHIN, Mr. MEEKS, Ms. MENG, Ms. MOORE, Mr. MOULTON, Ms. MUCARSEL-POWELL, Mr. NADLER, Mrs. NAPOLITANO, VerDate Sep 11 2014 03:29 Jun 07, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6652 E:\BILLS\H2975.IH H2975 pamtmann on DSKBFK8HB2PROD with BILLS 2 •HR 2975 IH Mr. O’HALLERAN, Ms. OMAR, Mr. PANETTA, Mr. PAPPAS, Mr. PAYNE, Mr. PERLMUTTER, Mr. PETERS, Ms. PINGREE, Mr. POCAN, Ms. PRESSLEY, Mr. PRICE of North Carolina, Mr. QUIGLEY, Mr. RASKIN, Miss RICE of New York, Mr. RICHMOND, Mr. ROUDA, Mr. RUPPERS- BERGER, Ms. SA´NCHEZ, Mr. SARBANES, Ms. SCHAKOWSKY, Mr. SCHIFF, Mr. SCHNEIDER, Mr. SCHRADER, Ms. SCHRIER, Mr. SERRANO, Ms. SHALALA, Mr. SIRES, Mr. SMITH of Washington, Mr. SOTO, Ms. SPEIER, Mr. SWALWELL of California, Mr. TAKANO, Mr. THOMPSON of California, Ms. TITUS, Mr. TRONE, Ms. TLAIB, Mr. TONKO, Mrs. TORRES of Cali- fornia, Mrs. TRAHAN, Mr. HUFFMAN, Mr. GARAMENDI, Mr. MCGOVERN, Ms. PORTER, Mr. CASE, Ms. OCASIO-CORTEZ, Mr. CICILLINE, Mr. GALLEGO, Mr. BRENDAN F. BOYLE of Pennsylvania, Mr. GARCI´A of Illi- nois, Ms. SHERRILL, Mr. DAVID SCOTT of Georgia, and Mr. DESAULNIER) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To protect a woman’s ability to determine whether and when to bear a child or end a pregnancy, and to protect a health care provider’s ability to provide reproductive health care services, including abortion services. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Women’s Health Pro- 4 tection Act of 2019’’. 5 SEC. 2. FINDINGS AND PURPOSE. 6 (a) FINDINGS.—Congress finds the following: 7 (1) Access to safe, legal abortion services is es- 8 sential to women’s health and central to women’s 9 ability to participate equally in the economic and so- 10 cial life of the United States. 11 VerDate Sep 11 2014 03:29 Jun 07, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2975.IH H2975 pamtmann on DSKBFK8HB2PROD with BILLS 3 •HR 2975 IH (2) Since 1973, the Supreme Court repeatedly 1 has recognized the constitutional right of a woman 2 to decide to terminate her pregnancy before fetal vi- 3 ability, and to terminate her pregnancy after fetal 4 viability where it is necessary, in the good-faith med- 5 ical judgment of the treating health care profes- 6 sional, for the preservation of her life or health. 7 (3) Nonetheless, access to safe, legal abortion 8 services has been hindered across the United States 9 in various ways, including blockades of health care 10 facilities and associated violence, prohibitions of and 11 restrictions on insurance coverage, restrictions which 12 shame and stigmatize women seeking abortion serv- 13 ices, and medically unnecessary regulations which 14 neither confer any health benefit nor further the 15 safety of abortion services, but which harm women 16 by delaying access to, and reducing the availability 17 of, services. Since 2010, States and local govern- 18 ments have passed more than 400 such restrictions 19 singling out health care providers who offer abortion 20 services and interfering with health care providers’ 21 ability to provide reproductive health care services 22 and the ability of patients to obtain those services. 23 (4) Many State and local governments have im- 24 posed restrictions on the provision of abortion that 25 VerDate Sep 11 2014 03:29 Jun 07, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2975.IH H2975 pamtmann on DSKBFK8HB2PROD with BILLS 4 •HR 2975 IH are neither evidence-based nor generally applicable 1 to the medical profession or to other medically com- 2 parable outpatient gynecological procedures, such as 3 endometrial ablations, dilation and curettage for rea- 4 sons other than abortion, hysteroscopies, loop 5 electrosurgical excision procedures, or other analo- 6 gous non-gynecological procedures performed in 7 similar outpatient settings including vasectomy, 8 sigmoidoscopy, and colonoscopy. 9 (5) Legal abortion is one of the safest medical 10 procedures in the United States. An independent re- 11 view of research on the safety and quality of abor- 12 tion services in the United States, published by the 13 National Academies of Sciences, Engineering, and 14 Medicine in 2018, found that abortion in all forms 15 is safe and effective and that the biggest threats to 16 the quality of abortion services in the United States 17 are State regulations that create barriers to care. 18 These abortion-specific restrictions conflict with 19 medical standards and are not supported by the rec- 20 ommendations and guidelines issued by leading re- 21 productive health care professional organizations in- 22 cluding the American College of Obstetricians and 23 Gynecologists, the Society of Family Planning, the 24 VerDate Sep 11 2014 03:29 Jun 07, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2975.IH H2975 pamtmann on DSKBFK8HB2PROD with BILLS 5 •HR 2975 IH National Abortion Federation, the World Health Or- 1 ganization, and others. 2 (6) Many abortion-specific restrictions do not 3 confer any health or safety benefits on the patient. 4 Instead, these restrictions have the purpose and ef- 5 fect of unduly burdening women’s personal and pri- 6 vate medical decisions to end their pregnancies by 7 making access to abortion services more difficult, 8 invasive, and costly, forcing women to travel signifi- 9 cant distances and make multiple unnecessary visits 10 to the provider, and in some cases, foreclosing the 11 option altogether. For example, a 2018 report from 12 the University of California San Francisco’s Advanc- 13 ing New Standards in Reproductive Health research 14 group found that in 27 cities across the United 15 States, people have to travel more than 100 miles in 16 any direction to reach an abortion provider. 17 (7) These restrictions additionally harm wom- 18 en’s health by reducing access not only to abortion 19 services but also to the other essential health care 20 services offered by the providers targeted by the re- 21 strictions, including— 22 (A) contraceptive services, which advance 23 women’s health and provide a range of benefits, 24 VerDate Sep 11 2014 03:29 Jun 07, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H2975.IH H2975 pamtmann on DSKBFK8HB2PROD with BILLS 6 •HR 2975 IH including preventing unintended pregnancies 1 and reducing the need for abortion; and 2 (B) screenings for cervical cancer and sex- 3 ually transmitted infections. 4 (8) The cumulative effect of these numerous re- 5 strictions has been to severely limit the availability 6 of abortion services in some areas, creating a patch- 7 work system where access to abortion services is 8 more available in some States than in others. A 9 2019 report from the Government Accountability Of- 10 fice examining State Medicaid compliance with abor- 11 tion coverage requirements analyzed 7 key chal- 12 lenges (identified both by health care providers and 13 research literature) and their effect on abortion ac- 14 cess, and found that access to abortion services var- 15 ied across the States and even within a State. 16 (9) The harms of these abortion-specific restric- 17 tions fall especially heavily on low-income women, 18 women of color, immigrants, young people, and 19 women living in rural and other medically under- 20 served areas. 21 (10) Abortion-specific restrictions single out 22 health services used by women, and rely on and rein- 23 force stereotypes about women’s roles, women’s deci- 24 sionmaking, and women’s need for protection. These 25 VerDate Sep 11 2014 03:29 Jun 07, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2975.IH H2975 pamtmann on DSKBFK8HB2PROD with BILLS 7 •HR 2975 IH restrictions harm the basic autonomy, dignity, equal- 1 ity, and ability of women to participate in the social 2 and economic life of the Nation. 3 (11) Not all people who become pregnant or 4 need abortion services identify as women. Access to 5 abortion services is critical to the health of every 6 person regardless of actual or perceived race, color, 7 national origin, immigration status, sex (including 8 gender identity, sex stereotyping, or sexual orienta- 9 tion), age, or disability status. This Act’s protection 10 is inclusive of all pregnant people. 11 (12) These restrictions affect the cost and 12 availability of abortion services, and the settings in 13 which abortion services are delivered. Women travel 14 across State lines and otherwise engage in interstate 15 commerce to access this important medical care, and 16 more would be forced to do so absent this Act. Like- 17 wise, health care providers travel across State lines 18 and otherwise engage in interstate commerce in 19 order to provide reproductive health services to pa- 20 tients, and more would be forced to do so absent this 21 Act. 22 (13) Health care providers, including those who 23 provide abortion services, engage in a form of eco- 24 nomic and commercial activity when they provide 25 VerDate Sep 11 2014 03:29 Jun 07, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H2975.IH H2975 pamtmann on DSKBFK8HB2PROD with BILLS 8 •HR 2975 IH abortion services, and there is an interstate market 1 for abortion services. 2 (14) To provide abortion services, health care 3 providers engage in interstate commerce to purchase 4 medicine, medical equipment, and other necessary 5 goods and services. To provide and assist others in 6 providing abortion services, health care providers en- 7 gage in interstate commerce to obtain and provide 8 training. To provide abortion services, health care 9 providers employ and obtain commercial services 10 from doctors, nurses, and other personnel who en- 11 gage in interstate commerce and travel across State 12 lines. Abortion restrictions substantially affect inter- 13 state commerce in numerous ways. 14 (15) It is difficult and time-consuming for clin- 15 ics to challenge State laws that burden or impede 16 abortion services. Litigation that blocks one abortion 17 restriction may not prevent a State from adopting 18 other abortion restrictions or using different meth- 19 ods to burden or impede abortion services. There is 20 a history and pattern of States passing successive 21 and different laws that impede and unduly burden 22 abortion services. 23 (16) When a health care provider ceases pro- 24 viding abortion services as a result of burdensome 25 VerDate Sep 11 2014 03:29 Jun 07, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H2975.IH H2975 pamtmann on DSKBFK8HB2PROD with BILLS 9 •HR 2975 IH and medically unnecessary regulations, it is often 1 difficult or impossible for that health care provider 2 to recommence providing those abortion services, 3 and difficult or impossible for other health care pro- 4 viders to provide abortion services that restore or re- 5 place the ceased abortion services. 6 (17) An overwhelming majority of abortions in 7 the United States are provided in clinics, not hos- 8 pitals. The large majority of United States counties 9 have no clinics that provide abortion. 10 (18) Congress has the authority to enact this 11 Act to protect abortion services pursuant to— 12 (A) its powers under the commerce clause 13 of section 8 of article I of the Constitution of 14 the United States; 15 (B) its powers under section 5 of the Four- 16 teenth Amendment to the Constitution of the 17 United States to enforce the provisions of sec- 18 tion 1 of the Fourteenth Amendment; and 19 (C) its powers under the necessary and 20 proper clause of section 8 of Article I of the 21 Constitution of the United States. 22 (19) Congress has used its authority in the past 23 to protect women’s ability to access abortion services 24 and health care providers’ ability to provide abortion 25 VerDate Sep 11 2014 03:29 Jun 07, 2019 Jkt 089200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H2975.IH H2975 pamtmann on DSKBFK8HB2PROD with BILLS 10 •HR 2975 IH services. In the early 1990s, protests and blockades 1 at health care facilities where abortion services were 2 provided, and associated violence, increased dramati- 3 cally and reached crisis level, requiring Congres- 4 sional action. Congress passed the Freedom of Ac- 5 cess to Clinic Entrances Act (Public Law 103–259; 6 108 Stat. 694) to address that situation and protect 7 physical access to abortion services. 8 (20) Congressional action is necessary to put an 9 end to harmful restrictions, to f [Text truncated for display. Full text available on Congress.gov.]