U.S. House of Representatives
Bill HR 6570 (2010)
Respect for Rights of Conscience Act of 2010
This bill was introduced by Representative Fortenberry and referred to
committee 22 December, 2010.
IN THE HOUSE OF REPRESENTATIVES
To amend the Patient Protection and Affordable
Care Act to protect rights of conscience with regard
to requirements for coverage of specific items and
Be it enacted by the Senate and House of
Representatives of the United States of America in
SECTION 1. SHORT TITLE.
This Act may be cited as the 'Respect for Rights
of Conscience Act of 2010'.
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
(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
(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
(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
(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.
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.
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