U.S. House of Representatives
Bill HR 1179 (2011)
Respect for Rights of Conscience Act of 2011
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
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
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
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
(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
(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.
(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
(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
(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
(b) Effective Date- The amendment made by subsection (a)
shall be effective as if included in the enactment of Public Law 111-148.