H.R. 1797, Pain-Capable Unborn Child Protection Act

Cost Estimate
June 27, 2013

As passed by the House of Representatives on June 18, 2013

H.R. 1797 would ban abortions from being performed 20 weeks or more after fertilization, except when the pregnancy is a result of reported rape or reported incest against a minor, or is necessary to save the life of the mother. Violators of the act’s provisions would be subject to a criminal fine or imprisonment, or both.

CBO estimates that enacting H.R. 1797 would increase direct spending, primarily for Medicaid in order to cover the costs of additional births under the act. Because the number of abortions that would be averted due to the act is very uncertain, the extent of that additional Medicaid spending is also very uncertain. Depending on the number of additional births under H.R. 1797, such Medicaid costs could range from about $75 million over the next 10 years to more than $400 million over that period. Using an assumption that, under the act, about three-quarters of the abortions that would occur 20 weeks or more after fertilization under current law would instead occur earlier, and the remaining one-quarter would not occur so those pregnancies would be taken to term, CBO estimates that federal spending for Medicaid would rise by $225 million over the 2014-2023 period.

Pay-as-you-go procedures apply because enacting the legislation would affect direct spending and revenues; however, H.R. 1797 would have a negligible impact on revenues.

H.R. 1797 would impose both intergovernmental and private-sector mandates on physicians who perform abortions and would preempt state and local laws that regulate abortions. However, CBO estimates that the direct costs of the mandates would fall below the annual thresholds established in UMRA for intergovernmental and private-sector mandates. (Adjusted for inflation, those thresholds are $75 million and $150 million in 2013, respectively.)