Last progress May 14, 2025 (8 months ago)
Introduced on May 14, 2025 by James Lankford
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
Prohibits the federal government and any recipient of federal financial assistance from punishing or discriminating against health care entities that decline to participate in, provide, or cover abortions. It preserves the ability of entities to voluntarily provide or cover abortion care, maintains emergency-stabilizing treatment requirements for pregnant patients, and allows competency or contract rules for providers who opt in to perform abortions. Strengthens HHS enforcement of federal conscience and religious freedom laws by authorizing rulemaking, requiring the Office for Civil Rights to investigate complaints and require corrective action, permitting temporary withholding of federal funds to secure compliance, and creating civil remedies (including money damages and attorney fees) enforceable by the Attorney General or affected parties. A severability rule preserves the rest of the law if any provision is struck down.
Thomas Jefferson’s statement about the importance of protecting rights of conscience is cited as a foundational principle.
Congress says no health care entity should be forced to give up religious, moral, ethical, or medical convictions to carry out its medical mission and lists more than two dozen federal statutory protections that exist to protect those conscience rights.
Courts have held some conscience statutes do not provide a private right of action for victims, and administrative enforcement by HHS’s Office for Civil Rights (OCR) has been inconsistent, allowing some cases to languish for years.
The California Department of Managed Health Care required coverage for elective abortions in plans under its authority, which the section says defied the Weldon Amendment; other States (New York, Illinois, Washington) have taken or considered similar actions, and some States have required hospitals to provide or facilitate abortions. The section notes OCR under the Obama Administration concluded in 2016 that California’s decision did not violate the Weldon Amendment and states at least 28,000 individuals and families lost abortion-free health plans as a result.
On January 24, 2020, OCR issued a notice of violation of the Weldon Amendment to California; after continued noncompliance, the Centers for Medicare & Medicaid Services (CMS) announced on December 16, 2020, a disallowance of $200,000,000 per quarter in Federal funds to California beginning in the first quarter of 2021.
Who is affected and how:
Health care providers and institutions: Hospitals, clinics, physicians, nurses, and other providers can more clearly refuse to perform, participate in, or facilitate abortions without fear of federal punishment or loss of federal funding; institutions will likely adopt or revise written conscience policies and procedures.
Insurers and plan sponsors: Public and private health plans that receive federal funds will be protected if they decline to cover or sponsor abortion services, but plans that choose to provide coverage may be subject to competency or contracting standards; state insurance rules remain largely intact except where preempted as specified.
Patients seeking abortion care: Some patients may face reduced local access to abortion services if more entities decline to provide or cover abortion care; emergency-stabilizing treatment requirements remain in place to protect pregnant patients in urgent situations.
Federal agencies and HHS/OCR: HHS will be required to promulgate regulations, expand OCR intake and investigations, impose corrective actions, and potentially manage funding withholdings — increasing administrative workload and likely requiring more staff time and resources.
Courts and litigants: The new private and government civil remedies will generate litigation (claims for damages, injunctions, and attorneys' fees), producing legal uncertainty and court involvement over the scope and application of conscience protections.
States and regulators: State-level health and insurance regulators may face conflicts between state laws that require abortion coverage or participation and the federal protections; the bill preserves state insurance regulation in general but could prompt preemption disputes in practice.
Faith-based and religiously affiliated entities: These organizations gain clearer federal protection for refusing participation in abortion-related activities, which may affect where and how reproductive services are offered.
Net effects: The legislation strengthens enforcement of conscience protections at the federal level and makes those protections enforceable through administrative and civil channels. That will likely reduce some federal penalties for refusal to participate in abortion-related services but may also reduce access to abortion in some places and increase regulatory and litigation costs for agencies, providers, and patients.
Updated 5 hours ago
Last progress May 14, 2025 (8 months ago)
