HR 1179
112th CONGRESS
1st Session
H. R. 1179
To amend the Patient Protection and Affordable Care Act to protect
rights of conscience with regard to requirements for coverage of specific
items and services.
IN THE HOUSE OF REPRESENTATIVES
March 17, 2011
Mr. FORTENBERRY (for himself, Mr. BOREN, Mrs. MCMORRIS RODGERS, Mr. SCALISE,
Mr. TIBERI, Mr. CONAWAY, Mr. LAMBORN, Mr. WALBERG, and Mr. LIPINSKI) introduced
the following bill; which was referred to the Committee on Energy and Commerce
A BILL
To amend the Patient Protection and Affordable Care Act to protect
rights of conscience with regard to requirements for coverage of specific
items and services.
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 `Respect for Rights of Conscience Act of 2011'.
SEC. 2. FINDINGS AND PURPOSES.
(a) Findings- Congress finds the following:
(1) As Thomas Jefferson declared to New London Methodists in 1809, `[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) Jefferson's statement expresses a conviction on respect for conscience
that is deeply embedded in the history and traditions of our Nation and
codified in numerous State and Federal laws, including laws on health care.
(3) Until enactment of the Patient Protection and Affordable Care Act (Public
Law 111-148, in this section referred to as `PPACA'), the Federal Government
has not sought to impose specific coverage or care requirements that infringe
on the rights of conscience of insurers, purchasers of insurance, plan sponsors,
beneficiaries, and other stakeholders, such as individual or institutional
health care providers.
(4) PPACA creates a new nationwide requirement for health plans to cover
`essential health benefits' and `preventive services' (including a distinct
set of `preventive services for women'), delegating to the Department of
Health and Human Services the authority to provide a list of detailed services
under each category, and imposes other new requirements with respect to
the provision of health care services.
(5) While PPACA provides an exemption for some religious groups that object
to participation in Government health programs generally, it does not allow
purchasers, plan sponsors, and other stakeholders with religious or moral
objections to specific items or services to decline providing or obtaining
coverage of such items or services, or allow health care providers with
such objections to decline to provide them.
(6) By creating new barriers to health insurance and causing the loss of
existing insurance arrangements, these inflexible mandates in PPACA jeopardize
the ability of individuals to exercise their rights of conscience and their
ability to freely participate in the health insurance and health care marketplace.
(b) Purposes- The purposes of this Act are--
(1) to ensure that health care stakeholders retain the right to provide,
purchase, or enroll in health coverage that is consistent with their religious
beliefs and moral convictions, without fear of being penalized or discriminated
against under PPACA; and
(2) to ensure that no requirement in PPACA creates new pressures to exclude
those exercising such conscientious objection from health plans or other
programs under PPACA.
SEC. 3. RESPECT FOR RIGHTS OF CONSCIENCE.
(a) In General- Section 1302(b) of the Patient Protection and Affordable Care
Act (Public Law 111-148; 42 U.S.C. 18022(b)) is amended by adding at the end
the following new paragraph:
`(6) RESPECTING RIGHTS OF CONSCIENCE WITH REGARD TO SPECIFIC ITEMS OR SERVICES-
`(A) FOR HEALTH PLANS- A health plan shall not be considered to have failed
to provide the essential health benefits package described in subsection
(a) (or preventive health services described in section 2713 of the Public
Health Service Act), to fail to be a qualified health plan, or to fail
to fulfill any other requirement under this title on the basis that it
declines to provide coverage of specific items or services because--
`(i) providing coverage (or, in the case of a sponsor of a group health
plan, paying for coverage) of such specific items or services is contrary
to the religious beliefs or moral convictions of the sponsor, issuer,
or other entity offering the plan; or
`(ii) such coverage (in the case of individual coverage) is contrary
to the religious beliefs or moral convictions of the purchaser or beneficiary
of the coverage.
`(B) FOR HEALTH CARE PROVIDERS- Nothing in this title (or any amendment
made by this title) shall be construed to require an individual or institutional
health care provider, or authorize a health plan to require a provider,
to provide, participate in, or refer for a specific item or service contrary
to the provider's religious beliefs or moral convictions. Notwithstanding
any other provision of this title, a health plan shall not be considered
to have failed to provide timely or other access to items or services
under this title (or any amendment made by this title) or to fulfill any
other requirement under this title because it has respected the rights
of conscience of such a provider pursuant to this paragraph.
`(C) NONDISCRIMINATION IN EXERCISING RIGHTS OF CONSCIENCE- No Exchange
or other official or entity acting in a governmental capacity in the course
of implementing this title (or any amendment made by this title) shall
discriminate against a health plan, plan sponsor, health care provider,
or other person because of such plan's, sponsor's, provider's, or person's
unwillingness to provide coverage of, participate in, or refer for, specific
items or services pursuant to this paragraph.
`(D) CONSTRUCTION- Nothing in subparagraph (A) or (B) shall be construed
to permit a health plan or provider to discriminate in a manner inconsistent
with subparagraphs (B) and (D) of paragraph (4).
`(E) PRIVATE RIGHTS OF ACTION- The various protections of conscience in
this paragraph constitute the protection of individual rights and create
a private cause of action for those persons or entities protected. Any
person or entity may assert a violation of this paragraph as a claim or
defense in a judicial proceeding.
`(i) FEDERAL JURISDICTION- The Federal courts shall have jurisdiction
to prevent and redress actual or threatened violations of this paragraph
by granting all forms of legal or equitable relief, including, but not
limited to, injunctive relief, declaratory relief, damages, costs, and
attorney fees.
`(ii) INITIATING PARTY- An action under this paragraph may be instituted
by the Attorney General of the United States, or by any person or entity
having standing to complain of a threatened or actual violation of this
paragraph, including, but not limited to, any actual or prospective
plan sponsor, issuer, or other entity offering a plan, any actual or
prospective purchaser or beneficiary of a plan, and any individual or
institutional health care provider.
`(iii) INTERIM RELIEF- Pending final determination of any action under
this paragraph, the court may at any time enter such restraining order
or prohibitions, or take such other actions, as it deems necessary.
`(G) ADMINISTRATION- The Office for Civil Rights of the Department of
Health and Human Services is designated to receive complaints of discrimination
based on this paragraph and coordinate the investigation of such complaints.
`(H) ACTUARIAL EQUIVALENCE- Nothing in this paragraph shall prohibit the
Secretary from issuing regulations or other guidance to ensure that health
plans excluding specific items or services under this paragraph shall
have an aggregate actuarial value at least equivalent to that of plans
at the same level of coverage that do not exclude such items or services.'.
(b) Effective Date- The amendment made by subsection (a) shall be effective
as if included in the enactment of Public Law 111-148.
END
