U.S. Code » Title 42 » Chapter CHAPTER 6A— PUBLIC HEALTH SERVICE › Subchapter SUBCHAPTER I— ADMINISTRATION AND MISCELLANEOUS PROVISIONS › Part Part B— Miscellaneous Provisions

42 U.S.C. § 238n

Abortion-related discrimination in governmental activities regarding training and licensing of physicians

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(a) In generalThe Federal Government, and any State or local government that receives Federal financial assistance, may not subject any health care entity to discrimination on the basis that—(1) the entity refuses to undergo training in the performance of induced abortions, to require or provide such training, to perform such abortions, or to provide referrals for such training or such abortions;(2) the entity refuses to make arrangements for any of the activities specified in paragraph (1); or(3) the entity attends (or attended) a post-graduate physician training program, or any other program of training in the health professions, that does not (or did not) perform induced abortions or require, provide or refer for training in the performance of induced abortions, or make arrangements for the provision of such training.(b) Accreditation of postgraduate physician training programs(1) In general

In determining whether to grant a legal status to a health care entity (including a license or certificate), or to provide such entity with financial assistance, services or other benefits, the Federal Government, or any State or local government that receives Federal financial assistance, shall deem accredited any postgraduate physician training program that would be accredited but for the accrediting agency’s reliance upon an accreditation standards 11 So in original. Probably should be “standard”. that requires an entity to perform an induced abortion or require, provide, or refer for training in the performance of induced abortions, or make arrangements for such training, regardless of whether such standard provides exceptions or exemptions. The government involved shall formulate such regulations or other mechanisms, or enter into such agreements with accrediting agencies, as are necessary to comply with this subsection.

(2) Rules of construction(A) In general

With respect to subclauses (I) and (II) of section 292d(a)(2)(B)(i) of this title (relating to a program of insured loans for training in the health professions), the requirements in such subclauses regarding accredited internship or residency programs are subject to paragraph (1) of this subsection.

(B) ExceptionsThis section shall not—(i) prevent any health care entity from voluntarily electing to be trained, to train, or to arrange for training in the performance of, to perform, or to make referrals for induced abortions; or(ii) prevent an accrediting agency or a Federal, State or local government from establishing standards of medical competency applicable only to those individuals who have voluntarily elected to perform abortions.(c) DefinitionsFor purposes of this section:(1) The term “financial assistance”, with respect to a government program, includes governmental payments provided as reimbursement for carrying out health-related activities.(2) The term “health care entity” includes an individual physician, a postgraduate physician training program, and a participant in a program of training in the health professions.(3) The term “postgraduate physician training program” includes a residency training program.(July 1, 1944, ch. 373, title II, § 245, as added Pub. L. 104–134, title I, § 101(d) [title V, § 515], Apr. 26, 1996, 110 Stat. 1321–211, 1321–245; renumbered title I, Pub. L. 104–140, § 1(a), May 2, 1996, 110 Stat. 1327.)
Notes of Decisions
Cited in 9 cases (1 in the last 5 years), 2006–2021 · leading case: Morr-Fitz, Inc. v. Blagojevich, 901 N.E.2d 373 (Ill. 2008).
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Morr-Fitz, Inc. v. Blagojevich, 901 N.E.2d 373 (Ill. 2008). · cites it 2× “§ 300a-7(b)(1) (2000); 42 U.S.C. § 238n(a)(1), (c)(2) (2000). [5] The Illinois Administrative Code defines "Director" as "the Director of the Division of Professional Regulation with the authority delegated by the Secretary [of the Department of Financial and Professional…”
Franciscan All., Inc. v. Burwell, 227 F. Supp. 3d 660 (N.D. Tex. 2016). “42 U.S.C. § 238n(a) (“Coats Amendment”). The Church Amendment forbids requiring any individual “to perform or assist in the performance of any part of a health service program .”
State of California v. Alex Azar, II, 950 F.3d 1067 (9th Cir. 2020). “1321 , 1321-245 (1996) (codified at 42 U.S.C. § 238n(a)). Finally, in 2004 Congress began including a rider in health care appropriations bills to prohibit discrimination by recipients of federal grants against health care entities that refused to make referrals for abortion,…”
Nat'l Fam. Plan. & Reproductive Health Ass'n v. Gonzales, 468 F.3d 826 (D.C. Cir. 2006). “1321 , 1321-245 (codified at 42 U.S.C. § 238n(a)(l), (c)(2)). But the 1996 provision hasn’t given rise to the parade of horribles that plaintiff hypothesizes — not even to a single horrible.”
Mayor & City Council of Balt v. Alex Azar, II (4th Cir. 2020). “See 42 U.S.C. § 238n(a). 12 The Weldon Amendment, an appropriations rider first included in health care bills in 2004, prohibits discrimination by recipients of federal grants against health care entities that refuse to “provide, pay for, provide coverage of, or provide…”
North Dakota, State of v. Burwell (D.N.D. 2021). “42 U.S.C. § 238n(a)(1). And the Church Amendments guarantee that a recipient of certain sources of federal funds cannot be compelled to perform or assist in sterilization procedures or abortions if “contrary to [the recipient’s] religious beliefs or moral objections.”
Vita Nuova Inc. v. Azar II (N.D. Tex. 2020). “3 42 U.S.C. § 238n. 4 Act of Dec. 16, 2009, Pub.”
State of Washington v. Azar II (E.D. Wash. 2019). “27 11 42 U.S.C. § 238n(c)(2); 84 Fed. Reg. at 23171.”
Morr-Fitz, Inc. v. Blagojevich (Ill. 2008). “This case is thus indistinguishable from Abbott Laboratories, where the Court found that the plaintiffs could not be denied access to the courts under a ripeness theory, stating as follows: “the regulation is directed at them in particular; it requires them to make significant…”
— 42 U.S.C. § 238n(a) — 3 cases
Franciscan All., Inc. v. Burwell, 227 F. Supp. 3d 660 (N.D. Tex. 2016). “42 U.S.C. § 238n(a) (“Coats Amendment”). The Church Amendment forbids requiring any individual “to perform or assist in the performance of any part of a health service program .”
State of California v. Alex Azar, II, 950 F.3d 1067 (9th Cir. 2020). “1321 , 1321-245 (1996) (codified at 42 U.S.C. § 238n(a)). Finally, in 2004 Congress began including a rider in health care appropriations bills to prohibit discrimination by recipients of federal grants against health care entities that refused to make referrals for abortion,…”
Mayor & City Council of Balt v. Alex Azar, II (4th Cir. 2020). “See 42 U.S.C. § 238n(a). 12 The Weldon Amendment, an appropriations rider first included in health care bills in 2004, prohibits discrimination by recipients of federal grants against health care entities that refuse to “provide, pay for, provide coverage of, or provide…”
— 42 U.S.C. § 238n(a)(1) — 3 cases
Morr-Fitz, Inc. v. Blagojevich, 901 N.E.2d 373 (Ill. 2008). “§ 300a-7(b)(1) (2000); 42 U.S.C. § 238n(a)(1), (c)(2) (2000). [5] The Illinois Administrative Code defines "Director" as "the Director of the Division of Professional Regulation with the authority delegated by the Secretary [of the Department of Financial and Professional…”
North Dakota, State of v. Burwell (D.N.D. 2021). “42 U.S.C. § 238n(a)(1). And the Church Amendments guarantee that a recipient of certain sources of federal funds cannot be compelled to perform or assist in sterilization procedures or abortions if “contrary to [the recipient’s] religious beliefs or moral objections.”
Morr-Fitz, Inc. v. Blagojevich (Ill. 2008). “This case is thus indistinguishable from Abbott Laboratories, where the Court found that the plaintiffs could not be denied access to the courts under a ripeness theory, stating as follows: “the regulation is directed at them in particular; it requires them to make significant…”
— 42 U.S.C. § 238n(a)(l) — 1 case
Nat'l Fam. Plan. & Reproductive Health Ass'n v. Gonzales, 468 F.3d 826 (D.C. Cir. 2006). “1321 , 1321-245 (codified at 42 U.S.C. § 238n(a)(l), (c)(2)). But the 1996 provision hasn’t given rise to the parade of horribles that plaintiff hypothesizes — not even to a single horrible.”
— 42 U.S.C. § 238n(c)(2) — 1 case
State of Washington v. Azar II (E.D. Wash. 2019). “27 11 42 U.S.C. § 238n(c)(2); 84 Fed. Reg. at 23171.”
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