FULL SUMMARY

The bill changes Alabama’s abortion exceptions to permit an abortion when an attending physician determines it is necessary to preserve the health of the pregnant woman, rather than only to prevent a serious health risk, with written confirmation by a second physician required within 180 days after the procedure except in a medical emergency. It also permits an abortion when the pregnancy results from rape or incest. The bill revises related definitions, including adding “man” and changing the medical-emergency terminology, and removes the existing detailed definition of “serious health risk to the unborn child’s mother.”

If a man is convicted of rape or incest that resulted in the pregnancy, the court must require him to pay all medical expenses associated with the pregnancy and abortion and to undergo either a vasectomy or castration. For an abortion performed to preserve the mother’s health, the mother may petition the circuit court to require the unborn child’s father to pay all pregnancy- and abortion-related medical expenses, including costs from complications. The alleged father may contest paternity; if adjudicated the biological father, he must pay the expenses or seek relief by agreeing to undergo a vasectomy and providing documentation of it.

Proceedings may be filed in the circuit court of the county where the alleged father or mother resides. The court must prioritize these cases and rule within 48 hours after filing, excluding Saturdays, Sundays, and legal holidays. The new provisions take effect October 1, 2026.

FULL SUMMARY

The bill establishes new Alaska abortion requirements centered on fetal-heartbeat detection. Before performing or inducing an abortion, a health care provider must determine, using a medically appropriate test consistent with standard practice, whether a detectable fetal heartbeat is present and record the gestational age, dating method, test, date, time, and result. An abortion is generally prohibited when a heartbeat is detected or when the required test is not performed, subject to exceptions for a medical emergency and abortions performed at the behest of federal personnel when preemption or intergovernmental immunity applies. Medical-emergency abortions require written medical-record documentation and retention of supporting records; the bill also requires documentation stating that maternal health was not a purpose of other abortions.

The bill requires a sonogram before an abortion, before sedation or anesthesia, and generally at least 24 hours beforehand. The provider must display the images, explain the findings—including dimensions, cardiac activity, external members, and internal organs—and make any detected heartbeat audible with an explanation. A woman may waive the 24-hour waiting period if she lives at least 100 miles from the nearest qualifying abortion provider. She must sign an election form acknowledging receipt of required information, understanding of the procedure and sonogram requirements, the option to view images, and the audible-heartbeat requirement; the provider must receive the signed certification before proceeding. Informed-consent provisions are revised to authorize health care providers and licensed staff to provide required information and to require disclosure, when medically accurate, of specified risks including infection, hemorrhage, infertility, breast-cancer risk, and risks of carrying the pregnancy to term. Existing abortion, minor-notice, reporting, and emergency provisions are revised throughout to replace physician-specific references with health care provider references and to add compliance with the new heartbeat requirements.

The bill creates monthly, nonidentifying reporting to the Department of Health on abortions performed at abortion facilities, including patient demographic and residence data, procedure type and date, gestational age, outcomes, prior births and abortions, and medical-emergency information; records are confidential, with specified disclosure exceptions, and violations are Class A misdemeanors. Enforcement of the heartbeat provisions is generally limited to private civil actions: any nonstate person may sue providers and persons who knowingly aid or abet prohibited abortions, including payment or reimbursement, with mandatory injunctive relief, statutory damages of at least $10,000 per abortion, available compensatory damages, and attorney fees, subject to specified defenses, exclusions, a six-year limitations period, and immunity for the woman. The state and its officials receive broad immunity from challenges to enforcement, while prevailing parties in actions seeking to block abortion restrictions may recover costs and attorney fees from the claimant and its attorneys. Related venue and fee provisions affecting Alaska civil and appellate procedure rules take effect only upon the required two-thirds vote of each legislative house; the bill otherwise takes effect immediately.

FULL SUMMARY

The bill adds the Alaska Heartbeat Act and legislative findings concerning fetal cardiac activity. It requires a physician, before performing or inducing an abortion, to determine whether a detectable fetal heartbeat is present using a medically appropriate test and to record the gestational age, dating method, test, date, time, and result. Except for specified exceptions, an abortion may not be performed when a fetal heartbeat is detected or when the physician fails to perform the required test. Exceptions apply when a physician believes a medical emergency prevents compliance, provided the physician documents the emergency and maintains the records, and when federal preemption or intergovernmental immunity would bar enforcement. The bill adds these requirements to the conditions for lawful abortion and excludes violations of the fetal-heartbeat requirements from the existing criminal penalty provision.

The bill changes informed-consent requirements by placing the written certification obligation on the physician performing the abortion and requiring provision of both the state-maintained Internet information and material information about the nature and risks of undergoing or not undergoing the procedure. It additionally requires disclosure, when medically accurate, of possible increased breast-cancer risk and the protective effect of completed pregnancy, medical risks associated with carrying the pregnancy to term, and the name of each person providing or explaining the information. It establishes a 24-hour pre-abortion sonogram requirement, with a two-hour alternative for a woman who lives at least 100 miles from the nearest qualifying abortion provider and signs a waiver. The sonogram must be performed before sedation or anesthesia, displayed to the woman, explained in lay terms—including fetal dimensions, cardiac activity, external members, and internal organs—and include audible heart auscultation when present; the woman must sign an election form acknowledging the information, sonogram, and opportunity to view the images. Physicians must retain the signed certification and specified medical-emergency documentation.

The bill creates monthly, non-patient-identifying physician reports to the Department of Health containing specified demographic, procedural, outcome, gestational, reproductive-history, and medical-emergency information; department records are confidential, violations are Class A misdemeanors, and the department must maintain a secure electronic reporting system. Enforcement of the fetal-heartbeat provisions is limited to private civil actions: any non-governmental person may sue those who perform, induce, aid, abet, finance, or intend prohibited abortions, subject to specified defenses and exclusions, including actions against the woman, federally protected conduct, an unwitting common carrier, or the perpetrator who impregnated a rape, sexual-assault, sexual-abuse, or incest survivor. Prevailing plaintiffs may receive injunctive relief, at least $10,000 in statutory damages per abortion, compensatory and nominal damages, costs, and attorney fees, with a six-year limitations period; defendants generally may not recover fees. The bill also preserves governmental immunity, restricts government participation in such suits, establishes venue rules, requires prevailing-party fees in actions challenging abortion restrictions, and provides broad severability and constitutional-saving rules. The fee provisions and non-transferable venue rule take effect only if each receives the constitutionally required two-thirds vote in both legislative chambers.

The bill removes the existing exception that allowed a physician to prescribe, dispense, or administer an abortion-inducing drug if the physician complied with AS 18.16.010, thereby making the prohibition in AS 08.64.364(c)(1) unconditional. The existing restriction on a physician or physician assistant prescribing, dispensing, or administering a prescription drug in response to an Internet questionnaire or email to a person without a prior physician-patient relationship remains in place.

The bill adds a requirement to AS 18.16.010 that any health care provider who prescribes, dispenses, or administers an abortion-inducing drug must first conduct an in-person physical examination. The provider must also schedule a follow-up appointment no later than 14 days after the abortion to confirm that the pregnancy was terminated and assess continued blood loss.

FULL SUMMARY

The bill expands the category of authorized abortion providers to include licensed physician assistants, nurse practitioners, and certified nurse midwives, alongside physicians. It removes the Arizona Board of Nursing’s authority to determine abortion-related scope of practice; deletes the physician-assistant prohibition on surgical abortions; removes surgical abortion from the definition of procedures excluded from physician-assistant “minor surgery”; and removes the prohibition on physician assistants prescribing, dispensing, or administering medication intended to induce an abortion. Physician assistants with the requisite training and authorization could therefore perform surgical abortions and prescribe abortion medication, subject to the bill’s other requirements.

The bill removes the 24-hour waiting/reflection-period requirements for abortion informed consent and strikes the associated prohibition on issuing abortion prescriptions or collecting payment before that period expires. It also eliminates the separate statutory ultrasound, fetal-heartbeat auscultation, viewing, explanation, and ultrasound-image-offer requirements that had to occur at least 24 hours before an abortion. Existing abortion-clinic ultrasound screening and documentation requirements remain, but responsibility for estimating gestational age, retaining ultrasound records, administering anesthesia or sedation, signing discharge orders, discussing and offering Rh immunoglobulin, and conducting specified follow-up care is extended to nurse practitioners, certified nurse midwives, and physician assistants.

The bill revises parental-consent, informed-consent, lethal or nonlethal fetal-condition, clinic-personnel, and non-provider provisions to recognize the expanded provider category. Civil actions for abortions performed without required informed consent are limited to the woman who underwent the abortion; the bill removes the parallel standing previously provided to a married father and, in specified cases, a maternal parent or grandparent, while retaining damages of $5,000 or three times the abortion cost, whichever is greater, plus compensatory damages, attorney fees, and a six-year limitations period. Reporting provisions are revised to permit and require the expanded provider category to provide, sign, and submit abortion and informed-consent reports, including reports concerning medical-emergency exceptions. Sections 36-2160 and 36-2301.02 are repealed; the bill otherwise retains and reorganizes requirements concerning care, documentation, reporting, and enforcement when a fetus or embryo is delivered alive.

FULL SUMMARY

The bill repeals Arizona statutes governing criminal abortion offenses and related restrictions, including Sections 1-219, 13-3603.01, 13-3603.02, 13-3605, 15-115, 15-115.01, 15-1630, 20-121, 32-3246, 35-196.02 and 36-3604. It also repeals Title 36, Chapter 4, Article 10; Chapter 20; and Chapter 23, Articles 1 and 3, and changes the heading of Chapter 23 from “Protection of Fetus or Embryo” to “Embryos.”

The bill removes abortion-specific restrictions from health-profession and facility laws. It eliminates abortion-related unprofessional-conduct provisions for nurses and physicians, removes the exclusion of medication-abortion mentoring from preceptorship definitions, removes provisions barring physician assistants from performing surgical abortions and related abortion-specific scope restrictions, and removes the pharmacy-practice exclusion concerning initiation of medication-abortion prescriptions. It also removes abortion-clinic exceptions and related references in health-care-institution regulation, removes the abortion-related exception from Arizona’s minor-consent statute, and eliminates the prohibition on abortion services in medical-district clinics.

The bill removes public-funding restrictions on research involving fetal remains from abortions and on grants or contracts for facilities performing nonfederally qualified abortions, while retaining the prohibition on public funding for human cloning. It removes the requirement that qualifying charitable organizations certify that they do not provide, fund, cover, or financially support abortions, thereby eliminating that abortion-related eligibility restriction for the state charitable-contribution tax credit. Medicaid family-planning coverage language is revised to remove the express exclusion of abortion and abortion counseling. Conforming changes also remove abortion-related exclusions from administrative-rule review and occupational-regulation provisions and make related technical revisions to health-care, licensing, and public-finance statutes.

FULL SUMMARY

California public university student health centers must, by January 1, 2028, promote awareness of the medication-abortion services they offer, provide service information to students, and post service availability on their websites.

Beginning January 1, 2029, and contingent on legislative appropriation, each community college with a student health center must offer access to medication abortion. Access may be provided onsite, through telehealth, an external contracted provider, or a community-provider partnership documented by a referral relationship, memorandum of understanding, or contract. Colleges may meet the access requirement through referrals or warm handoffs, support-resource assistance, and current provider referral information. They must also promote and provide information about available services and post that information online.

The Chancellor’s Office may advise community college health centers on billing public programs and insurers and may enter a statewide provider agreement. The Commission on the Status of Women and Girls must develop, with the Chancellor’s Office, a standardized, privacy-protective reporting framework and submit a report to the Legislature by January 1, 2030 covering community-college health-center access and medication-abortion activity. Reporting is limited to reasonably available existing records and does not require collection of protected health information from external providers, tracking beyond voluntarily supplied information, or new clinical data systems. The reporting provision becomes inoperative January 1, 2032.

Appropriated funds may support readiness and operating costs, including telehealth infrastructure, provider contracts, clinical staffing and oversight, training, administrative and legal support, billing infrastructure, outreach, data collection, and other reasonably necessary direct or indirect costs.

The bill amends Health and Safety Code Section 1317.1 to provide that emergency-services provisions do not require physician supervision of a licensed nurse-midwife in a labor and delivery unit, obstetric triage, or dedicated emergency obstetric evaluation unit when the nurse-midwife provides care authorized and consistent with Business and Professions Code Section 2746.5, or when the treating physician and surgeon specifically requests the nurse-midwife’s obstetric consultation. The change does not expand the nurse-midwife’s scope of licensure.

It also amends Section 1317.10 to apply the same physician-supervision exception to nurse-midwives providing care in the specified obstetric settings at Stanford Hospital and Clinics or Lucile Packard Children’s Hospital at Stanford, including when providing obstetric consultation at the treating physician’s specific request. The bill states that no reimbursement to local agencies or school districts is required because any resulting costs arise from changing the definition or scope of a crime.

FULL SUMMARY

The bill requires a person or entity located, headquartered, incorporated, or conducting business in California to notify the Attorney General at least seven business days before producing records in response to a subpoena, discovery request, or other information request connected to a civil, criminal, regulatory, or legislative investigation concerning abortion or legally protected gender-affirming health care services. The notice must include a copy of the request, subject to redaction of identifying or confidential information. If federal law or another federal obligation requires a shorter response period, notice must be provided no later than when the records are produced, and the responding party must make best efforts to produce the records by the required deadline.

The notice requirement does not apply to requests ordered by a court of competent jurisdiction, issued by a California state or local agency, accompanied by a qualifying attestation, or involving information about the protected services that is merely incidental to the investigation. A qualifying attestation must state that the information will not be used to impose liability for lawful services in California, or must identify the California law allegedly violated or the California grounds for professional discipline. Parties may rely on the attestation. Covered parties generally may not produce responsive records before the applicable waiting period, and the Attorney General may attempt to notify the individual connected with the health care service.

The Attorney General may intervene in civil actions brought to resist compliance with such requests and may enforce the requirements through civil actions and injunctions. Attaching a false attestation carries a $15,000 civil penalty; intentional, knowing, willful, or reckless violations may result in penalties of up to $10,000 for a first violation and $15,000 for each subsequent violation, in addition to other remedies. Enforcement actions must be filed within six years after the Attorney General receives the relevant notice, and courts must award the Attorney General costs and attorney’s fees when imposing a penalty. The bill also adds abortion-related terminology to the Civil Code’s definitions supporting these protections.

The legislation reaffirms the legality of medication abortion in California, specifically focusing on the use of mifepristone and misoprostol. It aims to protect access to abortion care in response to the U.S. Supreme Court's reversal of Roe v. Wade, which has heightened threats to reproductive rights and led to ongoing legal challenges affecting access to these medications.

Key provisions include the lawful delivery, mailing, and transportation of abortion-related drugs, as well as protections for manufacturers, distributors, healthcare providers, and individuals involved in the provision of medication abortion. These protections are retroactive to January 1, 2020, ensuring that those involved in the process are shielded from civil or criminal liability.

The legislation emphasizes the safety and effectiveness of medication abortion, which constitutes over 60% of abortions in the U.S. and is associated with a low risk of complications. By safeguarding access to safe abortion care, the Act aims to promote the health and welfare of Californians.

Additionally, the provisions of the Act are severable, ensuring that if any part is deemed invalid, the remaining sections will still be enforceable. Overall, the legislation seeks to ensure continued access to essential reproductive healthcare in California.

The Reproductive Health Emergency Preparedness Program (RHEPP) is designed to improve access to reproductive and sexual health care in California's emergency departments. This initiative addresses the increasing demand for abortion and related services, particularly in areas with a shortage of primary care providers and obstetrician-gynecologists.

The healthcare industry, especially emergency departments and outpatient clinics, will be significantly impacted as they expand their services to include comprehensive reproductive health care. This expansion will involve training and resources for medical staff to provide essential services such as abortion care, contraception, and treatment for pregnancy loss.

Funding for the program will come from appropriations by the Legislature or private sources, with grants awarded competitively to participating emergency departments. The financial support aims to facilitate various initiatives, including education, clinical fellowships, and the integration of medication abortion services.

The RHEPP will become effective upon the availability of funds and will remain in effect until January 1, 2030. The program seeks to ensure that reproductive health services are accessible and affordable, addressing the needs of over 36 million women and individuals who may become pregnant in light of recent legal changes affecting abortion rights.

The legislation introduces comprehensive protections for medical information related to gender-affirming health care in California, specifically aimed at safeguarding the rights of transgender and gender nonconforming individuals. It prohibits health care providers and related entities from disclosing medical information in response to subpoenas or requests from other states that conflict with California's laws, thereby preventing harassment and intimidation.

Additionally, the bill restricts cooperation with out-of-state agencies and federal law enforcement regarding inquiries into gender-affirming health care. It establishes regulations for the Controlled Substance Utilization Review and Evaluation System (CURES), mandating that healthcare practitioners report specific information about controlled substances dispensed while ensuring patient privacy and data security.

The legislation also addresses the reporting of prescriptions for testosterone and mifepristone, exempting them from certain reporting requirements and mandating the removal of related records by a specified date. Overall, the changes emphasize the importance of protecting sensitive health information and ensuring that individuals can access gender-affirming care without fear of legal repercussions from other states.

The document outlines significant changes to the licensing and Medi-Cal reimbursement provisions for alternative birth centers in California. These changes primarily affect alternative birth centers and primary care clinics that operate as such, requiring them to adhere to new licensure and reimbursement standards.

Under the new provisions, Medi-Cal reimbursement for facility-related delivery costs at alternative birth centers will be established at a statewide all-inclusive rate per delivery, capped at 80% of the average reimbursement received by general acute care hospitals with Medi-Cal contracts. This rate will be updated annually based on reports from the California Medical Assistance Commission and will not exceed the charges for similar services provided to non-Medi-Cal patients.

The new reimbursement structure is set to take effect no earlier than July 1, 2017, pending necessary federal approvals. Additionally, starting July 1, 2022, alternative birth centers will be exempt from certain payment reductions imposed by existing regulations.

Regulatory changes include the removal of the requirement for alternative birth centers to be certified as providers of comprehensive perinatal services under Medi-Cal. New criteria for hospital transfer policies and quality assurance programs have also been introduced.

Overall, these changes aim to improve the operational framework for alternative birth centers while ensuring compliance with updated standards and reimbursement protocols.

The document outlines a legislative proposal aimed at enhancing perinatal services in rural areas of California, particularly in Humboldt and Plumas Counties. The initiative seeks to address the inadequate distribution of maternal and infant health services in medically underserved regions by establishing a pilot project that introduces "standby perinatal services" in critical access hospitals. This project is designed to improve access to essential perinatal care and ensure better health outcomes for mothers and newborns.

Key components of the proposal include requirements for hospitals to comply with professional standards, maintain necessary equipment and supplies, and develop quality improvement programs. Additionally, hospitals will be mandated to collect and evaluate data on safety, outcomes, and utilization, with a report to be submitted to the Legislature after the pilot project's completion. The initiative emphasizes the importance of regulatory compliance and the establishment of operational requirements for participating hospitals.

The proposal also includes provisions for continuing education and training programs for medical and nursing staff involved in perinatal services. This encompasses mandatory biennial rotations at higher-level care facilities, participation in simulation-based training for obstetric emergencies, and annual verification of nursing competencies. Furthermore, the legislation aims to enhance patient safety through collaboration with higher-level care facilities and adherence to licensed nurse-to-patient ratios.

Overall, this legislative effort is focused on improving maternal and newborn health outcomes in rural California by ensuring access to necessary perinatal services and enhancing the training and competencies of healthcare providers in these areas. The initiative represents a significant step toward addressing the challenges faced by rural hospitals in delivering comprehensive perinatal care.

FULL SUMMARY

Effective July 1, 2026, the bill establishes protections for state-credentialed health care providers employed by or acting on behalf of a health care entity when providing reproductive or gender-affirming health care information and counseling. It defines reproductive health care services, gender-affirming health care services, health care entities and providers, and medically accurate and appropriate information and counseling.

When a provider acts in good faith, within the provider’s scope of practice, education, training and experience—including specialty practice and board certification—and within the accepted standard of care, a health care entity may not limit the provider’s ability to give patients comprehensive, medically accurate and appropriate information about the patient’s health status, including diagnosis, prognosis, recommended treatment, alternatives and potential risks to health or life. The provider may also give information and counseling about relevant community services and resources and how to access them to obtain the patient’s chosen care.

A health care entity may still conduct relevant peer review; require providers to give patients the full range of information about available legal care options as determined by the entity, including vaccinations; enforce preferred-provider-network or utilization-review requirements authorized by state or federal law; and require compliance with established health care quality and patient-safety guidelines or rules. The entity may take adverse action against a provider who fails to follow an instruction to provide the entity-determined information about available legal options.

Subject to these conditions, a health care entity may not discharge, demote, suspend, discipline or otherwise take adverse action against a provider solely because the provider supplied the specified reproductive or gender-affirming health care information or counseling.

The Connecticut Department of Public Health has amended regulations regarding abortion services, effective August 1, 2023. These changes authorize a broader range of healthcare providers, including physicians, advanced practice registered nurses, nurse-midwives, and physician assistants, to perform medication and abortion procedures under specific conditions.

Key updates include enhanced reporting requirements for healthcare providers, who must submit details about the abortion procedures they perform to the commissioner of public health within seven days, while ensuring patient confidentiality. Additionally, abortions after the second trimester are mandated to be conducted in licensed hospitals or ambulatory surgery centers to meet national standards of care.

The informed consent process has been revised to guarantee that patients receive thorough information about the procedure, associated risks, and necessary follow-up care. Furthermore, outpatient clinics are now required to establish quality assurance and risk management programs, which include annual evaluations and audits.

These amendments aim to align state regulations with best practices in healthcare, ensuring that abortion services are delivered safely and effectively. The changes may also lead to financial implications for healthcare facilities, particularly concerning compliance costs and adjustments to operational procedures.

The Connecticut Department of Public Health has amended regulations regarding abortion services, effective August 1, 2023. These changes expand the eligibility of healthcare providers, allowing certified nurse-midwives, advanced practice registered nurses, and physician assistants to perform medication and abortion procedures, in line with recent legislative updates.

Healthcare providers are now required to report specific details about abortions performed to the commissioner of public health within seven days, ensuring patient confidentiality while maintaining oversight. Outpatient clinics offering abortion services must comply with national standards set by the American College of Obstetricians and Gynecologists to guarantee quality medical care.

The regulations also emphasize the importance of informed consent, mandating that healthcare providers furnish comprehensive information about the procedures, associated risks, and necessary follow-up care. Additionally, clinics are required to develop safety plans to address various emergencies, thereby prioritizing patient safety.

These amendments are anticipated to impact the healthcare industry, particularly facilities providing abortion services, by increasing compliance costs related to reporting, facility standards, and staff training. The heightened focus on quality assurance and risk management may lead to additional operational expenses for clinics.

The proposal would add a Delaware constitutional right to reproductive freedom. It defines that right as each individual’s fundamental right to make and carry out decisions concerning their pregnancy, including prenatal care, childbirth, postpartum care, contraception, sterilization, abortion care, miscarriage management, and infertility care, and provides that the right may not be denied, burdened, or infringed.

The State could regulate abortion care after fetal viability, but could not prohibit an abortion that, in the good-faith medical judgment of the treating attending health care professional, is medically indicated to protect the pregnant individual’s life or physical or mental health.

Constitutional adoption requires passage of the same changes by the next General Assembly after the next general election, in addition to passage by the current General Assembly. Passage requires affirmative votes from two-thirds of the elected members of each house.

The bill proposes adding Article I, § 22, to the Delaware Constitution to establish an individual fundamental right to reproductive freedom, including decisions concerning pregnancy, prenatal care, childbirth, postpartum care, contraception, sterilization, abortion care, miscarriage management, and infertility care. The right could not be denied, burdened, or infringed.

The proposal would permit the State to regulate abortion care after fetal viability, but would prohibit any ban on an abortion that an attending health care professional determines is medically indicated to protect the pregnant individual’s life or physical or mental health. The constitutional change must also be approved in the same form by the General Assembly convened after the next general election, with two-thirds of the elected members of each chamber voting affirmatively.

FULL SUMMARY

The bill repeals Delaware’s existing statutory provisions on termination of human pregnancy and replaces them with the Pain-Capable Unborn Child Protection Act. It defines an unborn child as a human organism from fertilization until live birth and establishes a pain-capable post-fertilization age of 5 months. At that point, no person may perform, induce, or attempt an abortion unless the unborn child has a lethal, nonviable condition or the abortion is necessary to prevent the pregnant woman’s death or a serious risk of substantial and irreversible physical impairment of a major bodily function; psychological or emotional conditions do not qualify. The bill also bars reliance on a claimed risk that the woman will intentionally engage in conduct causing her death or such impairment.

Before performing or inducing an abortion, a health-care practitioner must determine, or rely on another practitioner’s determination of, the fetus’s probable post-fertilization age, except in a medical emergency. When an abortion is permitted because of a nonviable condition, the practitioner must use the method that provides the best opportunity for fetal survival unless that method poses a greater risk to the patient’s death or substantial and irreversible physical impairment. Related definitions are added or revised, including definitions of abortion, fertilization, fetus or unborn child, medical emergency, nonviable, post-fertilization age, probable post-fertilization age, reasonable medical judgment, and serious health risk to the mother.

Health-care practitioners must report every performed, induced, or attempted abortion to the Department of Health and Social Services at least annually, including gestational-age information, whether ultrasound was used, the method, the basis for abortions at or beyond 5 months, and whether the method offered the best opportunity for fetal survival. Patient-identifying information is prohibited in reports and must remain confidential. Beginning June 30, 2026, the Department must publish annual, non-identifying statistics and distribute the report to specified state officials and legislative entities.

Intentional or reckless violations are classified as Class D felonies; violating health-care practitioners may face licensure discipline, including loss of license, and other violators may be treated as engaging in unauthorized practice of medicine. Patients are exempt from penalties. Women subjected to an unlawful abortion and, in specified circumstances, the unborn child’s father, a parent or guardian, or the Department of Justice may seek damages or injunctive relief, subject to limits including exclusion where the pregnancy resulted from the plaintiff’s criminal conduct. Prevailing parties may receive attorney’s fees, while a woman who underwent the abortion generally cannot be assessed damages or fees except for a frivolous, bad-faith action.

FULL SUMMARY

The bill repeals Delaware’s existing Title 24 provisions on termination of human pregnancy and replaces them with the Pain-Capable Unborn Child Protection Act. It prohibits performing, inducing, or attempting an abortion on an unborn child capable of feeling pain, defined as a post-fertilization age of five or more months, unless the child has a nonviable condition or the abortion is necessary, in the physician’s reasonable medical judgment, to avert the pregnant woman’s death. A medical emergency based on the woman’s stated intention to engage in conduct resulting in her death does not qualify. When an abortion is permitted under these provisions, the health-care practitioner must use the method providing the best opportunity for fetal survival unless that method would pose a greater risk of the patient’s death.

The bill relocates the definitions and legislative findings within Subchapter IX, defines “nonviable” as a lethal anomaly expected with reasonable medical certainty to cause death at birth or shortly thereafter, and excludes conditions survivable with medical treatment. It authorizes physicians, appropriately qualified physician assistants, certified nurse midwives, and certified nurse practitioners to provide pre-viability pregnancy termination, and permits physician assistants and advanced practice registered nurses to prescribe termination medications, including Mifeprex, mifepristone, and misoprostol. It also revises related cross-references in § 1702 and retains protections for individuals and institutions that refuse to perform, participate in, or permit pregnancy-termination procedures.

Health-care practitioners must report every abortion or attempted abortion to the Department of Health and Social Services at least annually, including the probable post-fertilization age, abortion method, and, for procedures at five or more months, the applicable exception and whether the method maximized fetal survival. Patient-identifying information is prohibited in reports, which must remain confidential; beginning June 30, 2027, the Department must publish annual deidentified statistics. Intentional or reckless violations constitute a class D felony and may result in professional discipline, including license loss. Patients cannot be penalized, while specified women, parents or guardians, the Department of Justice, and—in certain cases—the child’s father may pursue damages or injunctive relief, subject to the bill’s limitations.

FULL SUMMARY

The bill adds § 1791A to Title 24 of the Delaware Code, requiring a health-care practitioner or the practitioner’s agent, except in a medical emergency, to offer a patient ultrasound imaging and fetal-heart-tone auscultation before terminating a human pregnancy. The ultrasound must be an active, standard-quality image the patient may view, including fetal dimensions and an accurate depiction of external members and internal organs; the auscultation must be of standard quality and available for the patient to hear.

The patient may decline to view the ultrasound or listen to the fetal heart tone, but the practitioner must obtain the patient’s signature on a form documenting that the services were offered. Proof of compliance becomes a requirement for accreditation under § 122(3)z. of Title 16.

The provision defines a health-care practitioner to include an individual authorized under § 1790 of Title 24 to terminate, attempt to terminate, or assist in terminating a human pregnancy, including by prescribing medication. A medical emergency is a condition that, based on the good-faith clinical judgment of the practitioner or another medically authorized person, requires immediate termination to avert the patient’s death or prevent a serious risk of substantial and irreversible impairment of a major bodily function; a condition based on a claim or diagnosis that the patient intends to engage in conduct causing such harm does not qualify. The Act is designated the “Woman’s Right to Know Act.”

FULL SUMMARY

For pregnant minors under age 16, the bill replaces the existing parental-notice framework with a requirement for written parental consent before an abortion, subject to the medical-emergency exception and judicial waiver. Consent may be provided by one or both parents, a grandparent, a legal guardian, or a licensed mental-health professional meeting specified independence requirements. The bill adds definitions of “neglect” and “abuse,” and requires the consent form to identify the minor, consenting parent or guardian, and attending physician and to state that the consenting party understands the procedure and consents voluntarily. Referral fees may not be charged by providers or persons authorized to give consent.

A minor unable to obtain appropriate parental consent because of abuse or neglect may petition Family Court for a waiver. The court must bypass the consent requirement upon clear and convincing evidence that the minor is mature and well-informed enough to decide independently or that consent is not in her best interest, including because of abuse, neglect, or coercion; the bill removes the existing presumption concerning married parents and grandparents. It also bars disclosure of the abortion to others after a waiver based on abuse or neglect without the minor’s written permission. The Act takes effect 30 days after enactment.

The document repeals sections 286.31, 286.311, and 381.00321, which previously restricted the use of state funds for travel related to abortion services, sex-reassignment procedures, and protected healthcare providers' conscience rights. It establishes new requirements for healthcare entities to provide written notices of refused services, submit lists of such services to the Department of Health, and maintain publicly accessible information on refused services, with policies to be adopted by October 1, 2026, and enforcement mechanisms including fines up to $5,000 per day. The department is tasked with developing rules, publishing lists of refused services, and overseeing compliance.

Additionally, the bill mandates that providers promote childbirth exclusively, ensure informational materials are current and cite sources, and deliver services that are noncoercive and free of religious content. It introduces detailed reporting obligations on service provision and expenditures, and restricts third-trimester abortions to specific conditions such as physician certification, emergencies, fetal abnormalities, or cases involving rape, incest, or trafficking, with documentation requirements. In-person physician performance of abortions is required, while telehealth and mailing of medications for medical abortions are prohibited. The bill grants the agency authority to regulate abortion clinics, including licensing, inspections, and record-keeping, and repeals section 395.3027.

The definition of "sex" is clarified to be based on reproductive anatomy, chromosomes, and hormones present at birth, and "sex-reassignment procedures" are clarified to exclude treatments for genetic or physical disorders, infections, injuries, or illnesses that could be caused or worsened by such procedures. Telehealth providers are prohibited from performing abortions via telehealth, including medical abortions. Statutes related to emergency jurisdiction and child custody enforcement are amended to include protections concerning sex-reassignment procedures. Medicaid reimbursement policies are modified to include protections for gender-affirming care, with specific provisions for hospital services and local government funding.

Finally, the bill enhances oversight of Medicaid fraud and abuse by establishing detailed reporting requirements, including annual reports to the Legislature, policy recommendations with fiscal analyses, and performance standards. It also updates provisions related to Medicaid recipient communication, the licensing deadline for Medicaid mental health service providers (set for December 31, 1998), and authorizes Medicaid payments for gender-affirming care.

The document establishes a new Section 383.295 in Florida Statutes to create the Doula Support for Healthy Births pilot program, which will operate in Broward, Miami-Dade, and Palm Beach Counties. The pilot aims to provide evidence-based doula support services to pregnant and postpartum women, particularly those overcoming substance use disorders, with the goal of improving birth outcomes. The program's duration is set between 12 and 24 months, contingent upon funding, and involves collaboration with healthcare providers and community organizations to ensure doulas meet specified criteria. Definitions for "doula" and "doula services" are included to clarify the scope of services provided.

Additionally, a Doula Certification Task Force is established within the Department of Health to review the scope of practice, develop core competencies, and recommend certification standards for doulas. The task force is tasked with setting minimum certification requirements, including education, training, supervised practice hours, background screening, and ethics education. The final report from the task force is due by January 1, 2028, and the task force will operate temporarily until October 2, 2029.

The document introduces new requirements and clarifications related to parental consent, notification, and access concerning minors' health and educational services. It mandates written parental consent for minors to receive health care services, procedures, and the use of biofeedback devices, with specific exceptions such as emergency situations or court orders. Parents are granted the right to review, inspect, and consent to surveys or questionnaires involving sensitive information, including biofeedback device results, prior to their minors' participation. The bill clarifies that minors acting alone can provide written consent for the disclosure of their treatment records, and that parental consent for disclosure is only necessary when the minor also consents. It emphasizes that minors' consent to treatment has the same legal effect as that of adults and maintains parental participation rights for involuntary admissions.

Additionally, the bill revises confidentiality and parental notification provisions for minors receiving substance abuse treatment, specifying that minors can independently consent to the disclosure of their treatment records to parents or guardians, and that parental consent for disclosure is only valid if the minor also consents. It reinforces that minors' consent to treatment is legally equivalent to that of adults and clarifies that parental rights to access health and education records are protected, including notification of changes in a student's health or related services. The bill also establishes detailed procedures and protections for parental involvement in student health services, mental health screenings, and dispute resolution processes within schools.

Furthermore, the bill reenacts statutory provisions to specify that failure to comply with parental consent requirements constitutes grounds for disciplinary action, effective July 1, 2026. Definitions are provided for terms such as "biofeedback device," "informed consent," "minor," "guardian," and related concepts to clarify the scope of these provisions. Overall, the changes reinforce parental rights and consent procedures across minors' health and educational services, emphasizing transparency, confidentiality, and the legal equivalence of minors' consent.

FULL SUMMARY

The bill creates s. 381.0026, Florida Statutes, the “Reproductive Freedom Act.” It defines abortion, pregnancy, and reproductive health care, and establishes a fundamental right to reproductive health care, including the right to use or refuse care and, for a pregnant individual, to choose whether to continue a pregnancy and give birth or obtain an abortion. The state may not deny or interfere with access to reproductive health care.

State and local law-enforcement agencies and officials may not harass, discriminate against, penalize, prosecute, or otherwise take adverse action against individuals for providing, obtaining, or assisting with reproductive health care, including based on actual, potential, perceived, or alleged pregnancy outcomes such as miscarriage, stillbirth, or abortion. Individuals exercising these rights, and those voluntarily aiding or assisting them, receive immunity from civil liability. The bill provides that a fertilized egg, embryo, or fetus has no independent rights under state law; bars local governments from imposing more restrictive regulation of reproductive health care; applies the protections to state and local laws, ordinances, rules, policies, practices, procedures, and government actions; and supersedes conflicting provisions of chapter 390, subject to severability.

The bill repeals ss. 286.31, 381.00321, and 765.113, Florida Statutes, concerning prohibited use of state funds, medical conscience rights of health care providers and payors, and consent restrictions for specified activities. It takes effect upon becoming law.

The document introduces several significant changes to Florida's healthcare statutes and regulations. It repeals statutes related to the prohibition of using state funds for travel to other states for abortion services, sex-reassignment procedures, and protections for healthcare providers' conscience rights. It establishes new requirements for covered entities to adopt policies, submit lists of refused services, notify the Department of Health of changes, and include such lists in grant or contract applications, with a deadline of October 1, 2026. The Department is tasked with publishing current refused service lists, developing public education programs, and maintaining an online list of covered entities and their refused services by January 1, 2027.

The bill mandates that health care facilities disclose refused services to patients and the Department, with penalties for non-compliance up to $5,000 per day. It also clarifies that the section does not alter existing legal liabilities or rights related to health care service denials. Additionally, it requires the development of public education and awareness programs about service denials and their impacts.

A new requirement is added that pregnancy and parenting support services must constitute at least 85% of contract funds, replacing the previous 90% threshold. The bill also prohibits telehealth abortions and the mailing or couriering of medications for medical abortions, mandating in-person performance of pregnancy termination procedures by licensed physicians.

Legal definitions are introduced or clarified for sex-reassignment prescriptions or procedures, with specific exceptions for treatments related to genetic disorders, injuries, or illnesses posing imminent danger. Emergency jurisdiction is expanded to include cases where minors are subjected to or threatened with sex-reassignment procedures, allowing courts to issue custody warrants if serious harm is likely. Reimbursement policies for Medicaid are revised to allow retroactive recalculations based on updated cost reports, with full payment at the new rate, and provisions are included for adjusting reimbursement rates, fees, and service parameters to align with available funds and legislative intent. The bill also emphasizes increased reporting and transparency in Medicaid fraud prevention, including detailed fiscal analyses, performance standards, and educational materials for recipients, along with provisions for emergency license suspension of practitioners arrested for certain offenses, including sex-reassignment procedures for minors.

FULL SUMMARY

The bill adds a new Georgia pharmacy-law provision authorizing pharmacists employed by a state-licensed hospital or pharmacy to dispense self-administered hormonal contraceptives and administer injectable hormonal contraceptives under a written joint protocol issued by the Department of Public Health and Georgia State Board of Pharmacy. The protocol, effective January 1, 2027, must address pharmacist training, patient information, documentation, practice review, and reporting. Pharmacists may not be compelled to provide these services, and existing duties concerning practitioner-prescribed contraception are unchanged.

For each new patient and at least every 12 months for returning patients, pharmacists must obtain a self-screening risk assessment, conduct a standardized patient assessment, provide the contraceptive when clinically appropriate or refer the patient to a practitioner, issue a visit summary, advise consultation with a practitioner, make required abuse referrals, and ensure confidential, infection-controlled space. Pharmacists must complete an approved contraceptive-specific certificate program incorporating federal eligibility criteria and CDC guidance, including specified initial coursework, examination, and injection assessment, and must complete at least one hour of annual continuing education. They must also provide specified written materials and counseling on use, storage, risks, backup contraception, emergency care, and sexually transmitted diseases. Pharmacists complying with the provision receive protection from criminal and civil liability.

The bill requires covered health benefit policies to cover FDA-approved contraceptive drugs and devices and provide at least a three-month supply on the first dispensing and a 12-month supply on subsequent dispensings, subject to a maximum 12-month supply in each 12-month period. Insurers may not deny reimbursement for pharmacist contraceptive services, and reimbursement must be at least the rate paid to physician assistants and nurse practitioners for the same or substantially similar service. Medicaid must provide the same supply limits and reimbursement requirements, submitting a state plan amendment or waiver request when necessary. The Act takes effect January 1, 2027, and applies to applicable insurance policies issued, delivered, or renewed on or after that date.

FULL SUMMARY

The bill changes Georgia law to protect individuals and healthcare professionals involved in pregnancy-related medical care. It bars state and local law-enforcement agencies from arresting a person for performing or assisting with an abortion, or administering treatment that may lead to an abortion, when the abortion complies with Code Section 16-12-141. It also protects individuals from investigation, civil or criminal penalties, or loss of rights based on actions or omissions concerning a pregnancy or an actual, potential, or alleged pregnancy outcome, including miscarriage, stillbirth, ectopic pregnancy, abortion, or perinatal death caused by conditions occurring in utero.

The bill expands an existing medical-care provision to cover a licensed physician who performs or assists with an abortion, or administers treatment that may lead to an abortion, to avert the pregnant woman’s death or when delay would create a serious risk of substantial or irreversible impairment of a major bodily function or death of the unborn child.

It also narrows the specified professional-discipline ground under Code Section 43-34-8 to performing, procuring, or aiding or abetting a criminal abortion that violates the requirements referenced in Code Section 16-12-141.

FULL SUMMARY

The bill establishes a statutory right to reproductive autonomy. It replaces Georgia’s existing health-law framework with a new Reproductive Freedom Act authorizing abortion by physicians, advanced practice registered nurses, and physician assistants acting within lawful scope and generally applicable, evidence-based medical standards. Individuals would have fundamental rights to continue a pregnancy, obtain an abortion, and choose or refuse contraception or sterilization; a fertilized egg, embryo, or fetus would have no independent rights under state law. State and local governments could not interfere with or enforce laws against those rights, and local regulations could not be more restrictive than the Act.

The new framework bars arrest, investigation, civil or criminal penalties, and other deprivation of rights based on a pregnancy or pregnancy outcome, including miscarriage, stillbirth, ectopic pregnancy, abortion, or in-utero causes of perinatal death. It also protects people who voluntarily assist someone exercising these rights, prohibits discrimination in enforcement on specified grounds, and permits civil actions for injunctive relief against state or local officials, with possible costs and attorney’s fees for substantially prevailing plaintiffs. Covered reproductive-health entities generally could not disclose related communications, information, or examination results without written consent, subject to HIPAA, and would have to notify individuals or their representatives of the right to refuse disclosure.

The bill revises parental-notification requirements for abortions involving unemancipated minors by allowing healthcare professionals to proceed without notice when notice may cause physical or emotional harm and the minor can give informed consent, when reasonable actual and written notice efforts fail, or when the notified parent confirms prior knowledge or declines consultation; qualifying professionals and agents receive immunity for decisions not to give notice. It retains judicial waiver procedures and adds a requirement that the minor consent freely and without coercion. The bill also removes the heartbeat-based threshold for wrongful-death recovery for an unborn child, repeals abortion-related criminal provisions, the Woman’s Right to Know Act, physician-obligation provisions, and several abortion-related licensing, disciplinary, delegation, and physician-assistant restrictions; removes abortion references from specified domestic-relations, education, and power-of-attorney provisions; and eliminates the statutory classification of an unborn child as a natural person or for population-based determinations.

Insurance provisions repeal the prohibition on abortion coverage through qualified health plans and remove abortion exclusions from specified state employee health-plan and insurance provisions. The bill removes the income-tax provision treating an unborn child with a detectable heartbeat as a dependent minor and requires the Department of Community Health to pay for all abortion and abortion-related services for Medicaid recipients. Conflicting laws are repealed.

FULL SUMMARY

The bill establishes the Reproductive Freedom Act and recognizes fundamental rights to continue a pregnancy, obtain an abortion, and choose or refuse contraception or sterilization. It provides that fertilized eggs, embryos, and fetuses have no independent rights under state law; prohibits state interference, prosecution, investigation, or penalties relating to pregnancy outcomes and lawful reproductive healthcare; protects persons who assist with such care with the pregnant person’s voluntary consent; and bars discrimination in enforcing these rights. State and local officials may be sued for injunctive relief, with costs and reasonable attorney’s fees available to substantially prevailing plaintiffs. Covered entities generally may not disclose reproductive-healthcare communications or examination information without written consent, subject to HIPAA, and must notify individuals of their right to refuse disclosure. Local governments may adopt equal or greater protections but may not impose more restrictive regulation; generally applicable, evidence-based regulation remains permitted if it is not a pretext for violating the Act.

The bill repeals Georgia’s criminal-abortion article, the Woman’s Right to Know Act, the physician-obligation chapter, and related abortion-specific licensing, disciplinary, delegation, and physician-assistant restrictions. It removes abortion-related references and restrictions from domestic-relations, education, advance-directive, and insurance statutes, including repeal of the prohibition on abortion coverage through qualified health plans and removal of the exclusion limiting state employee-plan abortion coverage. It also changes the parental-notification framework for unemancipated minors by allowing notice to be provided by a healthcare professional or qualified agent, requiring the minor’s uncoerced consent, and creating exceptions when notice may cause physical or emotional harm and the minor can provide informed consent, or when reasonable notice efforts fail; providers acting under these exceptions receive civil and criminal protection. Existing judicial-waiver procedures remain available where the statutory notice routes and exceptions do not apply.

The bill removes the rule treating a fetus with a detectable heartbeat as a dependent minor for Georgia income-tax purposes and removes the corresponding population-counting and “natural person” provisions. It adds a requirement that the Department of Community Health pay for all abortion and abortion-related services for Medicaid recipients. Conforming provisions redefine abortion by reference to the new reproductive-health chapter, repeal an abortion-related child-support provision, and remove the heartbeat-based limitation on wrongful-death recovery for an unborn child.

The bill adds Georgia Code § 1-2-12, establishing that life is valued and protected from the moment of conception and that each life from conception receives the same rights and protections guaranteed to persons under the U.S. Constitution, the Georgia Constitution, and Georgia law.

It defines “abortifacient” as a method of inhibiting human-pregnancy development at any stage after conception; “abortion” as using any means to terminate the pregnancy of a woman known to be pregnant when the termination will, with reasonable likelihood, cause the death of the unborn child; “conception” as the combination of male sperm and female ovum resulting in a fertilized ovum or zygote; and “contraception” as a method of inhibiting pregnancy development before conception. The definition of contraception expressly excludes abortifacients.

The new section specifies that it must not be construed to create or recognize a right to abortion or to prohibit any means of contraception. Laws conflicting with the Act are repealed.

FULL SUMMARY

The bill adds Chapter 9C to Georgia’s Title 31 and establishes the “Georgia Pro-Birth Accountability Act.” It entitles a pregnant woman to state compensation if she would otherwise be legally permitted to terminate the pregnancy but is compelled to continue it because of a law prohibiting abortion after a detectable fetal heartbeat.

Eligible compensation includes reasonable living, legal, medical, psychological, psychiatric, prenatal, delivery, and postpartum expenses; eligibility to claim the embryo or fetus for specified federal and state child-related tax credits and deductions after a detectable heartbeat; assignment of a specially trained nurse for home visits through the child’s second birthday; and automatic eligibility for specified public assistance, including TANF, SNAP, and WIC. TANF and SNAP benefits may not be reduced or suspended before the child reaches age 18. Additional support covers funeral and burial costs and, if the woman dies, lost future earnings; disability-related medical expenses and lost income; lifelong care for a child with a congenital abnormality or disability; the child’s health, dental, and vision insurance through age 18; child support in specified circumstances; and a fully funded Section 529 education savings trust.

To obtain compensation, the woman must file an affidavit with the Department of Human Services stating that, absent the heartbeat-based abortion prohibition, she would have chosen to terminate the pregnancy. The affidavit may be filed after a medical professional determines that a detectable heartbeat prevents termination and before birth. DHS must process claims timely, assign a case manager, develop a care plan, conduct monthly in-person prenatal meetings, review the assigned nurse’s reports, and conduct postbirth face-to-face visits as required by regulation. The General Assembly must establish a fund separate from the general fund and annually appropriate sufficient money for compensation and DHS administrative costs.

The bill adds Code section 1-2-12 to Georgia’s provisions concerning persons and their rights. It defines “abortifacient” as a method inhibiting development of a human pregnancy after conception; “abortion” as terminating a known pregnancy with knowledge that the termination will, with reasonable likelihood, cause the death of the unborn child; “conception” as combining male sperm and female ovum to produce a fertilized ovum or zygote; and “contraception” as a method inhibiting development of a pregnancy before conception, expressly excluding abortifacients.

The new section states that Georgia recognizes life as valued and protected from conception and that each life from conception receives the same rights and protections guaranteed to all persons under the U.S. Constitution, the Georgia Constitution, and Georgia law. It specifies that the section neither creates or recognizes a right to abortion nor prohibits any means of contraception. Conflicting laws and parts of laws are repealed.

FULL SUMMARY

The Act establishes separate fetal-death reporting and disposition requirements in Hawaii. A fetal-death certificate is mandatory for a fetus at least 20 weeks’ gestation, calculated from the last normal menstrual period or best ultrasound measurement, or weighing at least 350 grams when gestational age is unknown. The certificate must be filed with the Department of Health or its local agent within 14 days and before interment or other disposition. Certificates are not required for fetal deaths before 20 weeks’ gestation, fetuses weighing under 350 grams when gestational age is unknown, or pregnancies intentionally terminated under the specified medical-practice statutes.

The person responsible for disposition must prepare and file the certificate, obtain required personal and medical information, and present it to the attending physician, physician assistant, advanced practice registered nurse, or coroner’s physician for certification. If the cause cannot be determined within 14 days, the certifying provider may file later after providing the local agent written notice explaining the delay. For qualifying miscarriages below the reporting threshold, a certifying provider must, upon the birthing parent’s request, issue either a signed confirmation or an accurate copy of relevant medical records; this documentation is not prima facie evidence and has no legal standing as a bona fide government record.

The Act requires a written permit before removal, burial, or other disposition of fetal remains, but waives the permit requirement for fetal deaths below the 20-week or 350-gram thresholds and for specified intentional terminations. It separates fetal-death certificates from the general three-day death-registration system, revises related certificate and permit procedures, and authorizes the Department of Health to adopt and amend rules after notice and hearing. It also adds definitions for “department,” “physician assistant,” and “advanced practice registered nurse,” updates specified statutes to use the term “department,” and makes conforming changes to death-certificate certification and late-filing provisions. The Act takes effect upon approval, which occurred June 24, 2026.

The Senate resolution affirms and supports the requirement under the Emergency Medical Treatment and Active Labor Act (EMTALA) that hospitals provide medically necessary stabilizing emergency care to pregnant patients, including reproductive and abortion services, when needed to address life- or health-threatening conditions. It cites emergencies such as hemorrhage, ectopic pregnancy, and preeclampsia and states that EMTALA applies regardless of a patient’s ability to pay and does not provide religious exemptions.

The resolution urges all Hawaii hospitals, including religiously affiliated institutions, to continue these standards and ensure that no pregnant patient experiencing a medical emergency is denied or delayed stabilizing care. It directs certified copies to be sent to specified state officials and healthcare organizations, including the Governor, Director of Health, and representatives of Hawaii’s hospital, primary care, health plan, and medical associations.

The resolution affirms and supports the requirement under the Emergency Medical Treatment and Active Labor Act that hospitals provide medically necessary, life-saving emergency care to pregnant patients, including reproductive and abortion services, when required to stabilize an emergency medical condition.

It urges all Hawaii hospitals, regardless of religious affiliation, to continue providing this stabilizing care and to ensure that no pregnant patient experiencing a medical emergency is denied or delayed treatment. It directs certified copies to be transmitted to specified state officials and healthcare organizations, including the Governor, the Director of Health, and representatives of Hawaii’s hospital, primary care, health plan, and medical associations.

The resolution affirms and supports the requirement under the Emergency Medical Treatment and Active Labor Act that hospitals provide life-saving emergency care to pregnant patients, including reproductive and abortion services, when medically necessary to stabilize a patient with an emergency medical condition.

It urges all Hawaii hospitals, regardless of religious affiliation, to continue meeting these standards and to ensure that no pregnant patient experiencing a medical emergency is denied or delayed stabilizing care. It also directs that certified copies be transmitted to specified state health officials, healthcare organizations, health plans, and medical associations.

The resolution affirms and supports the requirement under the federal Emergency Medical Treatment and Active Labor Act (EMTALA) that hospitals provide life-saving emergency care to pregnant patients, including reproductive and abortion services, when medically necessary to stabilize an emergency medical condition. It specifically identifies conditions such as hemorrhage, ectopic pregnancy, and preeclampsia as circumstances in which abortion care may constitute necessary stabilizing treatment.

The resolution urges all Hawaii hospitals, regardless of religious affiliation, to continue following these standards and to ensure that no pregnant patient experiencing a medical emergency is denied or delayed stabilizing care. It directs that certified copies be transmitted to specified state officials and healthcare organizations.

FULL SUMMARY

The bill establishes separate fetal-death requirements in Hawaii Revised Statutes chapter 338. A certificate of fetal death is required for a fetus at least 20 weeks’ gestation or, when gestational age is unknown, at least 350 grams, and must be filed with the Department of Health or its local agent within 14 days and before interment or other disposition. No certificate or filing is required for fetal deaths under 20 weeks, under 350 grams when gestational age is unknown, or resulting from an intentional termination performed under sections 453-16 or 457-8.7. The person responsible for disposition must collect required personal information and present the certificate to a physician, physician assistant, or advanced practice registered nurse for certification and medical information.

Parents may request that the state registrar issue a certificate for a miscarriage below the mandatory threshold by submitting a prescribed request and either a health-care provider’s signed confirmation or an accurate copy of relevant medical records. The bill defines a miscarriage as a product of conception that is below 20 weeks’ gestation or, when gestational age is unknown, below 350 grams; is not born alive; and is not from an intentional termination covered by sections 453-16 or 457-8.7. If the cause of a fetal death cannot be determined within 14 days, the certifying physician, physician assistant, advanced practice registered nurse, or coroner’s physician may file the cause later after notifying the local department agent in writing of the reason.

A written permit will generally be required before fetal remains are removed from the registration district or disposed of, but not for fetal deaths below the 20-week or 350-gram threshold or resulting from an authorized intentional termination. Related death-registration provisions are revised to exclude fetal deaths from the general three-day filing and certification rules, cross-reference the new fetal-death sections, and make permits under either death or fetal-death provisions contingent on filing a certificate as far as circumstances permit. The Department of Health’s authority is updated to include adopting and amending rules after notice and hearing, and specified chapter 338 provisions replace references to the “department of health” with “department.” The Act takes effect July 1, 2026.

FULL SUMMARY

The bill adds a new Hawaii Revised Statutes chapter governing assisted reproduction agreements, including definitions for assisted reproduction, intended parents, donors, gestational carriers, surrogates, and traditional surrogates. A gestational-carrier agreement must state its execution date, identify the gamete sources or describe donated eggs, sperm, or embryos, identify the intended parents, and disclose how medical expenses for the carrier and newborns will be covered, including relevant insurance provisions and potential liabilities. The carrier and intended parent or parents must have separate independent licensed attorneys; all parties must execute the agreement with notarized or equivalent witnessed signatures; and embryo transfer or preparatory injectable medication may not begin until those requirements are completed.

The bill permits parentage proceedings to be filed before birth in specified circuits connected to the child, parties, agreement, or medical procedures. The agreement and attorney declarations must be lodged with the family court, and the parties must attest under penalty of perjury to compliance. A properly executed and filed agreement rebuts statutory parentage presumptions for the gestational carrier and the carrier’s spouse or partner. On petition, the family court must issue an order establishing the intended parent or parents’ legal parentage and declaring that the carrier and the carrier’s spouse or partner have no parental rights or duties, subject to compliance; the order may issue before birth but cannot be enforced until birth and generally requires no further hearing unless compliance is reasonably questioned or a party requests a hearing. Related court records are restricted from inspection, with disclosure allowed only under specified court-authorized circumstances and with identifying information protected where required. Compliant agreements are presumptively valid and may not be rescinded or revoked without a court order, while noncompliance rebuts that presumption. The Act takes effect upon approval.

FULL SUMMARY

The bill expands Hawaii’s existing protections for lawful reproductive health care to cover gender-affirming health care services. It prohibits covered entities from disclosing related communications, information, or examination results without written HIPAA-compliant authorization, subject to specified exceptions; bars enforcement of out-of-state subpoenas and other process seeking such information; and prohibits state agencies from providing nonpublic information or using resources to support out-of-state proceedings imposing liability for seeking, providing, receiving, paying for, inquiring about, assisting with, or materially supporting lawful reproductive or gender-affirming care. The exceptions include conduct that would also be criminal or otherwise subject to liability under Hawaii law. The State may not penalize or take adverse action against individuals based on pregnancy or gender-affirming-care outcomes or against persons assisting with lawful care, and the governor generally must deny extradition demands based on such conduct, subject to the bill’s in-state-criminality limitation and the federal constitutional exception. Foreign civil or penal judgments and orders targeting protected care may not be enforced in Hawaii.

The bill adds a public-policy rule barring Hawaii courts from applying another state’s law authorizing removal of a child from a parent or guardian because the child received or was allowed to receive gender-affirming care. It also changes child-custody jurisdiction rules: a child’s presence in Hawaii to obtain gender-affirming care satisfies the significant-connection basis for jurisdiction; inability to obtain such care can support temporary emergency jurisdiction; Hawaii courts may not decline jurisdiction as an inconvenient forum when the other state restricts a parent’s ability to obtain the care; and courts may not treat taking or retaining a child to obtain the care as a factor against a petitioner when the other state restricts access. The bill similarly bars Hawaii courts from issuing summonses compelling witnesses to participate in another state’s prosecution or grand-jury investigation involving the specified conduct, unless the conduct would also constitute an offense in Hawaii.

For marriage and family therapists, mental health counselors, physicians, osteopathic physicians, nurses, psychologists, and certain other licensed professionals, the bill prevents Hawaii licensing boards from denying, suspending, revoking, conditioning, or disciplining licenses—or relying on out-of-state discipline or convictions—when the underlying conduct involved lawful reproductive or gender-affirming care, or conduct that would have been lawful in Hawaii. It also prevents specified confidentiality disclosures and interim practice restrictions from being used in such cases. The bill takes effect upon approval. Its changes to the confidentiality provisions for marriage and family therapists and mental health counselors are preserved notwithstanding specified 2024 Act 93 changes scheduled to take effect July 1, 2026.

FULL SUMMARY

The bill adds a new Hawaii Revised Statutes chapter prohibiting physicians from performing or attempting abortions when the unborn child has a probable post-fertilization age of at least 20 weeks, subject to specified exceptions. Exceptions include abortions necessary to save the pregnant woman’s life because of a physical disorder, illness, or injury; pregnancies resulting from rape when required counseling, medical treatment, or law-enforcement reporting conditions are met; and pregnancies resulting from rape or incest involving a minor when reported to an authorized government or law-enforcement agency. The bill also prohibits dismemberment abortions, except when necessary to save the mother’s life.

Physicians must assess probable post-fertilization age before performing or attempting an abortion, use the method most likely to allow the unborn child to survive when acting under an exception unless that would create significant maternal risk, and meet specified documentation and informed-consent requirements. These include recording rape-related treatment or reporting documentation, providing and obtaining signatures on a disclosure form for abortions involving pain-capable unborn children, and maintaining the records in the patient’s file. A physician may deviate from the method and disclosure requirements only as necessary to prevent the pregnant woman’s death or substantial and irreversible impairment of a major bodily function. Counseling or medical treatment from an abortion-providing facility generally does not qualify for the rape-related exception unless provided by a hospital.

The bill requires physicians to submit annual, non-identifying summaries of abortions performed or attempted under the exceptions, including gestational age, method, location, applicable exception, and any resulting live birth. The Department of Health must compile and publicly report the information annually while protecting patient identity. Violations generally constitute a class C felony, while violations of the reporting requirement constitute a violation; dismemberment violations are class C felonies with a maximum two-year imprisonment term. Women who undergo abortions are exempt from prosecution as conspirators or accomplices and may bring civil actions for violations, with specified damages, punitive damages, attorney’s fees, and protections against monetary liability for the woman.

The bill also changes section 453-16 by conditioning abortion care provided by physicians, osteopathic physicians, and physician assistants on compliance with the new chapter; conditioning the statutory right to obtain or terminate a pregnancy on that compliance; and replacing the existing section-specific definitions of “abortion” and “nonviable fetus” with a cross-reference to the new chapter’s definition of “abortion.” It takes effect July 1, 2025.

The bill proposes adding a new Article I section to the Hawaii Constitution prohibiting the State from denying or interfering with an individual’s reproductive freedom in intimate decisions. The protected rights would include choosing to obtain an abortion of a nonviable fetus, obtaining an abortion necessary to protect the life or health of the parent, and choosing to obtain or use contraceptives.

It specifies a ballot question asking voters whether to amend the Constitution to protect reproductive freedom, expressly referencing the rights to obtain an abortion of a nonviable fetus and to obtain or use contraceptives. The constitutional amendment would take effect upon compliance with Article XVII, section 3, of the Hawaii Constitution.

FULL SUMMARY

The bill creates a new Hawaii Revised Statutes chapter, the Abortion Survivors Protection Act, governing infants born alive after an attempted abortion. It defines key terms, including “born alive” based on evidence such as breathing, a heartbeat, umbilical-cord pulsations, or voluntary movement, and requires that born-alive infants receive nourishment and medically appropriate, reasonable life-saving, life-sustaining, medical, and surgical care. The physician performing the abortion must take appropriate steps to preserve the infant’s life and health; in a hospital, the physician must provide immediate care, inform the mother, and seek transfer to an on-duty resident or emergency physician, with those duties shifting to other qualified personnel if necessary. The infant is treated as a legal person for purposes of care, may become a Department of Human Services ward if the mother previously made and did not retract a written refusal of custody, and may not be used for research or experimentation except as necessary to protect the infant’s life and health. Known failures to comply must be reported to law enforcement, while parental refusal of care that is not medically necessary or reasonable remains permitted under specified conditions.

The bill establishes criminal liability for intentionally killing a born-alive infant, reckless failure by a provider to provide required care when the infant dies, concealing the infant’s corpse to hide the birth or prevent determination of whether the infant was born alive, and prohibited research or experimentation; penalties include second-degree murder, manslaughter, the existing misdemeanor for concealing an infant’s corpse, and up to a $10,000 fine or five years’ imprisonment for the research prohibition. The mother may not be prosecuted as a conspirator or accomplice to the provider offense based on reckless failure to provide care. The mother may bring a civil action for violations by a healthcare provider, including claims based on negligence or more culpable conduct, with recoverable damages including verifiable monetary losses, up to three times the abortion or attempted abortion cost, punitive damages, other lawful relief, and prevailing-party attorney’s fees; monetary liability generally may not be imposed on the mother. Violations also support professional discipline, and a conviction automatically suspends the responsible license for at least one year.

The bill adds failure to comply with the new chapter as a disciplinary ground for physicians and nurses. It also specifies that, when an abortion is attempted but a live birth occurs, the surviving infant is treated as a newborn child for purposes of Hawaii’s offense of concealing an infant’s corpse. The new chapter does not alter existing abortion law, create or recognize a right to abortion, or change generally accepted medical standards. The Act takes effect July 1, 2025, with a stated preservation of the nursing-discipline changes despite the scheduled reenactment of the affected statute.

FULL SUMMARY

The bill adds a requirement that every new certificate of birth issued by Hawaii after the Act takes effect designate the person’s sex based on the person’s genitalia.

It changes the criteria for obtaining a new birth certificate to reflect a sex-designation change. The birth registrant must be at least 18 years old and submit an affidavit from a U.S.-licensed physician or physician assistant who has a bona fide provider-patient relationship with the registrant, has examined the registrant, and confirms that the registrant’s sex based on genitalia does not align with the existing certificate’s sex designation. The bill removes requirements that the provider have treated and evaluated the registrant, reviewed medical history, or confirmed clinical treatment and completion of a gender transition.

For certificates issued under this sex-designation process, the original certificate must be unsealed and the new certificate must be marked as amended with respect to sex designation. The new certificate must reflect any legally documented name change made before, at the same time as, or after the sex-designation change, and the Department of Health may not require medical information or records beyond those specified in the physician or physician-assistant affidavit requirements. The Act applies upon approval and preserves rights, duties, penalties, and proceedings that matured or began before its effective date.

FULL SUMMARY

The bill removes the June 30, 2025 repeal date for Hawaii’s midwife regulatory program and replaces the existing Chapter 457J framework with a new licensing program administered by the Department of Commerce and Consumer Affairs. It establishes licenses for certified midwives and certified professional midwives, with applicants required to submit an application and fees and maintain current, unencumbered national certification. Certified midwives must hold an accredited graduate degree, pass the American Midwifery Certification Board examination, and be at least 21; certified professional midwives may qualify through accredited education, a portfolio-evaluation and bridge-certificate pathway, or specified out-of-state licensure and bridge certification. The director may adopt rules, enforce and discipline under the program, and must establish an advisory committee representing midwives, the public, traditional birth attendants, and Native Hawaiian customary-practice practitioners.

The bill defines and expands the authorized scope of licensed midwives, including independent care during pregnancy, childbirth, postpartum, sexual and reproductive health, gynecology, family planning, and preconception, plus specified primary care and newborn care. Licensed midwives may order and interpret tests, perform ultrasound screenings and examinations, diagnose and treat, order devices and equipment, provide referrals and telehealth, and delegate nonjudgmental tasks subject to safety and supervision requirements. Licensed certified midwives receive additional authority—subject to department authorization and applicable limits—to prescribe medications and controlled substances, including substance-use-disorder and expedited-partner-therapy medications, manage hospital or freestanding-birthing-facility patients, order home health services, and, for certified nurse midwives, assist in surgery. Licensed certified professional midwives receive limited prescribing and birthing-facility or community-birth-home authority within their scope.

Beginning July 1, 2025, use of “licensed midwife” or an equivalent designation requires a state license, and use of “certified midwife” or “certified professional midwife” requires valid certification. Exceptions cover certified nurse-midwives licensed under Chapter 457, students, overlapping licensed professionals, limited perinatal-support providers, emergency aid, family care, protected cultural or religious practices, and traditional birth attendants who do not use legend drugs or devices and provide specified written and verbal disclosures, including training, lack of state licensure, disciplinary history, medication restrictions, and a hospital-transport plan. Health plans, including Medicaid, must cover licensed-midwife services within the applicable certified-midwife scope regardless of service location; violations may incur fines of up to $1,000 per offense. The Department of Commerce and Consumer Affairs must submit annual licensing and complaint reports to the Legislature.

The bill re-establishes a Department of Health home birth task force of up to 17 members, with statewide and county representation and participants from health agencies, physicians, emergency services, hospitals, midwives, Native Hawaiian customary practices, traditional birth attendants, home-birth stakeholders, and service users. The task force must recommend improvements concerning practitioner education, public information, home-birth and maternal-health data, hospital transfers, and public safety; its report is due 20 days before the 2026 legislative session, and it dissolves June 30, 2026. The new provisions take effect upon approval, while removal of the Chapter 457J repeal date takes effect June 29, 2025.

FULL SUMMARY

The bill adds a new Hawaii Revised Statutes chapter governing assisted reproduction agreements. It defines assisted reproduction, assisted reproduction agreements, donors, intended parents, gestational carriers, surrogates, and traditional surrogates. A gestational-carrier agreement must identify its execution date, the source and type of gametes, the intended parent or parents, and how medical expenses for the carrier and newborns will be covered, including relevant insurance provisions and potential liabilities. The carrier and intended parent or parents must have separate independent licensed attorneys, and the agreement must be signed and notarized or otherwise properly witnessed before embryo transfer or injectable preparation for transfer begins.

The bill establishes a parentage process allowing an action to be filed before birth in specified circuits, with the agreement and attorney compliance declarations lodged with the court. A properly executed and filed agreement rebuts statutory presumptions that the gestational carrier or the carrier’s spouse or partner is a parent. Upon petition and proof of compliance, the family court may issue a parentage judgment before or after birth, staying enforcement until birth, generally without a further hearing unless compliance is reasonably challenged; the order establishes the intended parent or parents’ rights and excludes the carrier and the carrier’s spouse or partner from parental rights and duties. Court records are restricted and may be disclosed only under limited judicial authorization, with identifying information of the carrier subject to redaction. Compliant agreements are presumptively valid and cannot be rescinded or revoked without a court order, while noncompliance rebuts that presumption. The Act takes effect upon approval.

FULL SUMMARY

Beginning January 1, 2026, qualified applicants may change the sex designation on a Hawaii birth certificate to male, female, or “X,” defined as a third non-binary gender option. An adult may apply for a change on the adult’s own certificate, while only a minor’s parent or legal guardian may apply for a minor; the prior physician or physician-assistant affidavit requirements are removed.

Applications must be completed, signed, and dated on a form provided by the state registrar and include the certificate holder’s full name, date and place of birth, both parents’ names as listed on the certificate, contact information, and requested sex designation. If required information cannot be provided, the applicant must explain the circumstances in writing, and the Department of Health may approve the change if the state registrar determines that the circumstances prevent obtaining one or more required items. Adult applications must be notarized and signed under penalty of perjury.

A minor’s application must include a signed statement from a licensed health care provider authorized to attest to a sex-designation change, confirming that the minor is under the provider’s care and that the requested change is consistent with the minor’s identity. The Department of Health must create and make available forms for applications for new birth certificates under all categories in section 338-17.7. The remaining provisions take effect July 1, 2025, while the birth-certificate sex-designation changes take effect January 1, 2026.

FULL SUMMARY

The bill adds a new chapter, the Abortion Survivors Protection Act, requiring that an infant born alive—including during an abortion procedure—receive nourishment and medically appropriate and reasonable medical or surgical care. The abortion physician must take medically appropriate and reasonable steps to preserve the infant’s life and health; in a hospital, the attending physician must provide immediate care, notify the mother, and seek transfer to an on-duty resident or emergency physician. If the physician cannot perform these duties, an assistant, nurse, or other healthcare provider must do so. The requirements do not prevent a parent or guardian from refusing care that is not medically necessary or reasonable, including treatment whose risks outweigh its benefits or that would only temporarily prolong dying when death is imminent. Infants born alive are treated as legal persons with corresponding rights to care; they may not be used for scientific research or medical experimentation except as necessary to protect their life and health. Covered personnel who know of noncompliance must immediately report it to law enforcement. A mother’s prior written refusal to retain custody causes a surviving infant to become immediately a ward of the Department of Human Services.

The chapter establishes criminal liability for intentionally killing a born-alive infant as second-degree murder; reckless failure by a physician, nurse, or healthcare provider to provide required care, when the infant dies as a result, as manslaughter; and concealment of an infant’s corpse to conceal the birth or prevent determination of whether the infant was born alive as the existing corpse-concealment offense. Knowingly using a born-alive infant for prohibited research or experimentation is punishable by a fine of up to $10,000, imprisonment for up to five years, or both. The mother may bring a civil action against a person who violates the physician-care requirements, seeking verifiable damages, up to three times the abortion or attempted abortion cost, punitive damages, other appropriate relief, and attorney’s fees if she prevails; a frivolous action may result in an award of the defendant’s fees, while the woman generally cannot be assessed damages or fees. A criminal conviction is prima facie evidence in the civil action.

Noncompliance provides a basis for professional discipline, including license suspension or revocation, and a person criminally convicted under the chapter automatically receives at least a one-year license suspension. The bill adds failure to comply with the new chapter to the grounds for disciplining physicians and nurses. It also specifies that, when an attempted abortion results in a live birth, the surviving infant is a “new-born child” for purposes of Hawaii’s corpse-concealment statute. The Act takes effect upon approval and does not affect matured rights or duties, incurred penalties, or proceedings begun before its effective date.

The bill proposes adding a new section to article I of the Hawaii Constitution providing that no law or state action may deny or interfere with a person’s right to obtain contraceptives or voluntarily engage in contraception.

It requires the constitutional question presented to voters to ask whether article I should be amended to establish those protections. The amendment would take effect upon compliance with article XVII, section 3, of the Hawaii Constitution.

The Department of Health must coordinate the stockpiling of mifepristone in a quantity determined by the department that is at least a one-year statewide supply.

The bill appropriates $75,000, or as much as necessary, from the state general revenues for fiscal year 2025–2026 to purchase mifepristone. The Department of Health must expend the appropriation for these purposes. The Act takes effect July 1, 3000.

FULL SUMMARY

The bill establishes protections for gender-affirming health care services under Hawaii law and extends existing protections for reproductive health care. It defines gender-affirming health care services to include medically necessary care addressing gender identity, including suppression of endogenous secondary sex characteristics, physical alignment, treatment of gender dysphoria, and developmentally appropriate mental or behavioral health care. It declares contrary out-of-state laws—including laws authorizing removal of a child from a parent or guardian because the child receives such care—to be against Hawaii public policy and prohibits their enforcement in Hawaii courts.

The bill bars covered entities from disclosing information about lawful gender-affirming or reproductive health care without written HIPAA-compliant authorization, subject to specified exceptions, and requires notice of the right to withhold consent. It prevents Hawaii courts from issuing subpoenas for out-of-state investigations involving seeking, receiving, paying for, inquiring about, providing, assisting with, attempting, or materially supporting lawful services, unless the conduct would also be an offense in Hawaii. State agencies may not provide nonpublic information or use resources to support such out-of-state proceedings, and the State may not penalize individuals for lawful care or for aiding it. The governor must deny extradition demands involving these activities unless the conduct would also be criminal in Hawaii, subject to the federal constitutional exception. Foreign civil or penal judgments interfering with protected services may not be enforced, and Hawaii courts may not compel witnesses to participate in qualifying out-of-state prosecutions or grand-jury investigations.

The bill prevents professional licensing authorities for marriage and family therapists, physicians, osteopathic physicians, nurses, mental health counselors, and psychologists from denying, restricting, or disciplining a license based on lawful gender-affirming care or assistance, including when another jurisdiction imposed discipline or a criminal conviction on that basis; comparable confidentiality protections are added for marriage and family therapists and mental health counselors. In child-custody cases involving gender-affirming care, Hawaii courts may not decline jurisdiction as an inconvenient forum when the other state restricts a parent’s ability to obtain the care, and may not weigh against a petitioner the taking or retention of a child when done to obtain such care under those circumstances. The Act takes effect December 31, 2050; specified confidentiality provisions remain in force notwithstanding provisions of the 2024 Act taking effect July 1, 2026.

The bill requires the Hawaii Department of Health to purchase and store a one-year supply of mifepristone, with the quantity determined by the department, in coordination with one or more pharmacies located in the state.

It appropriates an unspecified amount, or so much as necessary, from the state’s general revenues for fiscal year 2025–2026 to fund the purchase; the Department of Health must expend the appropriation for that purpose. The bill takes effect on December 31, 2050.

The document outlines significant amendments to Hawaii's parentage laws and family law statutes, aimed at modernizing legal frameworks to better reflect contemporary family structures and reproductive technologies. Key changes include the adoption of the Uniform Parentage Act of 2017, which introduces new legal statuses for children born to same-gender couples and clarifies the rights of non-marital children, ensuring they have the same legal rights as those born to married parents.

These updates are expected to impact various industries, particularly legal services, healthcare, and child support enforcement. Law firms specializing in family law may see increased demand for services related to parentage determinations and child support modifications. Healthcare providers, including fertility clinics and birthing centers, will need to adapt to new regulations regarding assisted reproduction and parental rights, while child support enforcement agencies may face operational changes due to the revised definitions of parentage.

The amendments also address the establishment of parent-child relationships in cases involving assisted reproduction and gestational agreements, ensuring that intended parents automatically assume legal custody upon birth. Financial responsibilities associated with surrogacy arrangements are clearly defined, which is anticipated to lead to increased demand for specialized legal services and healthcare coverage related to reproductive health.

Additionally, the revisions expand the definition of a parent to include individuals ordered to pay child support, potentially increasing the number of cases requiring legal representation. The Attorney General is granted concurrent jurisdiction in child support cases, which may lead to increased administrative costs for the state and affect the legal services industry. The court is required to use established guidelines for determining child support amounts, which may standardize payments and provide clearer expectations for parents.

Overall, these amendments aim to create a more equitable legal landscape for families, particularly those formed through assisted reproduction and non-traditional structures. The changes are expected to have significant implications for family law practices, child support enforcement agencies, and healthcare providers, potentially leading to increased legal costs and administrative responsibilities.

The bill amends Idaho Code § 18-623(1) by removing the requirement that an adult must recruit, harbor, or transport a pregnant, unemancipated minor within Idaho to commit abortion trafficking. As revised, the provision applies when an adult, intending to conceal the abortion from the minor’s parent or guardian, procures an abortion or obtains an abortion-inducing drug for the minor to use for an abortion within the state. The act declares an emergency and takes effect July 1, 2026.

The legislation establishes that performing a partial-birth abortion, resulting in the death of a human fetus or infant, is classified as a Class 4 felony. It specifies conditions under which such an abortion may be legally performed, requiring the involvement of a physician and a documented referral from another physician, with both determining that the mother's life is at risk due to a physical condition.

Additionally, the law permits maternal grandparents of the fetus or infant to seek civil relief if the mother is under 18 at the time of the abortion. This relief can include monetary damages that amount to three times the cost of the procedure.

Importantly, the legislation ensures that women who undergo a partial-birth abortion cannot be prosecuted under related criminal codes.

The affected industries primarily include healthcare providers, particularly those in obstetrics and gynecology, as well as legal services related to civil actions stemming from violations of the law. The financial implications may involve increased legal costs for healthcare providers and potential liabilities from civil actions.

FULL SUMMARY

The proposed rule replaces the existing Healthy Kids/Illinois Healthy Women framework in 89 Ill. Adm. Code 140.482–140.484 with a Family Planning Program authorized by Public Act 102-0665. It would cover family planning and related services for eligible individuals of childbearing age who are not pregnant, including examinations, STI/HIV/cervical-cancer screening, laboratory testing, contraceptive counseling and supplies, sterilization, fertility preservation, and specified related services. Related services include follow-up care for reproductive-health findings, vaccines, mammography or tomosynthesis, BRCA counseling and testing, abortion care, treatment of STI-related lesions, prenatal vitamins and folic acid, expedited partner therapy, HIV PrEP and PEP, and transportation connected with covered visits. Chronic disease treatment, including HIV/AIDS and hepatitis treatment, is excluded. Contraceptive services must be available without regard to age, sex, or marital status, and payment is limited to the provider’s usual and customary charge or the Department’s Family Planning Program fee schedule, whichever is lower.

Section 140.483 would impose federal informed-consent requirements for sterilization, including consent 30–180 days before the procedure, or at least 72 hours before procedures associated with premature delivery or emergency abdominal surgery; the patient must be at least 21 and mentally competent. Abortion care would be paid under the limitations in Section 140.413. Fertility-preservation services would require prior approval and would be limited to medically necessary office visits, pelvic ultrasounds, sperm or oocyte cryopreservation and storage, medications or injectables, and laboratory testing. Section 140.484 would be repealed.

Other changes update Sections 140.9, 140.402, and 140.413 to use gender-neutral terminology and reduce the postpartum coverage period from 12 months to 60 days, including the related copayment exemption and tobacco-cessation counseling eligibility period. Section 140.413 would also remove the requirement that every abortion claim include an HFS 2390 Abortion Payment Application. Written comments are requested within 45 days after publication of the notice; the proposed text states no effective date.

FULL SUMMARY

The bill creates the Reproductive Health Records Privacy Act. By July 1, 2027, health information exchanges must implement policies, procedures, and technical capabilities to limit access to abortion-care information; prevent its disclosure, access, transfer, transmission, or processing by persons or entities outside Illinois; segregate it from the remainder of a patient’s record; and automatically disable out-of-state access to the segregated information. Compliance fees charged to health care providers must be consistent with 45 CFR 171.302, and the requirements do not apply directly to health care providers.

A person aggrieved by a violation may seek damages, injunctive relief, or other appropriate relief, with potential recovery of reasonable attorney’s fees and costs. The Attorney General may bring an enforcement action for injunctive or equitable relief, and courts may impose a civil penalty of up to $50,000 after considering good-faith compliance efforts, patient harm, the number and magnitude of violations, duration, and the defendant’s financial condition. The bill also amends the Medical Patient Rights Act to expressly permit abortion-care information in a health information exchange to be segregated and access to it limited under the new Act, while retaining the existing patient privacy framework and its opt-out provisions. The bill provides for severability.

FULL SUMMARY

The bill changes hospital procedures for spontaneous fetal demise before 20 completed weeks. Hospitals must notify the patient of the right to arrange burial or cremation and may offer options such as a ceremony or common burial or cremation of fetal tissue, but no longer include a certificate among the listed options. If the patient makes a written election within 24 hours, no fetal death certificate is required under the Vital Records Act. The Department of Public Health must develop forms for the required notifications and elections; hospitals must provide them, and the funeral director or other person first assuming custody of the fetal remains must use the form to obtain a disposition permit.

The bill removes the provision that would have required registration of a fetal death before 20 weeks when the patient elected burial or cremation under the Hospital Licensing Act. It separately specifies that, for a fetal death before 20 weeks or an abortion as defined in the Reproductive Health Act, no fetal death certificate is required for disposition. The Department must create a form for funeral directors or others to obtain a permit for burial, entombment, or cremation, include the form as an appendix to the existing rules, and require the local registrar to seal filed forms without retaining a copy for the funeral director.

The document outlines amendments to the Illinois Insurance Code that specifically address medical liability insurance for obstetricians and gynecologists (OB-GYNs). These changes primarily impact medical liability insurance providers and OB-GYN practitioners, requiring insurance companies to evaluate premium rates based on the specific scope of practice for each insured OB-GYN.

One significant change is the classification of OB-GYNs who do not provide obstetric services, such as childbirth, as lower-risk providers. This classification is expected to result in reduced premium rates for these practitioners, potentially lowering their overall insurance costs.

The Department of Insurance is responsible for establishing guidelines to ensure fair and equitable medical malpractice premiums based on the risk profiles of OB-GYNs. These amendments aim to create a more balanced insurance landscape for medical professionals in this field.

FULL SUMMARY

The bill creates the Ultrasound Opportunity Act, requiring every facility where abortions are performed to offer a woman seeking an abortion after 8 weeks of gestation the opportunity to receive and view an active ultrasound of her unborn child. The offer must be made by the physician performing the abortion, the referring physician, or another qualified person working with either physician, and must occur before any part of the abortion is performed or induced and before anesthesia or medication is administered in preparation for it. The ultrasound may be performed at the abortion facility or at a local provider listed by the facility.

The ultrasound must be performed by a person with documented training in operating ultrasound equipment and otherwise compliant with applicable legal requirements, and the image must meet standard medical-practice quality. The facility must document the woman’s response, including the date and time of the offer and her signature confirming an informed decision to accept or decline it. The requirements do not apply when the physician determines, based on the particular facts and in the physician’s medical judgment, that a medical emergency requires immediate abortion to avert the woman’s death or prevent a serious risk of substantial and irreversible impairment of a major bodily function. The Act takes effect upon becoming law.

FULL SUMMARY

The bill establishes the Abolish Abortion Illinois Act and adds definitions to the Criminal Code’s homicide and assault-and-battery provisions. “Person,” “individual,” and “another” would include any living human being, including a preborn child from fertilization through natural death; “fertilization” means fusion of a human spermatozoon and ovum. The provisions would not apply to an unborn child’s unintentional death resulting from life-saving procedures for a pregnant woman—if reasonable steps, when available, are taken to save the unborn child—or from spontaneous miscarriage. When the victim is an unborn child, enforcement would be subject to the same presumptions, defenses, justifications, immunities, and clemencies applicable to a born human victim, and the new provisions would prevail over conflicting laws concerning an unborn child’s death or injury.

The bill repeals Criminal Code Sections 9-1.2, 9-2.1, 9-3.2, and 12-3.1, which are identified as conforming provisions concerning unborn-child homicide and battery. It also changes the Wrongful Death Act to specify that “person” includes an unborn child, define “unborn child” as a living human being at any developmental stage from fertilization to birth, and define “fertilization” as the fusion of a human spermatozoon and ovum. The Wrongful Death Act changes would apply in addition to other provisions concerning injury or death of an unborn child and supersede conflicting or inconsistent provisions; Section 2.2 of that Act would be repealed.

The bill applies prospectively only and excludes acts or neglect occurring before its effective date, including conduct for which any element occurred earlier. It contains a severability provision and takes effect upon becoming law.

The Department of Public Health is in the process of recodifying the Pregnancy Termination Report Code under 77 Ill. Adm. Code 505. This review was conducted by the Administrative Code Division on November 21, 2025.

The recodification will involve changes to the subchapter headings related to vital records, specifically moving from Subchapter e to Subchapter f. Both subchapters are focused on vital records.

The document does not provide specific details regarding the monetary impacts on business industries or any implementation dates beyond the review date.

The document outlines significant amendments to the Illinois Parentage Act of 2015, aimed at enhancing the rights and protections of children regarding parentage, regardless of their parents' marital status, gender, or sexual orientation. Key changes include a public policy declaration affirming that every child has equal rights to parentage and support, a lowered burden of proof for challenging parentage, and the establishment of legal parentage through voluntary acknowledgment by various parties involved in a child's birth.

The amendments also clarify the implications of assisted reproduction and surrogacy, recognizing individuals who consent to assisted reproduction as parents and detailing the legal processes surrounding surrogacy agreements. Genetic testing regulations are updated to restrict challenges to parentage based on assisted reproduction and to streamline the process for establishing parentage through genetic testing. Additionally, a confirmatory adoption process is established for children born through assisted reproduction.

These changes are expected to impact various sectors, including legal services, healthcare, and child welfare agencies, leading to increased demand for legal counsel and potential adjustments in administrative procedures. The financial implications may include higher legal fees, costs associated with genetic testing, and adjustments in child support calculations.

Overall, the amendments reflect a progressive shift in Illinois law towards inclusivity and recognition of diverse family structures, ensuring that all children have equal rights to parentage and support.

The document outlines amendments to the Freedom of Information Act in Illinois, focusing on enhancing privacy protections across various sectors, particularly in health care and law enforcement. Key provisions include the protection of personal information for health care professionals, especially those providing abortion-related care, ensuring their confidentiality when interacting with governmental agencies or businesses.

In the realm of public health, records pertaining to sexually transmitted infections and reproductive health are exempt from disclosure, safeguarding sensitive health information. Law enforcement is also prioritized, with exemptions for officer identification information and records related to ongoing investigations, thereby maintaining the confidentiality of critical law enforcement data.

Educational institutions are required to protect student records and data, reinforcing the privacy of students and educational staff. Additionally, confidential business information and records related to financial acts are exempt from public disclosure, which may affect businesses operating in these sectors.

Overall, the amendments establish clear guidelines for the handling of sensitive information, emphasizing the importance of privacy across multiple industries while ensuring that personal information is adequately protected from public access.

The document outlines significant amendments to various Illinois laws, particularly focusing on healthcare practices and child welfare services. Changes to abortion laws establish stricter regulations for healthcare providers, including new definitions that impact the legality of abortions and the reinstatement of previous provisions affecting healthcare facilities and practitioners.

Amendments to the Children and Family Services Act aim to enhance services for homeless and neglected children, emphasizing family preservation and financial assistance for adoptive parents of children with disabilities. The changes also address the rights of children in the welfare system, including the establishment of interest-bearing accounts and requirements for background checks for foster and adoptive parents.

The Freedom of Information Act has been amended to introduce exemptions from public disclosure, particularly for sensitive information in healthcare, law enforcement, and education, balancing confidentiality with public access. Additionally, regulations concerning Health Maintenance Organizations (HMOs) focus on financial practices, ensuring enrollees are informed about potential refunds or premium adjustments.

Changes affecting healthcare professionals include enhanced regulatory oversight and the establishment of processes for investigating complaints against licensed medical professionals. Advanced practice registered nurses (APRNs) will gain full practice authority by 2028, allowing them to operate independently and prescribe medications under certain conditions, which is expected to streamline healthcare delivery.

The document also highlights modifications to the Health Care Right of Conscience Act and the Rights of Married Persons Act, clarifying the rights of healthcare providers and spouses regarding healthcare decisions. Collectively, these amendments reshape the landscape of healthcare practice and child welfare in Illinois, impacting operational practices and the delivery of services across various sectors.

The Ultrasound Opportunity Act establishes requirements for abortion facilities in Illinois, mandating that women seeking an abortion after 8 weeks of gestation must be offered the opportunity to receive and view an active ultrasound of their unborn child. This requirement aims to ensure that women have complete and accurate information about their pregnancy, thereby promoting informed consent.

The Act impacts healthcare facilities that provide abortion services, as they must comply with the new ultrasound requirements. This compliance may involve financial implications, including costs for hiring qualified personnel, maintaining ultrasound equipment, and documenting adherence to the law.

There is a provision in the Act that exempts facilities from these requirements in cases of medical emergencies, as determined by the physician's clinical judgment. Additionally, the provisions of the Act are severable, meaning that if any part is found to be invalid, the remaining sections will still be enforceable. The Act takes effect immediately upon becoming law.

The document outlines a new provision in the Criminal Code of Illinois that establishes the offense of coercing an abortion. This law addresses the use of force, intimidation, or manipulation to compel a woman to undergo an abortion against her will, categorizing it as a Class 3 felony.

The impacted business industries include healthcare providers, particularly those involved in reproductive health services, who may need to implement additional training and protocols to ensure compliance with the new law. Legal services may also experience increased demand as individuals seek advice regarding the implications of this legislation.

Monetary impacts could arise from potential legal liabilities for healthcare providers, as well as costs associated with compliance and training. Additionally, there may be broader societal costs related to enforcement and legal proceedings stemming from violations of this law.

The effective date of the changes is not specified in the provided text.

The document outlines a new law in Illinois regarding abortion practices, particularly focusing on the care of fetuses born alive during an abortion procedure. Physicians are mandated to employ methods that prioritize the life and health of a fetus if there is a reasonable chance of survival outside the womb. Additionally, an extra physician must be present during abortions involving viable fetuses to provide immediate medical care for any child born alive.

The law requires physicians to inform women about the availability of anesthetics or analgesics to alleviate potential pain for the fetus during the abortion process. Exceptions to these requirements are permitted in cases of medical emergencies or when the use of anesthetics may hinder the fetus's chances of survival.

Healthcare providers, especially those in obstetrics and gynecology, as well as medical facilities that perform abortions, will be significantly impacted by this law. Compliance with the new regulations may lead to increased operational costs due to the necessity for additional medical personnel and adherence to new reporting standards.

Overall, the law emphasizes the protection of fetuses born alive during abortion procedures and introduces new obligations for medical professionals in Illinois.

The Ultrasound Opportunity Act establishes specific requirements for facilities performing abortions in Illinois. Physicians or qualified personnel are mandated to offer women seeking an abortion after 8 weeks of gestation the opportunity to receive and view an active ultrasound of their unborn child prior to any abortion procedure or the administration of anesthesia or medication.

Following the ultrasound, a mandatory waiting period of 72 hours must elapse before any anesthesia or medication can be administered for the abortion. However, these requirements do not apply in cases where a medical emergency is determined by the physician's clinical judgment.

Facilities are required to document the woman's response to the ultrasound offer, including the date, time, and her signature to indicate her informed decision. This legislation may have implications for healthcare providers in the reproductive health sector, as well as ultrasound service providers and legal or counseling services related to abortion.

Additionally, the Act includes a severability clause, ensuring that if any part of the legislation is found invalid, the remaining provisions will still be enforceable. The specific effective date of these changes is not mentioned.

The Parental Notice of Abortion Act of 2025 mandates that parents or adult family members be notified before an abortion is performed on an unemancipated minor or an incompetent person. This requirement is based on the belief that parental consultation is crucial due to the potential serious and long-lasting consequences of abortion on minors.

Under the Act, physicians are required to provide at least 48 hours of actual notice to an adult family member prior to the procedure. There are exceptions to this requirement, including situations where the minor is accompanied by someone entitled to notice, if notice is waived in writing, in medical emergencies, or if the minor reports abuse.

Minors have the option to petition for a judicial waiver of the notice requirement, with the process designed to be confidential and expedited to ensure timely decisions. The Act emphasizes the importance of parental involvement while also providing a legal pathway for minors who may need to bypass the notification requirement.

While the Act does not specify the financial impacts on businesses such as healthcare providers and legal services, it is anticipated that compliance with the new requirements may lead to increased administrative costs and potential legal fees related to judicial waivers.

The Parental Notice of Abortion Act of 2025 establishes requirements for parental notification prior to performing an abortion on an unemancipated minor or an incompetent person. Physicians are mandated to provide at least 48 hours of actual notice to an adult family member before the procedure, with alternative options for notification if actual notice is not feasible.

There are specific exceptions to the notification requirement, including situations where the minor is accompanied by someone entitled to notice, if notice is waived in writing, in cases of medical emergencies, or if the minor reports being a victim of abuse. Additionally, minors or incompetent persons have the option to petition for a judicial waiver of the notice requirement through expedited and confidential court proceedings.

Consent from the minor is necessary for an abortion, except in medical emergencies. The Act imposes additional administrative responsibilities on healthcare providers in the reproductive health sector, which may lead to increased compliance costs and potential legal liabilities.

Overall, the Act aims to regulate the process surrounding abortions for minors and incompetent individuals while providing certain protections and options for both patients and healthcare providers.

The document outlines amendments to the Reproductive Health Act in Illinois, focusing on informed consent requirements for abortion procedures. Physicians are mandated to provide specific information to women seeking an abortion at least 24 hours prior to the procedure. This information includes details about the nature and risks of the procedure, the probable gestational age of the fetus as verified by an ultrasound, and the medical risks associated with carrying the pregnancy to term.

An ultrasound must be conducted by a qualified individual, and women are given the option to view the live images and receive an explanation. If a woman chooses not to view the ultrasound, she is required to complete a form acknowledging her decision. Additionally, certain informed consent requirements may be waived for women who present documentation indicating they are victims of rape, incest, domestic violence, or human trafficking.

Women seeking an abortion must also receive printed materials from the Department of Public Health, which include information on fetal development, alternatives to abortion, and medical assistance benefits. In cases of medical emergencies, physicians may proceed with an abortion without fulfilling the informed consent requirements if they obtain a corroborative medical opinion regarding the necessity of the procedure.

These amendments primarily impact healthcare providers involved in reproductive health services, as well as legal and counseling services related to domestic violence and reproductive rights. The document does not specify the monetary impacts of these changes.

FULL SUMMARY

Effective July 1, 2026, the bill revises Indiana’s definitions of “abortion” and “abortion inducing drug.” The revised drug definition covers drugs or multi-drug regimens prescribed, dispensed, or administered to terminate a clinically diagnosable pregnancy with knowledge that fetal death is reasonably likely, expressly including mifepristone, misoprostol, methotrexate, and qualifying off-label uses. It excludes drugs used for other medical purposes. The bill also adds related “health facility” and “physician” definitions for the new abortion-inducing-drug chapter and provides that specified health professionals and facility personnel may not be required to participate in abortions or abortion-drug activities to which they object on ethical, moral, or religious grounds.

The bill revises abortion-complication reporting. Reports must indicate whether the abortion occurred in Indiana or elsewhere, whether medication was obtained by mail or website and identify its source, and include the facility and city or town where treatment occurred and the full name of the treating provider, along with medication, diagnosed-complication, treatment, and follow-up information. The Indiana Department of Health must forward every report to the inspector general, while continuing to compile quarterly public summaries and annual aggregate data for the federal Centers for Disease Control and Prevention without identifying information about the pregnant woman. The bill also adds allergic reactions to abortion-inducing drugs to the specified reportable complications. It makes conforming changes to provisions governing informed-consent materials, admitting-privileges records, fetal-remains disposition, anti-SLAPP protections, civil-rights liability, and unlawful transfer or collection of fetal tissue.

New IC 16-34-7 generally prohibits knowingly or intentionally manufacturing, distributing, possessing, mailing, transporting, delivering, prescribing, or providing an abortion-inducing drug to or from a person or location in Indiana, subject to exceptions for the pregnant woman’s own conduct, constitutionally protected speech, non-abortion purposes, federal-law duties, certain state-licensed Indiana providers and state facilities, Internet and cloud-service intermediaries, and drugs in continuous interstate transit. Enforcement of the prohibition is limited to civil wrongful-death actions and qui tam actions. A person involved in providing or aiding provision of such a drug may be jointly and severally liable for the wrongful death or personal injury of an unborn child or pregnant woman when the conduct contributed in any way to the injury; the mother or father may sue for wrongful death of an unborn child, subject to specified defenses and exclusions. Qui tam relators may sue violators or intended violators, with prevailing relators entitled to injunctive relief, at least $100,000 per violation, and costs and attorney’s fees; actions may be brought within 20 years. The chapter includes protections for the woman, federal actors, transportation and delivery-network participants, Internet intermediaries, qualifying common carriers, and conduct involving legally authorized abortions, and establishes venue, jurisdiction, choice-of-law, immunity, and anti-“clawback” rules. It also authorizes the attorney general to sue on behalf of unborn children of Indiana residents for specified federal-mail and interstate-carriage violations, and imposes fee shifting against persons or counsel who unsuccessfully seek declaratory or injunctive relief to block abortion restrictions or related funding limits.

The bill adds that an abortion report submitted by a health care provider to the Indiana Department of Health is a medical record under IC 5-14-3-4(a)(9), is confidential, and may not be disclosed by the department to the public under Indiana’s public-records law. The provision applies to reports required for abortions and abortion-inducing drugs, including reports transmitted separately to the Department of Child Services for patients younger than 16.

The act takes effect upon passage, and an emergency is declared.

Governor Michael K. Braun of Indiana has issued an Executive Order that mandates strict enforcement of the state's abortion laws. This order requires health care providers to submit Terminated Pregnancy Reports (TPRs) to the Indiana Department of Health (IDOH) each time an abortion is performed, reflecting the state's preference for childbirth over abortion.

The new requirements will directly impact health care providers, particularly those involved in performing abortions, as well as state agencies responsible for health and legal oversight. Compliance with these laws may lead to increased operational costs for health care providers due to the need for adherence to new reporting requirements and potential legal fees from investigations.

The order stipulates that a report evaluating IDOH's historical operations and necessary changes must be submitted to the Governor by July 1, 2025. However, the enforcement of the abortion laws is to be implemented immediately.

Overall, the Executive Order aims to enhance the enforcement of Indiana's abortion laws and ensure that both state agencies and health care providers comply with these regulations.

FULL SUMMARY

The bill adds exclusions to Iowa’s definition of abortion: treatment of miscarriage, removal of conception products after an incomplete or inevitable pregnancy loss, and treatment of an ectopic pregnancy. It also aligns the definition used in section 146E.1 with the revised definition in section 146B.1.

Before performing an abortion, a physician must conduct an in-person examination of the pregnant woman, screen for indications of coercion or abuse, and refer her to an appropriate health care provider when necessary. For chemical abortions, the physician must first obtain the patient’s signature on the applicable U.S. Food and Drug Administration patient agreement form; obtain written confirmation that the patient was informed of specified risks, including gestational-age-specific risks, hemorrhage, incomplete removal of fetal tissue, sepsis, sterility, possible continuation of pregnancy, recommended follow-up seven to fourteen days after administration, and reported trauma from seeing fetal remains; and explain how to obtain emergency surgical intervention. These requirements do not apply when the chemical abortion responds to a medical emergency. Violations may result in professional license discipline, and the Board of Medicine must adopt implementing rules.

The bill restricts dispensing abortion-inducing drugs to direct dispensing to the prescribed woman in a pharmacy, clinic, medical office, or hospital by a person authorized under section 147.107, except in a medical emergency. Violations create civil liability for all damages caused to an interested party, subject to an exception for persons already subject to specified professional license discipline; prevailing plaintiffs may recover compensatory or punitive damages, costs, and reasonable attorney fees. Court filings must redact the woman’s name and identifying information, and no civil or criminal liability is imposed on the woman. Noncompliant licensees are subject to discipline under chapters 148 or 155A.

Pregnancy-termination reporting must identify whether mifepristone or misoprostol was used in an induced termination and, for a spontaneous termination, whether the patient ingested either drug during the preceding fourteen calendar days. The definition of spontaneous termination is revised to exclude an unintended termination at twenty weeks’ gestation or later when reported as a fetal death. Chapter 146C is repealed.

FULL SUMMARY

The bill changes Iowa’s abortion definition to exclude a spontaneous termination of pregnancy, commonly called a miscarriage, when not all products of conception are expelled. Before performing an abortion, a physician must conduct an in-person examination that includes screening for coercion or abuse and must make a treatment referral when necessary. Before prescribing or dispensing an abortion-inducing drug, the physician must obtain the patient’s signed federal FDA patient agreement and written confirmation that she received specified information on gestational-age and drug-specific risks, including hemorrhage, retained tissue, sepsis, sterility, continued pregnancy, recommended follow-up within seven to 14 days, possible trauma from seeing fetal remains, and the possibility and time sensitivity of reversal. The physician must also explain how to obtain emergency surgical care; these requirements do not apply in a medical emergency, and noncompliance subjects the physician to professional discipline. The Department of Health and Human Services must publish notice and resources concerning possible chemical-abortion reversal.

The bill restricts dispensing abortion-inducing drugs—including mifepristone, misoprostol, and specified other drugs used with intent to terminate a pregnancy—to dispensing directly to the prescribed woman in a health care setting by a person authorized under Iowa Code section 147.107, except in a medical emergency. Hospitals, rural emergency hospitals, or attending physicians must report abortion-inducing-drug complications to the department within 30 days after the woman’s discharge or death. Reports must be physician-signed and include specified demographic, timing, gestational-age, provider, facility, referral, complication, and disease-code information, while excluding identifiers that could identify the woman. Reports are confidential and exempt from open-records disclosure. By December 31, 2026, and annually thereafter, the department must publish downloadable, anonymized aggregate statistics that also protect the reporting facility and physician’s identity.

A person who unlawfully dispenses an abortion-inducing drug is liable to an interested party—including the woman or her personal representative—for resulting damages, with prevailing plaintiffs eligible for compensatory and punitive damages, costs, and reasonable attorney fees. Licensed persons subject to specified professional discipline are immune from this civil liability; the woman herself incurs no civil or criminal liability, and court filings must redact her identifying information. Licensees who violate the dispensing chapter are subject to discipline. The bill also expands pregnancy-termination reporting to record whether mifepristone or misoprostol was used to induce a spontaneous termination and whether either drug was ingested during the preceding 14 days.

The bill changes terminology in Iowa Code sections 707.7 and 707.8 by replacing references to a “pregnant person” with “pregnant female” in provisions concerning feticide, attempted feticide, unlawful or nonconsensual termination of a human pregnancy, force or intimidation to obtain consent, and injury or termination caused by another person. It also makes related grammatical wording changes in the feticide and statutory-exception provisions, including replacing “where … results” constructions with direct “resulting in” or “that does not result” language and replacing “which” with “that” in the medical-procedure exception.

The bill changes the exception in section 707.7 to refer to “This section” and makes the same terminology changes in the provision exempting approved medical procedures performed by licensed physicians, including procedures performed without the pregnant female’s voluntary consent when circumstances prevent consent. In section 708.2, subsection 4, it specifies that the enhanced penalty applies to a violation of subsection 3 against a person the offender knows or reasonably should know is a pregnant female; the offense remains a class “D” felony.

The bill establishes new Iowa Code section 135.196, under which a minor may consent to prenatal, intrapartum, or postnatal care when the minor’s parent, guardian, or legal custodian is not reasonably available. The authorization applies to care provided by a physician, physician’s designee, advanced registered nurse practitioner, physician assistant, registered nurse, licensed practical nurse, or emergency medical care provider.

The provision expressly preserves each listed provider’s duty to obtain the minor patient’s informed consent for the care. These requirements appear in the new section on page 2.

The bill repeals Chapters 146C and 146E of the Iowa Code. These chapters prohibit a physician from performing an abortion after prescribed testing detects a fetal heartbeat.

FULL SUMMARY

The bill requires a physician, before performing an abortion, to conduct an in-person examination of the pregnant woman that includes screening for coercion or abuse and, when necessary, refer her to an appropriate health care provider. Before prescribing or dispensing an abortion-inducing drug, the physician must obtain the woman’s signature on the applicable federal FDA patient agreement form, written confirmation that specified risks and follow-up information were provided, and acknowledgment of possible chemical-abortion reversal resources; the physician must also explain how to obtain emergency surgical intervention for incomplete abortion, severe bleeding, or other complications. These requirements do not apply in a medical emergency, and noncompliance may result in professional license discipline. The Department of Health and Human Services must publish accessible online notice and resources regarding possible reversal of a chemical abortion, while the Board of Medicine must adopt implementing rules.

The bill restricts dispensing abortion-inducing drugs—including mifepristone, misoprostol, and other drugs used with the intent to terminate a known pregnancy—to dispensing directly to the prescribed woman in a health care setting by a person authorized under Iowa law, except in a medical emergency. Hospitals, rural emergency hospitals, or attending physicians must report specified abortion-inducing-drug complications to HHS within 30 days after the woman’s discharge or death. Reports must include patient and treatment details, the probable postfertilization age, involved physicians and facilities, and applicable disease codes, but may not identify the woman; reports are confidential and exempt from open-records disclosure. HHS must publish an anonymized, downloadable statistical report annually by December 31 based on the preceding year’s reports.

A person who unlawfully dispenses an abortion-inducing drug is strictly liable to the woman or her personal representative for resulting damages. A prevailing plaintiff may recover compensatory and punitive damages, $50,000 in statutory damages, court costs, and reasonable attorney fees. Court filings must redact identifying information about the woman, and the bill does not impose civil or criminal liability on the woman herself; licensees violating these requirements are subject to professional discipline.

For required reporting of spontaneous pregnancy terminations, the bill expands disclosure to cover whether misoprostol, as well as mifepristone, was used to induce the termination and separately requires reporting whether the patient ingested either drug within the preceding 14 calendar days. It also modifies the abortion definition so that a spontaneous termination of pregnancy is excluded when not all products of conception are expelled.

FULL SUMMARY

The bill establishes statutory findings that human life begins at conception and that Iowa has an interest in protecting human life from conception. It creates Code chapter 146F definitions for “elective abortion,” “fertilization,” “medical emergency,” and “unborn child.” Elective abortion is defined as using, prescribing, administering, procuring, or selling a drug, instrument, device, substance, or other means intended to terminate a clinically diagnosed pregnancy with knowledge that it will likely cause the death of an unborn child. Exceptions include in-vitro fertilization and fertility treatment; actions to preserve an unborn child’s life or health, treat an ectopic pregnancy, remove a deceased unborn child after miscarriage, or address a physician-determined medical emergency; miscarriage; and medical treatment not intended to cause an abortion that unintentionally injures or kills an unborn child.

The bill prohibits knowingly performing or administering an elective abortion and knowingly aiding or abetting such conduct. Licensed persons who violate the prohibition are subject to professional discipline, and the Board of Medicine must adopt administrative rules to administer and enforce it.

It revises Iowa’s feticide law by removing the requirements that intentional or attempted pregnancy termination occur after the second trimester and with the pregnant person’s knowledge and voluntary consent. Intentionally causing the death of an unborn child becomes feticide, a class A felony; attempting to cause that death when it does not result becomes attempted feticide, a class B felony. It removes the separate criminal offense for an unlicensed person who terminates a consensual pregnancy. The revised law also establishes penalties for causing an unborn child’s death during a forcible felony, causing death during another public offense, and intentionally or unintentionally causing death or serious injury through conduct likely to cause such harm. It excludes medically necessary procedures by a licensed physician to preserve the life of a pregnant woman whose life is endangered by a physical disorder, illness, or injury, as well as legally justified or excused conduct, and bars prosecution of the pregnant woman. The attorney general may prosecute violations, and Code section 707.8 is repealed. The bill takes effect upon enactment.

FULL SUMMARY

The bill requires a physician, before performing an abortion, to conduct an in-person examination of the pregnant woman that includes screening for coercion or abuse and, when necessary, referral to an appropriate health care provider. Before prescribing or dispensing an abortion-inducing drug, the physician must obtain the woman’s signature on the applicable FDA patient agreement form, secure written confirmation that specified risks and information were provided, and explain how to obtain emergency surgical intervention for incomplete abortion, severe bleeding, or other complications. The disclosures include gestational-age-specific and drug-specific risks, FDA-recommended follow-up approximately 7–14 days after administration, possible trauma from viewing fetal remains, and the possibility and resources for chemical-abortion reversal. These requirements do not apply to a chemical abortion performed in a medical emergency. The woman is not subject to civil or criminal liability, while noncompliant physicians are subject to professional discipline; the Board of Medicine must adopt implementing rules, and the Department of Health and Human Services must publish accessible online notice and resources concerning chemical-abortion reversal.

The bill prohibits dispensing an abortion-inducing drug in Iowa unless it is provided directly to the woman in a clinic, medical office, or hospital by a person authorized under Code section 147.107, except in a medical emergency. It defines abortion-inducing drugs to include mifepristone, misoprostol, and other FDA-approved drugs or substances prescribed or administered with intent to terminate a known pregnancy, including qualifying off-label use, while excluding drugs prescribed for other medical conditions. Hospitals, rural emergency hospitals, or attending physicians must file a department report within 30 days after the discharge or death of a woman treated for an abortion-inducing-drug complication. The physician-signed report must include specified demographic, treatment, timing, gestational-age, provider, facility, referring-source, complication, and applicable ICD-code information, but may not identify the woman; reports are confidential and exempt from open-records disclosure. HHS must publish anonymized aggregated statistics annually by December 31, beginning in 2026, in a downloadable format. Licensees violating these requirements face professional discipline.

A person who unlawfully dispenses an abortion-inducing drug is strictly liable to defined interested parties—including the woman, the biological father, and specified relatives or legal representatives—for resulting damages. A prevailing plaintiff may recover compensatory and punitive damages, $50,000 in statutory damages, court costs, and reasonable attorney fees. Pleadings must redact the woman’s name and identifying characteristics without a court order, and courts may issue additional privacy protections; the woman herself incurs no civil or criminal liability under this cause of action.

The bill also changes pregnancy-termination reporting requirements by requiring disclosure of whether mifepristone or misoprostol was ingested within 14 days before a spontaneous termination, and by specifying reporting of the method used for an induced termination, including whether either drug was used. It revises the definition of spontaneous termination of pregnancy to cover an unintended termination from conception through 20 weeks’ gestation, excluding a termination at 20 weeks or later reported as a fetal death, and provides that a miscarriage is excluded from the statutory definition of abortion when not all products of conception are expelled.

FULL SUMMARY

The joint resolution proposes adding Section 26, “Right to reproductive care,” to Article I of the Iowa Constitution. It would recognize reproductive freedom as a fundamental individual right and prohibit the state from denying, burdening, interfering with, or infringing that freedom or private reproductive decisions unless justified by a compelling state interest using the least restrictive means. Reproductive freedom would expressly include prenatal care, childbirth, postpartum care, contraception, sterilization, abortion care, miscarriage management, and infertility care.

The proposed section would allow regulation of abortion care after fetal viability, but would prohibit an abortion ban when, in the attending health care professional’s judgment, the abortion is medically indicated to protect the pregnant individual’s life or physical or mental health. “Fetal viability” would mean the point at which, based on the particular facts and the professional judgment of the attending health care professional, there is a significant likelihood of sustained fetal survival outside the uterus without extraordinary medical measures. If adopted, the proposal must be published for three consecutive months before the relevant election and referred to the General Assembly elected at the next general election; it would then proceed toward submission to voters for ratification.

The document outlines regulations in Iowa regarding parental notification prior to an abortion for a pregnant minor. Effective July 1, 2025, these rules require a licensed physician to notify a parent of the minor's intent to terminate a pregnancy, unless a judicial waiver is obtained or specific conditions are met.

The notification must include the minor's name, the intent to terminate the pregnancy, and the name, address, and relationship of the person being notified. The physician is responsible for maintaining the original notification form in the minor's medical record and providing a copy to the minor.

If the minor chooses to notify a grandparent instead of a parent, similar notification procedures apply. This includes a declaration regarding potential civil action against the grandparent for accepting the notification and provisions for the grandparent to refuse acceptance.

These regulations primarily impact the healthcare industry, particularly providers of abortion services, who will need to implement the notification procedures and ensure proper documentation. Overall, the rules aim to enhance parental involvement in the decision-making process concerning abortions for minors.

The document outlines new regulations affecting various aspects of medical practice, particularly in pain management, medical spas, telemedicine, and the use of medical cannabidiol and abortion procedures. It emphasizes the importance of ethical standards and patient safety in the prescribing and dispensing of medications, particularly opioids, while promoting nonopioid therapies and safeguards against substance abuse.

Key provisions include the requirement for physicians to conduct thorough evaluations and document treatment plans before prescribing opioids, as well as the necessity for participation in prescription monitoring programs. Additionally, all prescriptions must be transmitted electronically, and physicians are mandated to complete continuing medical education in medical aesthetic services annually.

The regulations also address the practice of chelation therapy, automated dispensing systems, and the responsibilities of medical directors at medical spas, ensuring proper supervision and training of nonphysician staff. Telemedicine practices are governed by guidelines that require adherence to evidence-based protocols and patient privacy standards.

Furthermore, the document outlines specific requirements for the medical use of cannabidiol, including the need for written certification and restrictions on financial relationships with manufacturers. It also details prerequisites for performing abortions, emphasizing the importance of documentation and compliance with established medical ethics.

Overall, these regulations aim to enhance the quality of care provided by healthcare professionals while ensuring that practices align with ethical standards and patient safety considerations.

The document outlines a legislative proposal in Iowa regarding medication abortions, introducing several new requirements for healthcare facilities and providers. Healthcare settings where medication abortions are performed must display signs informing patients about the potential ineffectiveness of these abortions and the possibility of reversing their effects. This requirement may impact the operations of clinics and hospitals that provide reproductive health services.

Physicians are mandated to obtain written certification from patients, confirming that they have been informed of the risks associated with medication abortions and the possibility of reversal. This could lead to increased administrative burdens for healthcare providers and may affect the overall patient experience.

Additionally, after dispensing abortion-inducing drugs, physicians must provide written discharge instructions that reiterate the information about the potential for reversal. This requirement may necessitate additional resources and time for healthcare providers.

Furthermore, regulations stipulate that mifepristone, a drug used in medication abortions, can only be dispensed directly to patients in a healthcare setting, which may affect pharmacies and healthcare providers involved in the dispensing process.

Overall, the implementation of these provisions is likely to influence the reproductive health industry, potentially increasing costs related to compliance and patient education.

The document outlines a legislative proposal in Iowa concerning medication abortions, introducing several new requirements for healthcare facilities and providers involved in administering abortion-inducing drugs. One key requirement mandates that healthcare facilities, including private offices and hospitals, post conspicuous signs informing patients about the potential ineffectiveness of medication abortions and the possibility of reversing their effects. This could lead to increased operational costs for these facilities.

Additionally, physicians are required to obtain written certification from patients, confirming that they have been informed of the risks associated with medication abortions and the possibility of reversal. This requirement may impose additional administrative burdens on healthcare providers.

The Department of Health and Human Services is tasked with publishing informational materials to educate women about the possibility of reversing medication abortions, which may incur costs related to the development and distribution of these resources.

Furthermore, the proposal includes regulations that prohibit the dispensing of mifepristone outside of a healthcare setting, potentially impacting pharmacies and other entities involved in the distribution of abortion-inducing drugs.

Overall, the implementation of these regulations is likely to significantly affect the operations of healthcare providers and facilities involved in medication abortions in Iowa.