S. 178 — Ensuring Accurate and Complete Abortion Data Reporting Act of 2025

This section states congressional findings regarding the incompleteness of state abortion data reporting to the Centers for Disease Control and Prevention (CDC), including that (1) past voluntary reporting has not resulted in complete data; (2) states vary in data collected despite CDC requests for specific data points; (3) no single abortion data point is publicly reported for all 50 states and the District of Columbia; (4) three states accounting for 15% of U.S. women of childbearing age report no data; and (5) accurate abortion data is critical to public health and policy analysis.

This section conditions federal Medicaid matching payments at 90% under subsection 1903(a)(5) for family planning services and supplies specified in section 1905(a)(4)(C) furnished to individuals eligible only for such services under state plan section 1902(ii) or section 1115 waivers on states submitting specified abortion data to the CDC's abortion surveillance system. (As background, such payments previously were not subject to data-reporting conditions; section 1902(ii) enables states to furnish family planning to certain individuals who previously received comprehensive Medicaid benefits but are now income-ineligible.) States must submit by December 31 of the previous year—beginning with the year following two years after enactment—data for the year before the previous year on mandatory questions under section 317W(a)(3)(A) of the Public Health Service Act (42 U.S.C. 317W(a)(3)(A)); late submissions by December 31 of the expenditure year remain eligible (including retroactively); states must certify data accuracy to CDC; and states determined to have knowingly submitted false data are ineligible for such payments during the first full fiscal year following the determination.

This section establishes a CDC surveillance system to collect aggregate data on abortions in the United States in a standardized format, including a standard worksheet for states to report mandatory data on specified variables (maternal age; gestational age; maternal race and ethnicity; abortion method; maternal marital status; previous pregnancies, including live births, induced abortions, and spontaneous abortions; maternal residence at county and state levels; and child survival post-abortion). The system requires cross-tabulation capabilities (e.g., maternal age by gestational age; race/ethnicity by gestational age, maternal age, or marital status; abortion procedure by gestational age) and periodic updates to worksheet questions; directs CDC to provide technical assistance to states; and requires an annual report on the data, published by December 30 of the third calendar year following the covered year. (Thus, non-reporting states on mandatory variables risk penalties under SSA §1903(cc), which reduces Medicaid payments for incomplete vital statistics reporting.)