S.F. 297 Section 1. Section 146.1, Code 2023, is amended by striking 1 the section and inserting in lieu thereof the following: 2 146.1 Protection of religious beliefs and moral convictions 3 of health care providers and health care facilities. 4 1. For the purposes of this section: 5 a. “Health care facility” or “facility” means a public 6 or private hospital, clinic, center, medical school, medical 7 training institution, health care business, physician office, 8 infirmary, dispensary, ambulatory surgical center, or other 9 institution or location or business wherein medical care or 10 pharmaceuticals are provided to any person. 11 b. “Health care provider” means a person who is licensed, 12 certified, or otherwise authorized or permitted by the law of 13 this state to administer health care in the ordinary course of 14 business or in the practice of a profession. 15 c. “Person” means the same as defined in section 4.1. 16 d. “Religious beliefs and moral convictions” means the 17 religious, moral, ethical, or philosophical beliefs or 18 principles held by a person. If the person is other than an 19 individual, “religious beliefs and moral convictions” means 20 religious beliefs and moral convictions as determined by 21 reference to that person’s governing documents, including but 22 not limited to any published religious, moral, ethical, or 23 philosophical guidelines or directives; mission statements; 24 constitutions; articles of incorporation; bylaws; policies; or 25 regulations. 26 2. It is the public policy of the state to protect the 27 religious beliefs and moral convictions of health care 28 providers as a necessary prerequisite to health care providers 29 acting in good faith to fulfill their professional obligation 30 to do no harm. 31 3. A health care provider who may lawfully perform, 32 assist, or participate in, or provide a referral for, any 33 medical procedure, surgery, treatment, counseling, or 34 prescribing in this state, regardless of whether the health 35 -1- LSB 2180XS (3) 90 pf/rh 1/ 5

S.F. 297 care provider’s place of employment is private or public, has 1 the right to refuse to perform, assist, or participate in, 2 or provide a referral for the medical procedure, surgery, 3 treatment, counseling, or prescribing, if to do so would 4 violate that health care provider’s religious beliefs and 5 moral convictions. A person shall not discriminate against 6 any health care provider in any way, including but not limited 7 to employment, promotion, advancement, transfer, licensing, 8 education, training, or the granting of hospital privileges 9 or staff appointments, because of the health care provider’s 10 performance, assistance, participation in, or provision of a 11 referral for, or refusal to perform, assist, participate in, 12 or provide a referral for, any medical procedure, treatment, 13 counseling, prescribing, or surgery due to the person’s 14 religious beliefs and moral convictions. 15 4. a. A health care facility that is not controlled, 16 maintained, and supported by a public authority shall not 17 be required to provide a referral for or permit any medical 18 procedure, surgery, treatment, counseling, or prescribing if to 19 do so would violate the facility’s religious beliefs and moral 20 convictions. 21 b. This section shall not be construed to require a facility 22 to accept a patient for any procedure, surgery, treatment, 23 counseling, or prescribing that would violate the facility’s 24 religious beliefs and moral convictions. 25 c. The refusal to provide a referral for or permit a medical 26 procedure, surgery, treatment, counseling, or prescribing 27 that would violate the facility’s religious beliefs and moral 28 convictions shall not be grounds for civil liability nor a 29 basis for any disciplinary or other recriminatory action 30 against a health care provider or a health care facility. 31 5. This section shall not be construed to allow any person 32 to deny visitation, to deny recognition of a designated 33 representative for health care decision making, or to deny 34 emergency medical examination or treatment as required by law 35 -2- LSB 2180XS (3) 90 pf/rh 2/ 5

S.F. 297 pursuant to the Emergency Medical Treatment and Active Labor 1 Act, 42 U.S.C. §1395dd. 2 6. A civil action for damages, injunctive relief, or any 3 other appropriate relief may be brought by any health care 4 provider or health care facility protected by this section for 5 a violation of this section. This section may be used as a 6 defense in any action related to or arising out of the exercise 7 of rights protected under this section. 8 7. If any provision of this section or its application to 9 any person or circumstance is held invalid, the invalidity does 10 not affect other provisions or applications of this section 11 which can be given effect without the invalid provision or 12 application, and to this end the provisions of this section are 13 severable. 14 Sec. 2. Section 146D.1, subsection 4, paragraph a, Code 15 2023, is amended to read as follows: 16 a. “Abortion” means as defined in section 146.1 the 17 termination of a human pregnancy with the intent other than to 18 produce a live birth or to remove a dead fetus. Abortion does 19 not include medical care which has as its primary purpose the 20 treatment of a serious physical condition requiring emergency 21 medical treatment necessary to save the life of a mother . 22 Sec. 3. Section 707.8A, subsection 1, paragraph a, Code 23 2023, is amended to read as follows: 24 a. “Abortion” means abortion as defined in section 146.1 the 25 termination of a human pregnancy with the intent other than to 26 produce a live birth or to remove a dead fetus. Abortion does 27 not include medical care which has as its primary purpose the 28 treatment of a serious physical condition requiring emergency 29 medical treatment necessary to save the life of a mother . 30 Sec. 4. REPEAL. Section 146.2, Code 2023, is repealed. 31 EXPLANATION 32 The inclusion of this explanation does not constitute agreement with 33 the explanation’s substance by the members of the general assembly. 34 This bill relates to the protection of religious beliefs 35 -3- LSB 2180XS (3) 90 pf/rh 3/ 5

S.F. 297 and moral convictions of health care providers and health care 1 facilities. 2 The bill replaces Code section 146.1 (liability of persons 3 relating to performance of abortions) with a new Code section 4 146.1 (protection of religious beliefs and moral convictions of 5 health care providers and health care facilities). 6 The bill provides definitions for the purposes of the new 7 Code section, including “health care facility” or “facility”, 8 “health care provider”, “person”, and “religious beliefs and 9 moral convictions”. 10 The bill provides that it is the public policy of the 11 state to protect the religious beliefs and moral convictions 12 of health care providers as a necessary prerequisite to 13 health care providers acting in good faith to fulfill their 14 professional obligation to do no harm. 15 The bill provides that a health care provider who may 16 lawfully perform, assist, participate in, or provide a referral 17 for, any medical procedure, surgery, treatment, counseling, or 18 prescribing in this state, regardless of whether the health 19 care provider’s place of employment is private or public, 20 has the right to refuse to perform, assist, or participate 21 in, or provide a referral for, the medical procedure, 22 surgery, treatment, counseling, or prescribing, if to do so 23 would violate that health care provider’s religious beliefs 24 and moral convictions. The bill prohibits a person from 25 discriminating against any health care provider in any way 26 because of the health care provider’s performance, assistance, 27 or participation in, or provision of a referral for, or refusal 28 to perform, assist, or participate in, or provide a referral 29 for, any medical procedure, treatment, counseling, prescribing, 30 or surgery due to the person’s religious beliefs and moral 31 convictions. 32 Under the bill, a health care facility that is not 33 controlled, maintained, and supported by a public authority 34 shall not be required to provide a referral for or permit 35 -4- LSB 2180XS (3) 90 pf/rh 4/ 5

S.F. 297 any medical procedure, surgery, treatment, counseling, or 1 prescribing if to do so would violate the facility’s religious 2 beliefs and moral convictions. The bill is not to be construed 3 to require a facility to accept a patient for any procedure, 4 surgery, treatment, counseling, or prescribing that would 5 violate the facility’s religious beliefs and moral convictions. 6 The refusal to provide a referral for or permit a medical 7 procedure, surgery, treatment, counseling, or prescribing 8 that would violate the facility’s religious beliefs and moral 9 convictions shall not be grounds for civil liability nor a 10 basis for any disciplinary or other recriminatory action 11 against a health care provider or a health care facility. 12 The bill is not to be construed to allow any person to deny 13 visitation, to deny recognition of a designated representative 14 for health care decision making, or to deny emergency medical 15 examination or treatment as required by the federal Emergency 16 Medical Treatment and Active Labor Act. 17 A health care provider or health care facility may bring 18 a civil action for damages, injunctive relief, or any other 19 appropriate relief for a violation of the bill. The bill may 20 be used as a defense in any action related to or arising out of 21 the exercise of rights protected under the bill. 22 The bill includes a severability clause and makes other 23 conforming changes in the Code to harmonize the provisions of 24 the bill. 25 -5- LSB 2180XS (3) 90 pf/rh 5/ 5