119-hr4611

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4611 Introduced in House

    (IH) ]

<DOC>

119th CONGRESS
 1st Session
 H. R. 4611

 To ensure affordable abortion coverage and care for every person, and 
 for other purposes.

_______________________________________________________________________

 IN THE HOUSE OF REPRESENTATIVES

 July 22, 2025

Ms. Pressley (for herself, Ms. DeGette, Mr. Frost, Ms. Schakowsky, Ms. 
 Adams, Mr. Aguilar, Mr. Amo, Ms. Ansari, Mr. Auchincloss, Ms. Balint, 
Ms. Barragan, Mrs. Beatty, Mr. Bell, Mr. Bera, Mr. Beyer, Ms. Bonamici, 
 Ms. Brown, Ms. Brownley, Ms. Budzinski, Ms. Bynum, Mr. Carbajal, Mr. 
 Carson, Mr. Carter of Louisiana, Mr. Casar, Mr. Case, Mr. Casten, Ms. 
 Castor of Florida, Mr. Castro of Texas, Mrs. Cherfilus-McCormick, Ms. 
Chu, Mr. Cisneros, Ms. Clark of Massachusetts, Ms. Clarke of New York, 
Mr. Cleaver, Mr. Cohen, Mr. Correa, Ms. Craig, Ms. Crockett, Mr. Crow, 
Ms. Davids of Kansas, Mr. Davis of Illinois, Ms. Dean of Pennsylvania, 
Ms. DeLauro, Ms. DelBene, Mr. Deluzio, Mr. DeSaulnier, Ms. Dexter, Mr. 
 Doggett, Ms. Elfreth, Ms. Escobar, Mr. Espaillat, Mr. Evans of 
Pennsylvania, Mr. Figures, Mrs. Fletcher, Mr. Foster, Mrs. Foushee, Ms. 
 Lois Frankel of Florida, Mr. Garamendi, Mr. Garcia of California, Ms. 
 Garcia of Texas, Mr. Garcia of Illinois, Mr. Golden of Maine, Mr. 
 Goldman of New York, Ms. Goodlander, Mr. Gottheimer, Mr. Green of 
 Texas, Mrs. Hayes, Mr. Himes, Mr. Horsford, Ms. Hoyle of Oregon, Mr. 
Huffman, Mr. Ivey, Ms. Jacobs, Ms. Jayapal, Mr. Johnson of Georgia, Ms. 
 Kamlager-Dove, Mr. Keating, Ms. Kelly of Illinois, Mr. Kennedy of New 
 York, Mr. Khanna, Mr. Krishnamoorthi, Mr. Landsman, Mr. Larsen of 
Washington, Mr. Larson of Connecticut, Mr. Latimer, Ms. Lee of Nevada, 
Ms. Lee of Pennsylvania, Ms. Leger Fernandez, Mr. Levin, Mr. Lieu, Mr. 
 Magaziner, Mr. Mannion, Ms. Matsui, Mrs. McBath, Ms. McBride, Mrs. 
 McClain Delaney, Ms. McClellan, Ms. McCollum, Mr. McGarvey, Mr. 
 McGovern, Mr. Meeks, Mr. Menendez, Ms. Meng, Mr. Mfume, Mr. Min, Ms. 
 Moore of Wisconsin, Mr. Morelle, Ms. Morrison, Mr. Moskowitz, Mr. 
 Moulton, Mr. Mullin, Mr. Nadler, Ms. Norton, Ms. Ocasio-Cortez, Ms. 
Omar, Mr. Pallone, Mr. Panetta, Mr. Pappas, Ms. Pelosi, Mr. Peters, Ms. 
 Pettersen, Ms. Pingree, Mr. Pocan, Mr. Quigley, Mrs. Ramirez, Ms. 
 Randall, Mr. Raskin, Ms. Rivas, Ms. Ross, Mr. Ruiz, Mr. Ryan, Ms. 
 Salinas, Ms. Sanchez, Ms. Scanlon, Mr. Schneider, Ms. Scholten, Ms. 
 Schrier, Mr. David Scott of Georgia, Mr. Sherman, Ms. Sherrill, Ms. 
Simon, Mr. Smith of Washington, Mr. Sorensen, Mr. Soto, Ms. Stansbury, 
 Mr. Stanton, Ms. Stevens, Ms. Strickland, Mr. Subramanyam, Mr. 
 Swalwell, Mrs. Sykes, Mr. Takano, Mr. Thanedar, Mr. Thompson of 
California, Ms. Titus, Ms. Tlaib, Ms. Tokuda, Mr. Tonko, Mrs. Torres of 
 California, Mr. Torres of New York, Mrs. Trahan, Mr. Tran, Ms. 
 Underwood, Mr. Vargas, Mr. Vasquez, Mr. Veasey, Ms. Velazquez, Ms. 
Wasserman Schultz, Mr. Whitesides, Ms. Williams of Georgia, Ms. Wilson 
 of Florida, Ms. Johnson of Texas, Mr. Neguse, Mr. Olszewski, and Mr. 
 Courtney) introduced the following bill; which was referred to the 
Committee on Energy and Commerce, and in addition to the Committees on 
 Ways and Means, Natural Resources, Armed Services, Veterans' Affairs, 
 the Judiciary, Oversight and Government Reform, and Foreign Affairs, 
for a period to be subsequently determined by the Speaker, in each case 
for consideration of such provisions as fall within the jurisdiction of 
 the committee concerned

_______________________________________________________________________

 A BILL

 To ensure affordable abortion coverage and care for every person, and 
 for other purposes.

 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 ``Equal Access to Abortion Coverage in 
Health Insurance Act of 2025'' or the ``EACH Act of 2025''.

SEC. 2. FINDINGS.

 Congress makes the following findings:

    (1) All people should have access to abortion services 
 regardless of actual or perceived race, color, ethnicity, 
 language, ancestry, citizenship, immigration status, sex 
 (including a sex stereotype; pregnancy, childbirth, or a 
 related medical condition; sexual orientation or gender 
 identity; and sex characteristics), age, disability, or sex 
 work status or behavior.

    (2) A person's income level, wealth, or type of insurance 
 should not prevent them from having access to a full range of 
 pregnancy-related health care, including abortion services.

    (3) No person seeking abortion care should be barred from 
 receiving the procedure based on the ability or inability to 
 afford the health care service.

    (4) Since the decision in Dobbs v. Jackson Women's Health 
 Organization (597 U.S. 215

    (2022) ) held that there is no 
 constitutional right to abortion, 19 States have outright 
 banned the procedure or imposed a ban at an arbitrary point in 
 pregnancy. More than 25,000,000 women aged 15 to 44 live in 
 States where there are more restrictions imposed than prior to 
 the Dobbs decision. This is nearly 1 in 5 women.

    (5) Since 1976, the Federal Government has banned the use 
 of Federal funds to pay for abortion services and allows for 
 exceptions only in very narrow circumstances. This ban affects 
 people of reproductive age in the United States who are insured 
 through the Medicaid program, as well as individuals who 
 receive insurance or care through other federally funded health 
 programs and plans.

    (6) Women make up the majority of Medicaid enrollees (54 
 percent), and nearly 2 out of 3 women enrolled in the program 
 are of reproductive age. Due to systematic barriers and 
 discrimination, a disproportionately higher number of women of 
 color and Lesbian, Gay, Bisexual, Transgender, or Queer

    (LGBTQ) individuals are enrolled in the program.

    (7) More than 40 percent of youth and children under age 19 
 and 12 percent of young people aged 19 to 25 get their health 
 insurance through government programs.

    (8) Women of color are more likely to be insured by the 
 Medicaid program. As of 2020, 25 percent of all Black women 
 aged 19 to 64, or 33,000,000 Black women, and 22 percent of all 
 Hispanic women are enrolled in Medicaid. Nearly 15 percent of 
 Asian American and Pacific Islander women are enrolled in the 
 Medicaid program as of 2019.

    (9) Medicaid also provides coverage to more than 1 in 4 (25 
 percent) non-elderly American Indian and Alaska Native

    (AIAN) women.

    (10) The Indian Health Service

    (IHS) is the federally 
 funded health program for American Indians and Alaska Natives. 
 The IHS serves a population of approximately 2,560,000 and as a 
 federally funded system, since 1988, it has been barred from 
 providing abortion services except for very limited cases. 
 American Indians and Alaska Natives often face higher levels of 
 poverty and limited access to health care for a number of 
 intersecting oppressions thus leaving them without recourse for 
 the Federal ban on abortion services.

    (11) As of 2025, 30 States and the District of Columbia 
 apply Hyde-like restrictions and restrict Medicaid from 
 covering abortion procedures except in cases of rape, incest, 
 or the pregnant person's life is in danger despite allowance 
 for a State's unmatched funds to provide coverage for abortion. 
 As of 2024, 35 percent, or 5,500,000 women aged 15 to 49 who 
 are enrolled in Medicaid live in States where abortion is legal 
 but not covered by the program except in Hyde-allowable 
 circumstances.

    (12) Moreover, 25 States also prohibit coverage of abortion 
 services in the marketplaces and 10 prohibit coverage in 
 private health insurance plans under the Patient Protection and 
 Affordable Care Act (Public Law 111-148). Conversely, 8 States 
 have no coverage limitations, and an additional 12 require 
 coverage in Medicaid, private and marketplace plans.

    (13) A recent report details how restrictions on abortion 
 services coverage interfere with a person's individual decision 
 making, with their health and well-being, with their economic 
 security, with their vulnerability to intimate partner 
 violence, and with their constitutionally protected right to a 
 safe and normal health care service.

    (14) About 25 percent of women covered by Medicaid seeking 
 abortion services must carry their pregnancies to term because 
 they are unable to obtain funds for their care. Government-
 imposed barriers to abortion services restrict people's 
 decisions on if, when, and how to parent, and have long-lasting 
 and life-altering harmful effects on the pregnant person, their 
 families and their communities. Those who seek and are denied 
 abortion services are more likely to remain in or fall into 
 poverty than those who access the care they need.

    (15) Restrictions on abortion service coverage have a 
 disproportionately harmful impact on women with low incomes, 
 women of color, immigrant women, LGBTQ people, and young women. 
 Additionally, numerous State-imposed barriers make it 
 disparately difficult for low-income people, people of color, 
 immigrants, LGBTQ people, and young people to access the health 
 care and resources necessary to prevent unintended pregnancy or 
 to assure that they are able to carry healthy pregnancies to 
 term. Furthermore, young people of reproductive age (ages 15 to 
 24) are more likely to have a lower income than those older 
 than that, and this income gap is greater for young BIPOC. 
 Without insurance coverage for abortion services, young people 
 are at greater risk of not having the economic means to afford 
 care outside of insurance. Young people face disproportionate 
 access barriers to abortion, including parental involvement 
 requirement (notification and consent) and cost, in addition to 
 barriers to contraception and inadequate and incomplete sexual 
 and sexuality education. These challenges, which are magnified 
 for BIPOC and queer, trans, and nonbinary youth, can cause 
 significant delays in access to needed care, and could 
 ultimately harm the life of the young person seeking abortion 
 services. These institutionalized barriers deny young people's 
 right to bodily autonomy and can force young people to 
 encounter an abusive parent or guardian, ignores trusted 
 relationships young people may have with adults other than a 
 parent or legal guardian, and in the case of the judicial 
 bypass process, may force young BIPOC to interact with a legal 
 system that has historically targeted and caused harm to 
 communities of color.

    (16) These and other government-created and government-
 institutionalized barriers--including the restriction on 
 funding for abortion services in Federal programs--exacerbate 
 and create poverty and racial inequality in income, wealth-
 generation, and access to services.

    (17) Access to health care, including abortion services, 
 promotes the general welfare of people living in the United 
 States. Singling out abortion services for funding restrictions 
 in health care programs otherwise designed to promote the 
 health and well-being of people in the United States has cost 
 pregnant people their lives, their livelihoods, their ability 
 to obtain or maintain economic security for themselves and 
 their families, their ability to meet their family's basic 
 needs, their ability to continue their education without 
 disruption, and their ability to break free of abusive 
 relationships.

    (18) Like other health care and health insurance markets in 
 the United States, abortion services and public insurance 
 programs are commercial activities that affect interstate 
 commerce. Providers and patients travel across State lines, and 
 otherwise engage in interstate commerce, to provide and access 
 abortion services. Material goods, services, and federally 
 regulated medications used in abortion services circulate in 
 interstate commerce.

    (19) Congress has the authority to enact this Act to ensure 
 affordable coverage of abortion and other services pursuant 
 to--
        (A) its powers under the necessary and proper 
 clause of 

Section 8, Article I of the Constitution of 
 the United States;
        (B) its powers under the commerce clause of 

Section 8, Article 1 of the Constitution of the United States;
            (C) its powers to tax and spend for the general 
 welfare under 

Section 8, Article 1 of the Constitution 
 of the United States; and
            (D) its powers to enforce 

section 1 of the 
 Fourteenth Amendment under 

Section 5 of the Fourteenth 
 Amendment to the Constitution of the United States.

    (20) Congress has exercised these constitutional powers to 
 create, expand, and insure health care access for people in the 
 United States for decades. Pursuant to this constitutional 
 authority, Congress has enacted, and subsequently reauthorized, 
 numerous health care programs including title XVIII of the 
 Social Security Act (Medicare, enacted in 1965); title XIX of 
 the Social Security Act (Medicaid, enacted in 1965); and title 
 XXI of the Social Security Act (Children's Health Insurance 
 Program, enacted in 1997).

SEC. 3. DEFINITIONS.

 For purposes of this Act:

    (1) Abortion services.--The term ``abortion services'' 
 means an abortion and any services related to, and provided in 
 conjunction with, an abortion, whether or not provided at the 
 same time or on the same day as the abortion.

    (2) Health program or plan.--The term ``health program or 
 plan'' means the following health programs or plans that pay 
 the cost of, or provide, health care:
        (A) The Medicaid program under title XIX of the 
 Social Security Act (42 U.S.C. 1396 et seq.).
        (B) The Children's Health Insurance Program under 
 title XXI of the Social Security Act (42 U.S.C. 1397 et 
 seq.).
            (C) The Medicare program under title XVIII of the 
 Social Security Act (42 U.S.C. 1395 et seq.).
            (D) A medicare supplemental policy as defined in 
 

section 1882

    (g)

    (1) of the Social Security Act (42 
 U.S.C. 1395ss

    (g)

    (1) ).
        (E) The Indian Health Service program under the 
 Indian Health Care Improvement Act (25 U.S.C. 1601 et 
 seq.).
        (F) Medical care and health benefits under the 
 TRICARE program (as defined in 

section 1072

    (7) of title 
 10, United States Code).
        (G) Benefits under the uniform health benefits 
 program for employees of the Department of Defense 
 assigned to a nonappropriated fund instrumentality of 
 the Department established under 

section 349 of the 
 National Defense Authorization Act for Fiscal Year 1995 
 (Public Law 103-337; 10 U.S.C. 1587 note).
        (H) Benefits for veterans under chapter 17 of title 
 38, United States Code.
            (I) Medical care for survivors and dependents of 
 veterans under 

section 1781 of title 38, United States 
 Code.
        (J) Medical care for individuals in the care or 
 custody of the Department of Homeland Security pursuant 
 to any of sections 235, 236, or 241 of the Immigration 
 and Nationality Act (8 U.S.C. 1225, 1226, 1231).
        (K) Medical care for individuals in the care or 
 custody of the Department of Health and Human Services, 
 Office of Refugee Resettlement under 

section 235 of the 
 William Wilberforce Trafficking Victims Protection 
 Reauthorization Act of 2008 (8 U.S.C. 1232) or 

section 462 of the Homeland Security Act of 2002 (6 U.S.C. 
 279).
            (L) Medical assistance to refugees under 

section 412 of the Immigration and Nationality Act (8 U.S.C. 
 1522).
            (M) Other coverage, such as a State health benefits 
 risk pool, as the Secretary of Health and Human 
 Services, in coordination with the Secretary of the 
 Treasury, recognizes for purposes of 

section 5000A

    (f)

    (1)
        (E) of the Internal Revenue Code of 1986.
        (N) The Federal Employees Health Benefit Plan under 
 chapter 89 of title 5, United States Code.
        (O) Medical care for individuals under the care or 
 custody of the Department of Justice pursuant to 
 chapter 301 of title 18, United States Code.
        (P) Medical care for Peace Corps volunteers under 
 

section 5

    (e) of the Peace Corps Act (22 U.S.C. 
 2504

    (e) ).
        (Q) Other government-sponsored programs established 
 after the date of the enactment of this Act.

SEC. 4. ABORTION COVERAGE AND CARE REGARDLESS OF INCOME OR SOURCE OF 
 INSURANCE.

    (a) Ensuring Abortion Coverage and Care Through the Federal 
Government in Its Role as an Insurer and Employer.--Each person insured 
by, enrolled in, or otherwise receiving medical care from health 
programs or plans described in 

section 3

    (2) shall receive coverage of 
abortion services. Health programs or plans described in 

section 3

    (2) shall provide coverage of abortion services.

    (b) Ensuring Abortion Coverage and Care Through the Federal 
Government in Its Role as a Health Care Provider.--In its role as a 
provider of health services, including under health programs described 
in 

section 3

    (2) and health services covered by health plans described 
in 

section 3

    (2) , the Federal Government shall ensure access to abortion 
services for individuals who are eligible to receive medical care in 
its own facilities or in facilities with which it contracts to provide 
medical care.
            (c) Prohibiting Restrictions on Private Insurance Coverage of 
Abortion Services.--The Federal Government shall not prohibit, 
restrict, or otherwise inhibit insurance coverage of abortion services 
by State or local government or by private health plans.

SEC. 5. REPEAL OF 

SECTION 1303.

    (a) In General.--

Section 1303 of the Patient Protection and 
Affordable Care Act (42 U.S.C. 18023) is repealed.

    (b) Conforming Amendments.--

    (1) Basic health plans.--

Section 1331
            (d) of the Patient 
 Protection and Affordable Care Act (42 U.S.C. 18051
            (d) ) is 
 amended by striking paragraph

    (4) .

    (2) Multi-state plans.--

Section 1334

    (a) of the Patient 
 Protection and Affordable Care Act (Public Law 111-148) is 
 amended--
        (A) by striking paragraph

    (6) ; and
        (B) by redesignating paragraph

    (7) as paragraph

    (6) .

SEC. 6. SENSE OF CONGRESS.

 It is the sense of Congress that--

    (1) the Federal Government, acting in its capacity as an 
 insurer, employer, or health care provider, should serve as a 
 model for the Nation to ensure coverage of abortion services; 
 and

    (2) restrictions on coverage of abortion services in the 
 private insurance market must end.

SEC. 7. RULE OF CONSTRUCTION.

 Nothing in this Act shall be construed to have any effect on any 
Federal, State, or local law that includes more protections for 
abortion coverage or abortion services than those set forth in this 
Act.

SEC. 8. RELATIONSHIP TO FEDERAL LAW.

 This Act supersedes and applies to all Federal law, and the 
implementation of that law, whether statutory or otherwise, and whether 
adopted before or after the date of enactment of this Act and is not 
subject to the Religious Freedom Restoration Act of 1993 (42 U.S.C. 
2000bb et seq.).

SEC. 9. SEVERABILITY.

 If any portion of this Act or the application thereof to any 
person, entity, government, or circumstances is held invalid, such 
invalidity shall not affect the portions or applications of this Act 
which can be given effect without the invalid portion or application.
 <all>