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House
File
2563
-
Introduced
HOUSE
FILE
2563
BY
COMMITTEE
ON
HEALTH
AND
HUMAN
SERVICES
(SUCCESSOR
TO
HSB
704)
A
BILL
FOR
An
Act
relating
to
abortions
including
informed
consent,
1
dispensing
abortion-inducing
drugs,
and
reporting
2
abortion-inducing
drug
complications.
3
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
4
TLSB
5778HV
(2)
91
ak/ko
H.F.
2563
DIVISION
I
1
ABORTION
——
DEFINED
2
Section
1.
Section
146B.1,
subsection
1,
Code
2026,
is
3
amended
to
read
as
follows:
4
1.
“Abortion”
means
the
termination
of
a
human
pregnancy
5
with
the
intent
other
than
to
produce
a
live
birth
or
to
6
remove
a
dead
fetus.
“Abortion”
does
not
include
a
spontaneous
7
termination
of
pregnancy,
commonly
known
as
a
miscarriage,
if
8
not
all
the
products
of
conception
are
expelled.
9
DIVISION
II
10
INFORMED
CONSENT
11
Sec.
2.
Section
146A.1,
Code
2026,
is
amended
by
adding
the
12
following
new
subsection:
13
NEW
SUBSECTION
.
1A.
Prior
to
performing
an
abortion,
14
a
physician
shall
perform
an
in-person
examination
of
the
15
pregnant
woman
including
screening
for
indicia
of
coercion
or
16
abuse.
A
physician
shall,
if
necessary,
refer
the
woman
to
an
17
appropriate
health
care
provider
for
treatment
consistent
with
18
the
examination
results.
19
Sec.
3.
Section
146A.1,
subsection
6,
Code
2026,
is
amended
20
by
adding
the
following
new
paragraphs:
21
NEW
PARAGRAPH
.
0a.
“Abortion”
means
the
same
as
defined
in
22
section
146B.1.
23
NEW
PARAGRAPH
.
00a.
“Health
care
provider”
means
a
24
person
who
is
licensed,
certified,
or
otherwise
authorized
or
25
permitted
by
the
laws
of
this
state
to
administer
health
care
26
in
the
ordinary
course
of
business
or
in
the
practice
of
a
27
profession.
28
NEW
PARAGRAPH
.
0b.
“Physician”
means
the
same
as
defined
29
in
section
146B.1.
30
Sec.
4.
NEW
SECTION
.
146A.2
Dispensing
abortion-inducing
31
drugs
——
licensee
discipline.
32
1.
As
used
in
this
section,
unless
the
context
otherwise
33
requires:
34
a.
“Abortion-inducing
drug”
means
the
same
as
defined
in
35
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section
146F.1.
1
b.
“Chemical
abortion”
means
the
same
as
defined
in
section
2
146F.1.
3
c.
“Dispense”
means
the
same
as
defined
in
section
146F.1.
4
d.
“Medical
emergency”
means
the
same
as
defined
in
section
5
146A.1.
6
e.
“Pregnant”
or
“pregnancy”
means
the
human
female
7
reproductive
condition
of
having
a
living
unborn
child
within
8
the
pregnant
woman’s
body
throughout
every
stage
of
the
unborn
9
child’s
life
and
development,
from
fertilization
to
full
10
gestation
and
childbirth.
11
2.
A
physician
who
is
performing
or
attempting
to
perform
12
a
chemical
abortion
shall
do
all
of
the
following
prior
to
13
prescribing
or
dispensing
an
abortion-inducing
drug
to
a
14
pregnant
woman:
15
a.
Obtain
the
signature
of
the
woman
on
the
United
States
16
food
and
drug
administration
patient
agreement
form
required
17
for
each
abortion-inducing
drug
authorized
to
be
manufactured
18
or
sold
in
the
United
States.
19
b.
Obtain
written
confirmation
from
the
woman
that
the
woman
20
has
been
informed
of
all
of
the
following
information:
21
(1)
The
gestational
age-specific
risks
of
abortion-inducing
22
drugs.
23
(2)
The
risks
related
to
the
specific
abortion-inducing
24
drug
or
drugs
to
be
used,
including
hemorrhage,
failure
to
25
remove
all
tissue
of
the
unborn
child,
sepsis,
sterility,
and
26
possible
continuation
of
the
pregnancy.
27
(3)
That
the
United
States
federal
food
and
drug
28
administration
recommends
that
the
pregnant
woman
follow
up
29
with
the
woman’s
health
care
provider
approximately
seven
30
to
fourteen
calendar
days
after
the
administration
of
an
31
abortion-inducing
drug
to
confirm
complete
termination
of
32
pregnancy
has
occurred
and
to
evaluate
the
degree
of
bleeding.
33
(4)
That
women
using
abortion-inducing
drugs
have
suffered
34
trauma
from
seeing
the
remains
of
the
unborn
child
in
the
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process
of
a
chemical
abortion.
1
(5)
That
it
may
be
possible
to
reverse
the
intended
effects
2
of
a
chemical
abortion,
but
time
is
of
the
essence.
3
(6)
That
information
on
reversing
the
effects
of
a
chemical
4
abortion
is
available
on
the
department’s
internet
site.
5
c.
Advise
the
pregnant
woman
how
to
access
emergency
6
surgical
intervention
in
case
of
an
incomplete
abortion,
severe
7
bleeding,
or
other
medical
complications.
8
3.
Subsection
2
shall
not
apply
to
a
chemical
abortion
9
performed
in
a
medical
emergency.
10
4.
This
section
shall
not
be
construed
to
impose
civil
or
11
criminal
liability
on
a
woman
upon
whom
a
chemical
abortion
has
12
been
performed.
13
5.
A
physician
who
fails
to
comply
with
this
section
is
14
subject
to
licensee
discipline
under
chapter
148.
15
6.
The
board
of
medicine
shall
adopt
rules
pursuant
to
16
chapter
17A
to
administer
this
section.
17
Sec.
5.
NEW
SECTION
.
146A.3
Informational
materials.
18
1.
As
used
in
this
section,
“chemical
abortion”
means
the
19
same
as
defined
in
section
146F.1.
20
2.
The
department
shall
publish
on
the
department’s
21
internet
site,
in
an
easily
accessible
location
and
format,
all
22
of
the
following:
23
a.
Notice
that
it
may
be
possible
to
reverse
the
effects
of
24
a
chemical
abortion.
25
b.
Information
and
resources
on
reversing
the
effects
of
a
26
chemical
abortion.
27
DIVISION
III
28
DISPENSING
AND
REPORTING
——
ABORTION-INDUCING
DRUGS
29
Sec.
6.
NEW
SECTION
.
146F.1
Definitions.
30
As
used
in
this
chapter,
unless
the
context
otherwise
31
requires:
32
1.
“Abortion-inducing
drug”
means
any
of
the
following:
33
a.
Mifepristone.
34
b.
Misoprostol.
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c.
Any
other
drug,
measure,
or
chemical
approved
by
the
1
United
States
food
and
drug
administration
when
prescribed
or
2
administered
with
the
intent
to
terminate
the
pregnancy
of
a
3
woman
known
to
be
pregnant.
“Abortion-inducing
drug”
includes
4
off-label
use
of
a
drug
known
to
have
abortion-inducing
5
properties,
which
is
prescribed
with
the
intent
of
causing
an
6
abortion.
“Abortion-inducing
drug”
does
not
include
drugs
that
7
may
be
known
to
cause
an
abortion
but
that
are
prescribed
for
8
other
medical
conditions.
9
2.
“Abortion-inducing
drug
complication”
means
any
physical
10
or
psychological
condition
which,
in
the
reasonable
medical
11
judgment
of
a
health
care
provider,
may
occur
as
a
primary
or
12
secondary
result
of
the
patient’s
use
of
abortion-inducing
13
drugs
including
but
not
limited
to:
14
a.
Uterine
rupture,
bleeding,
or
hemorrhage.
15
b.
Failure
to
actually
terminate
the
pregnancy.
16
c.
Incomplete
abortion
or
retained
tissue.
17
d.
Missed
ectopic
pregnancy.
18
e.
Infection.
19
f.
Sepsis.
20
3.
“Chemical
abortion”
means
an
abortion
performed
by
the
21
administration
or
use
of
an
abortion-inducing
drug.
22
4.
“Department”
means
the
department
of
health
and
human
23
services.
24
5.
“Dispense”
means
to
distribute,
administer,
or
send
an
25
abortion-inducing
drug
to
the
ultimate
user.
26
6.
“Health
care
provider”
means
the
same
as
defined
in
27
section
146A.1.
28
7.
“Health
care
setting”
means
a
pharmacy,
clinic,
medical
29
office,
or
hospital.
30
8.
“Hospital”
means
the
same
as
defined
in
section
135B.1.
31
9.
“Interested
party”
means
any
of
the
following
persons:
32
a.
A
woman
upon
whom
a
chemical
abortion
was
performed
or
33
attempted.
34
b.
The
personal
representative
of
a
woman
upon
whom
a
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chemical
abortion
was
performed
or
attempted.
1
10.
“Medical
emergency”
means
the
same
as
defined
in
section
2
146A.1.
3
11.
“Personal
representative”
means
an
administrator
or
4
an
executor,
or
if
there
is
no
such
personal
representative
5
appointed,
then
a
person
legally
authorized
to
perform
6
substantially
the
same
functions.
7
12.
“Physician”
means
the
same
as
defined
in
section
146B.1.
8
13.
“Postfertilization
age”
means
the
same
as
defined
in
9
section
146B.1.
10
14.
“Pregnancy”
or
“pregnant”
means
the
same
as
defined
in
11
section
146A.2.
12
15.
“Rural
emergency
hospital”
means
the
same
as
defined
in
13
section
135B.1.
14
Sec.
7.
NEW
SECTION
.
146F.2
Dispensing
of
abortion-inducing
15
drugs
——
restrictions.
16
1.
A
person
shall
not
dispense
an
abortion-inducing
drug
in
17
this
state
unless
all
of
the
following
criteria
are
met:
18
a.
The
drug
is
dispensed
in
a
health
care
setting
directly
19
to
the
woman
prescribed
the
drug.
20
b.
The
person
dispensing
the
drug
is
authorized
to
do
so
21
pursuant
to
section
147.107.
22
2.
Subsection
1
does
not
apply
to
the
dispensing
of
an
23
abortion-inducing
drug
in
response
to
a
medical
emergency.
24
Sec.
8.
NEW
SECTION
.
146F.3
Abortion-inducing
drug
25
complication
——
reporting.
26
1.
a.
Within
thirty
calendar
days
of
the
date
of
discharge
27
or
death
of
a
woman
who
presented
with
or
was
treated
for
28
an
abortion-inducing
drug
complication,
a
hospital,
rural
29
emergency
hospital,
or
an
attending
physician
shall
file
a
30
report
with
the
department.
The
report
shall
be
in
a
form
31
prescribed
by
the
department
and
include
a
list
of
the
most
32
common
abortion
complications
and
the
most
recent
international
33
classification
of
diseases
code
as
maintained
by
the
world
34
health
organization
for
each.
The
report
must
be
completed
and
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signed
by
the
woman’s
attending
physician
and
contain
all
of
1
the
following
information:
2
(1)
The
age
of
the
woman
who
presented
with
or
was
treated
3
for
an
abortion-inducing
drug
complication.
4
(2)
The
state
and
county
of
residence
of
the
woman
who
5
presented
with
or
was
treated
for
an
abortion-inducing
drug
6
complication.
7
(3)
The
date
the
abortion-inducing
drug
was
used
by
the
8
woman.
9
(4)
The
probable
postfertilization
age
of
the
unborn
child
10
on
the
date
of
the
abortion-inducing
drug
complication.
11
(5)
The
identity
of
the
physician
who
performed
the
12
chemical
abortion,
the
facility
where
the
chemical
abortion
was
13
performed,
and
the
referring
physician,
agency,
or
service,
if
14
any.
15
(6)
The
specific
complication
or
complications
that
led
to
16
the
treatment
and
the
most
recent
international
classification
17
of
diseases
code
for
each
complication
as
maintained
by
the
18
world
health
organization,
if
applicable.
19
b.
A
report
shall
not
contain
the
name
of
the
woman
or
20
other
information
or
identifiers
that
would
make
it
possible
to
21
identify
the
woman
who
suffered
the
reported
abortion-inducing
22
drug
complication.
23
2.
A
report
filed
pursuant
to
subsection
1
shall
be
24
confidential
and
not
subject
to
disclosure
under
chapter
22.
25
3.
a.
On
or
before
December
31,
2026,
and
every
calendar
26
year
thereafter,
the
department
shall
prepare
a
comprehensive
27
statistical
report
based
upon
the
aggregated
data
gathered
from
28
reports
filed
pursuant
to
subsection
1
for
the
immediately
29
preceding
calendar
year.
The
aggregated
data
shall
be
30
anonymized
to
prevent
public
disclosure
of
either
of
the
31
following:
32
(1)
The
hospital,
rural
emergency
hospital,
or
attending
33
physician
that
filed
a
report.
34
(2)
The
woman
about
whom
a
report
was
filed.
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b.
The
anonymized
aggregated
data
shall
be
made
available
to
1
the
public
by
the
department
in
a
downloadable
format
on
the
2
department’s
internet
site.
3
Sec.
9.
NEW
SECTION
.
146F.4
Private
cause
of
action
——
4
civil
liability.
5
1.
A
person
who
dispenses
an
abortion-inducing
drug
6
in
violation
of
section
146F.2
shall
be
civilly
liable
7
to
any
interested
party
for
all
damages
caused
by
the
8
abortion-inducing
drug.
A
person
who
is
subject
to
licensee
9
discipline
under
chapter
148
or
155A
shall
be
immune
from
civil
10
liability
under
this
section.
11
2.
In
addition
to
compensatory
or
punitive
damages,
a
12
prevailing
plaintiff
who
brings
an
action
under
this
section
is
13
entitled
to
court
costs
and
reasonable
attorney
fees.
14
3.
In
an
action
brought
under
this
section,
the
name
and
15
other
identifying
characteristics
of
a
woman
who
sought
or
16
obtained
an
abortion-inducing
drug
shall
be
redacted
without
17
a
court
order
from
all
pleadings
and
documents
filed
in
the
18
action.
The
court
may
make
further
orders
as
necessary
to
19
protect
the
identity
and
privacy
of
the
woman
who
sought
or
20
obtained
an
abortion-inducing
drug.
21
4.
This
section
shall
not
be
construed
to
impose
civil
or
22
criminal
liability
on
a
woman
upon
whom
a
chemical
abortion
is
23
performed.
24
Sec.
10.
NEW
SECTION
.
146F.5
Licensee
discipline.
25
A
licensee
who
fails
to
comply
with
this
chapter
is
subject
26
to
licensee
discipline
under
chapter
148
or
155A.
27
DIVISION
IV
28
ABORTION-RELATED
PROVISIONS
29
Sec.
11.
Section
144.29A,
subsection
1,
paragraph
k,
Code
30
2026,
is
amended
to
read
as
follows:
31
k.
The
method
used
for
an
induced
termination,
including
32
whether
mifepristone
or
misoprostol
was
used.
33
Sec.
12.
Section
144.29A,
subsection
1,
Code
2026,
is
34
amended
by
adding
the
following
new
paragraph:
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2563
NEW
PARAGRAPH
.
l.
If
a
spontaneous
termination
of
1
pregnancy,
whether
the
patient
ingested
mifepristone
or
2
misoprostol
within
fourteen
calendar
days
prior
to
the
date
of
3
the
spontaneous
termination
of
pregnancy.
4
Sec.
13.
Section
144.29A,
subsection
7,
paragraph
c,
Code
5
2026,
is
amended
to
read
as
follows:
6
c.
“Spontaneous
termination
of
pregnancy”
,
commonly
known
7
as
a
miscarriage,
means
the
occurrence
of
an
unintended
8
termination
of
pregnancy
at
any
time
during
the
period
from
9
conception
to
twenty
weeks
gestation
and
which
is
not
a
10
spontaneous
termination
of
pregnancy
at
any
time
during
the
11
period
from
twenty
weeks
or
greater
which
is
reported
to
the
12
department
as
a
fetal
death
under
this
chapter
.
13
EXPLANATION
14
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
15
the
explanation’s
substance
by
the
members
of
the
general
assembly.
16
This
bill
relates
to
abortions,
including
informed
17
consent,
dispensing
of
abortion-inducing
drugs,
and
reporting
18
abortion-inducing
drug
complications.
19
DIVISION
I
——
ABORTION
DEFINED.
The
bill
excludes
20
a
spontaneous
termination
of
pregnancy,
if
not
all
the
21
products
of
conception
are
expelled,
from
the
definition
of
22
abortion
for
the
purpose
of
the
reporting
requirements
and
23
penalties
on
abortions
under
Code
chapter
146B
(abortion
——
24
postfertilization
age).
25
DIVISION
II
——
INFORMED
CONSENT.
Under
the
bill,
a
26
physician,
prior
to
performing
or
attempting
to
perform
an
27
abortion,
is
required
to
perform
an
in-person
examination
of
28
the
woman
seeking
an
abortion,
including
screening
for
indicia
29
of
coercion
or
abuse;
if
necessary,
the
physician
shall
make
a
30
referral
to
an
appropriate
health
care
provider
consistent
with
31
the
examination
results.
32
The
bill
requires
a
physician
who
is
performing
or
33
attempting
to
perform
a
chemical
abortion,
prior
to
prescribing
34
or
dispensing
an
abortion-inducing
drug,
to
do
all
of
the
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following:
have
the
woman
being
prescribed
or
dispensed
the
1
drug
sign
a
patient
agreement
form,
obtain
written
confirmation
2
that
the
physician
has
informed
the
woman
of
specific
health
3
and
safety
information
related
to
abortion-inducing
drugs
4
as
detailed
in
the
bill,
and
advise
the
pregnant
woman
how
5
to
access
emergency
surgical
intervention
in
cases
of
an
6
incomplete
abortion,
severe
bleeding,
or
other
medical
7
complications.
The
bill
specifies
that
these
requirements
8
shall
not
apply
to
a
chemical
abortion
performed
in
response
to
9
a
medical
emergency.
The
bill
provides
that
the
prohibition
on
10
dispensing
of
abortion-inducing
drugs
shall
not
be
construed
11
to
impose
civil
or
criminal
liability
on
a
woman
upon
whom
12
a
chemical
abortion
has
been
performed.
Under
the
bill,
13
a
physician
who
fails
to
comply
with
the
informed
consent
14
requirements
is
subject
to
licensee
discipline.
The
bill
15
requires
the
board
of
medicine
to
adopt
rules
to
administer
16
this
division
of
the
bill.
The
bill
defines
“abortion-inducing
17
drug”,
“chemical
abortion”,
“dispense”,
“medical
emergency”,
18
and
“pregnant”
or
“pregnancy”.
19
The
bill
requires
the
department
of
health
and
human
20
services
(HHS)
to
publish
on
HHS’s
internet
site
notice
that
it
21
may
be
possible
to
reverse
the
effects
of
a
chemical
abortion,
22
and
information
and
resources
on
reversing
the
effects
of
a
23
chemical
abortion.
24
DIVISION
III
——
DISPENSING
AND
REPORTING
——
25
ABORTION-INDUCING
DRUGS.
The
bill
defines
“abortion-inducing
26
drug”,
“abortion-inducing
drug
complication”,
“chemical
27
abortion”,
“dispense”,
“health
care
setting”,
“interested
28
party”,
“medical
emergency”,
“physician”,
“postfertilization
29
age”,
and
“rural
emergency
hospital”.
30
The
bill
prohibits
a
person
from
dispensing
an
31
abortion-inducing
drug
in
this
state
unless
the
drug
is
32
dispensed
in
a
health
care
setting
directly
to
the
woman
33
prescribed
the
drug,
and
the
person
dispensing
the
drug
is
34
authorized
to
do
so
pursuant
to
Code
section
147.107
(drug
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dispensing,
supplying,
and
prescribing
——
limitations).
These
1
requirements
do
not
apply
to
a
medical
emergency.
2
The
bill
requires
a
hospital,
rural
emergency
hospital,
3
or
the
attending
physician
to
file
a
report
with
HHS
using
a
4
prescribed
form
within
30
days
of
discharge
or
death
of
a
woman
5
who
presented
with
or
was
treated
for
an
abortion-inducing
6
drug
complication.
The
form
must
be
signed
and
completed
7
by
the
attending
physician
and
contain
the
age
of
the
woman
8
experiencing
the
abortion-inducing
drug
complication,
9
the
woman’s
state
and
county
of
residence,
the
date
the
10
abortion-inducing
drug
was
used
by
the
woman,
and
the
probable
11
postfertilization
age
of
the
unborn
child
at
the
time
of
12
the
abortion-inducing
drug
complication.
The
report
must
13
identify
the
physician
who
performed
the
chemical
abortion,
14
the
facility
where
the
chemical
abortion
was
performed,
15
the
referring
physician,
agency,
or
service,
if
any,
and
16
the
specific
complication
or
complications
that
led
to
the
17
treatment
performed
along
with
the
most
recent
international
18
classification
of
diseases
code
for
each,
if
applicable.
The
19
report
shall
be
confidential
and
not
subject
to
disclosure
20
under
Code
chapter
22
(open
records).
21
The
bill
also
requires
HHS
to
prepare
annually
on
or
22
before
December
31
a
comprehensive
statistical
report
based
23
upon
the
aggregated
data
gathered
from
the
reports
filed
on
24
abortion-inducing
drug
complications.
Under
the
bill,
the
data
25
gathered
by
HHS
must
be
anonymized
to
prevent
public
disclosure
26
of
either
the
physician
or
hospital
that
filed
a
report,
or
the
27
woman
about
whom
a
report
is
filed.
HHS
is
required
to
make
the
28
anonymized
data
publicly
available
in
a
downloadable
format
on
29
its
internet
site.
30
This
division
of
the
bill
imposes
civil
liabilities
on
any
31
person
who
dispenses
an
abortion-inducing
drug
in
violation
32
of
this
division
of
the
bill
for
all
damages
caused
by
the
33
abortion-inducing
drug
suffered
by
a
woman
upon
whom
a
chemical
34
abortion
was
performed
or
was
attempted
or
the
personal
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representative
of
the
woman
upon
whom
a
chemical
abortion
was
1
performed
or
was
attempted.
A
licensed
pharmacist
or
physician
2
is
immune
from
civil
liability.
The
bill
defines
“personal
3
representative”
as
an
administrator
or
an
executor,
or
if
there
4
is
no
such
personal
representative
appointed,
then
a
person
5
legally
authorized
to
perform
substantially
the
same
functions.
6
A
prevailing
plaintiff
in
an
action
brought
under
this
division
7
of
the
bill,
in
addition
to
compensatory
and
punitive
damages,
8
is
entitled
to
court
costs
and
reasonable
attorney
fees.
In
9
an
action
brought
under
this
division
of
the
bill,
the
name
10
and
other
identifying
characteristics
of
a
woman
who
sought
or
11
obtained
an
abortion-inducing
drug
shall
be
redacted
from
all
12
pleadings
and
documents
filed
in
the
action
without
a
court
13
order,
and
the
court
may
make
further
orders
as
necessary
to
14
protect
the
identity
and
privacy
of
the
woman
who
sought
or
15
obtained
an
abortion-inducing
drug.
This
division
of
the
bill
16
is
not
to
be
construed
to
impose
civil
or
criminal
liability
17
upon
a
woman
upon
whom
a
chemical
abortion
is
performed.
18
Under
the
bill,
a
licensed
pharmacist
or
physician
that
19
fails
to
comply
with
this
division
of
the
bill
is
subject
to
20
licensee
discipline.
21
DIVISION
IV
——
ABORTION-RELATED
PROVISIONS.
The
bill
amends
22
Code
section
144.29A
(termination
of
pregnancy
reporting
——
23
legislative
intent)
to
require
a
health
care
provider
that
24
diagnoses
or
induces
a
spontaneous
termination
of
pregnancy
25
to
include
in
the
required
report
to
HHS
if
mifepristone
or
26
misoprostol
was
used
to
induce
a
spontaneous
termination
of
27
pregnancy.
Current
law
requires
the
health
care
provider
to
28
only
disclose
if
mifepristone
was
used
to
induce
a
spontaneous
29
termination
of
pregnancy.
The
bill
also
requires
the
health
30
care
provider
to
disclose
whether
mifepristone
or
misoprostol
31
were
ingested
by
the
patient
within
14
days
prior
to
the
32
spontaneous
termination
of
pregnancy.
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