H.R. 4611 — EACH Act of 2025

This section states congressional findings on barriers to abortion access post-Dobbs v. Jackson Women's Health Organization, including federal restrictions under the Hyde Amendment since 1976 (which limits Medicaid and other federally funded programs to coverage only in cases of rape, incest, or life endangerment); state-level bans or gestational limits in 19 states affecting over 25 million women aged 15-44; and disparate impacts on Medicaid enrollees (54% women, with higher rates among women of color, LGBTQ individuals, youth under 25, and over 25% of non-elderly American Indian and Alaska Native women), Indian Health Service users, and low-income individuals. (Thus, such barriers reportedly increase poverty risk, hinder economic security, and exacerbate health disparities for affected groups.)

This section defines, for purposes of this Act, (1) "abortion services" as 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; and (2) "health program or plan" as 17 specified federal health care programs or plans—including Medicaid, the Children's Health Insurance Program, Medicare, TRICARE, benefits under the Department of Defense uniform health benefits program for nonappropriated fund instrumentality employees (i.e., civilian employees of military exchanges and similar entities), veterans' medical care under 38 U.S.C. chapter 17, the Federal Employees Health Benefits Program, and others—and any other government-sponsored programs established after enactment.

This section requires each federal health program or plan described in section 3(2) (e.g., those in which the federal government acts as insurer or employer) to provide coverage of abortion services. The section further requires the federal government, as a health care provider including under such programs and plans, to ensure access to abortion services in its own facilities or contracted facilities; and prohibits the federal government from restricting, prohibiting, or inhibiting coverage of abortion services by private health plans or by state or local government health plans.

This section repeals Section 1303 of the Patient Protection and Affordable Care Act, which (1) allows states to elect to prohibit abortion coverage in qualified health plans (QHPs) offered through an ACA Exchange and (2) requires QHP issuers to segregate funds to prohibit use of federal premium tax credits or cost-sharing reductions for abortions for which public funding is prohibited (i.e., those restricted under the Hyde Amendment). (Thus, states will no longer be able to prohibit such coverage through Exchanges, and QHP issuers will not be required to maintain separate allocation accounts for prohibited abortion services.) It also makes conforming amendments by (1) striking a cross-reference in the basic health program provisions and (2) striking and redesignating paragraphs in the multi-state plan program provisions.

This section expresses the sense of Congress that (1) the federal government, acting as an insurer, employer, or health care provider, should serve as a model for the nation by ensuring coverage of abortion services; and (2) restrictions on coverage of abortion services in the private insurance market must end.

This section provides a rule of construction clarifying that nothing in the Act affects any Federal, State, or local law that includes more protections for abortion coverage or abortion services than those set forth in the Act.

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

This section establishes a severability clause, providing that the invalidity of any portion of the Act or its application to any person, entity, government, or circumstance does not affect the remaining valid portions or applications.