Subject to subsection (b), no funds appropriated by Congress for the purpose of paying (directly or indirectly) for the provision of health care services may be used—

(1) to provide any health care item or service furnished for the purpose of causing, or for the purpose of assisting in causing, the death of any individual, such as by assisted suicide, euthanasia, or mercy killing;

(2) to pay (directly, through payment of Federal financial participation or other matching payment, or otherwise) for such an item or service, including payment of expenses relating to such an item or service; or

(3) to pay (in whole or in part) for health benefit coverage that includes any coverage of such an item or service or of any expenses relating to such an item or service.

Nothing in subsection (a), or in any other provision of this chapter (or in any amendment made by this chapter), shall be construed to apply to or to affect any limitation relating to—

(1) the withholding or withdrawing of medical treatment or medical care;

(2) the withholding or withdrawing of nutrition or hydration;

(3) abortion; or

(4) the use of an item, good, benefit, or service furnished for the purpose of alleviating pain or discomfort, even if such use may increase the risk of death, so long as such item, good, benefit, or service is not also furnished for the purpose of causing, or the purpose of assisting in causing, death, for any reason.

Subject to subsection (b), with respect to health care items and services furnished—

(1) by or in a health care facility owned or operated by the Federal government, or

(2) by any physician or other individual employed by the Federal government to provide health care services within the scope of the physician’s or individual’s employment,

Subsection (a) applies to funds appropriated under or to carry out the following:

Subsection (a) applies to funds appropriated under or to carry out the following:

(A) Medicare program Title XVIII of the Social Security Act [42 U.S.C. 1395 et seq.].

(B) Medicaid program Title XIX of the Social Security Act [42 U.S.C. 1396 et seq.].

(C) Title XX social services block grant Title XX of the Social Security Act [42 U.S.C. 1397 et seq.].

(D) Maternal and child health block grant program Title V of the Social Security Act [42 U.S.C. 701 et seq.].

(E) Public Health Service Act The Public Health Service Act [42 U.S.C. 201 et seq.].

(F) Indian Health Care Improvement Act The Indian Health Care Improvement Act [25 U.S.C. 1601 et seq.].

(G) Federal employees health benefits program Chapter 89 of title 5.

(H) Military health care system (including Tricare and CHAMPUS programs) Chapter 55 of title 10.

(I) Veterans medical care Chapter 17 of title 38.

(J) Health services for Peace Corps volunteers Section 2504(e) of title 22.

(K) Medical services for Federal prisoners Section 4005(a) of title 18.

The provisions of subsection (c) apply to facilities and personnel of the following:

(A) Military health care system The Department of Defense operating under chapter 55 of title 10.

(B) Veterans medical care The Veterans Health Administration of the Department of Veterans Affairs.

(C) Public Health Service The Public Health Service.

(3) Nonexclusive list Nothing in this subsection shall be construed as limiting the application of subsection (a) to the programs specified in paragraph (1) or the application of subsection (c) to the facilities and personnel specified in paragraph (2).

(Pub. L. 105–12, § 3, Apr. 30, 1997, 111 Stat. 23.)