Strengthening enforcement of Federal conscience laws

Title II of the Public Health Service Act (42 U.S.C. 202 et seq.), as amended by section 3, is further amended by inserting after section 245A the following: 245B. Administrative enforcement of Federal conscience laws (a) Regulations (1) In general Under this section, the Secretary may issue regulations under any provision of law described in paragraph (2). (2) Provisions of law The provisions of law described in this paragraph are each of the following: (A) Sections 245, 245A, 399M(d), and 520E(f) of this Act. (B) The Religious Freedom Restoration Act of 1993, with respect to any program or activity funded, administered, or conducted by the Department of Health and Human Services. (C) Any of subsections (b) through (e) of section 401 of the Health Programs Extension Act of 1973 (commonly known as the Church Amendments), only with respect to an objection based on a religious belief or moral conviction. (D) Section 507(d) of the Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2023 (division H of the Consolidated Appropriations Act, 2023 (Public Law 117–328)) (commonly known as the Weldon Amendment) and any subsequent substantially similar provision in an appropriations Act, to the extent administered by the Secretary. (E) Section 209 of the Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2023 (division H of the Consolidated Appropriations Act, 2023 (Public Law 117–328)) and any subsequent substantially similar provision in an appropriations Act, to the extent administered by the Secretary. (F) Clauses (i) and (ii) of paragraph (1)(A) of section 1303(b) of the Patient Protection and Affordable Care Act (only with respect to a determination not to provide coverage of abortion), and paragraph (4) of such section. (G) Section 1411(b)(5)(A) of the Patient Protection and Affordable Care Act (other than with respect to an exemption as an Indian or a hardship exemption) and section 5000A(d)(2)(A) of the Internal Revenue Code of 1986. (H) Section 1553 of the Patient Protection and Affordable Care Act. (I) Sections 1122(h), 1162, 1821, 1861(e), 1861(y)(1), and 1861(ss) of the Social Security Act, and the first paragraph of the matter following section 1902(a)(87)(D) of such Act, each of such provisions only with respect to protections for religious nonmedical health care institutions. (J) Sections 1852(j)(3)(B), 1866(f)(4), 1902(w)(3), 1902(w)(5), 1907, 1928(c)(2)(B)(ii) (with respect to a religious or other exemption), 1932(b)(3)(B), and 2012(b) of such Act. (K) Section 4206(c) of the Omnibus Budget Reconciliation Act of 1990. (L) Section 7 of the Assisted Suicide Funding Restriction Act of 1997. (M) Section 113(a) of the Child Abuse Prevention and Treatment Act. (N) Section 301(d) of the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 to the extent administered by the Secretary. (O) The third sentence of section 20(a)(5) of the Occupational Safety and Health Act of 1970. (P) Section 104(f)(1) of the Foreign Assistance Act of 1961 (commonly known as the Helms Amendment), and any provision of an appropriations Act or other Federal law that restates or incorporates by reference the protections of such section, to the extent administered by the Secretary. (Q) The ninth proviso under the heading Global Health Programs under the heading Funds Appropriated to the President under title III of the Department of State, Foreign Operations, and Related Programs Appropriations Act, 2023 (division K of the Consolidated Appropriations Act, 2023 (Public Law 117–328)) and any subsequent substantially similar provision in an appropriations Act to the extent administered by the Secretary. (R) Any other provision of law protecting the exercise of conscience or religious freedom under programs or activities funded, administered, or conducted by the Department of Health and Human Services. (b) Office for Civil Rights The Secretary shall designate the Director of the Office for Civil Rights of the Department of Health and Human Services— (1) to receive complaints alleging a violation of any provision of law described in subsection (a)(2); and (2) to promptly investigate such complaints, issue findings, and require corrective action in cases of such a violation. (c) Enforcement (1) In general The Secretary shall, as permitted under law (including the Constitution of the United States), induce compliance of an individual or entity, including a State or local government, failing to comply with any provision of law described in subsection (a)(2), by terminating, in whole or in part, any Federal financial assistance provided by the Secretary to such individual or entity. (2) Referrals The Secretary shall, as the Secretary determines necessary for inducing compliance with a provision described in paragraph (1), refer a violation of such a provision to the Attorney General for a civil action in accordance with section 245C. 245C. Civil action for violations of Federal conscience laws (a) In general A qualified party may, in a civil action, obtain relief described in subsection (e) with respect to a designated violation. (b) Definitions For purposes of this section: (1) Designated violation The term designated violation means an actual or threatened violation of any provision of law described in section 245B(a)(2). (2) Qualified party The term qualified party means— (A) the Attorney General; or (B) any individual or entity adversely affected by the designated violation without regard to whether such individual or entity is a health care entity as defined in section 245A(c). (c) Administrative remedies not required An action under this section may be commenced, and relief may be granted, without regard to whether the party commencing the action has sought or exhausted any available administrative remedies. (d) Defendants in actions under this section may include governmental entities as well as others (1) In general An action under this section may be maintained against any individual or entity receiving Federal financial assistance (as defined in section 245A(c)), including a State governmental entity. Relief in an action under this section may include money damages even if the defendant is a governmental entity. (2) Definition For the purposes of this subsection, the term State governmental entity means a State, a local government within a State, and any agency or other governmental unit or subdivision of a State, or of such a local government. (e) Nature of relief In an action under this section, the court shall grant— (1) all appropriate relief, including injunctive relief, declaratory relief, and compensatory damages to prevent the occurrence, continuance, or repetition of the designated violation and to compensate for losses resulting from the designated violation; and (2) to a prevailing plaintiff, reasonable attorneys’ fees and litigation costs..