Secures protections for patients and providers accessing and providing reproductive health care services; establishes right of residents to reproductive health care activity that is restricted in other states.*

All references to gender-affirming health care services were removed throughout the bill. The introduced version protected both reproductive and gender-affirming care; the substitute covers only reproductive health care.

The entire legislative findings section (Section 1 of the introduced version) was deleted, which had cited statistics on post-Roe restrictions, picketing increases, violent incidents at gender-affirming care facilities, and the Alabama embryo rights ruling.

The facility definition changed from 'reproductive or gender-affirming health care services facility' to the broader 'health care services facility,' meaning any hospital, clinic, office, or site providing health care services is now covered by the obstruction and interference provisions.

The prohibition on state entities assisting interstate investigations (C.2A:84A-22.19) was expanded to also cover federal investigations 'to the extent permitted by federal law,' not just interstate ones.

The section amending C.10:7-2 to establish a fundamental constitutional right to reproductive choice (contraception, pregnancy decisions, assisted reproduction) and making it enforceable under the NJ Civil Rights Act was removed.

The section declaring that 'a fertilized egg, embryo, or fetus shall not have independent rights under the laws of this State' was removed.

A new section amends C.17:30D-22 to prohibit medical malpractice insurers from increasing premiums when a provider is dismissed within 180 days of the last responsive pleading, and from taking adverse action (denial of coverage, sanctions, fines, rate increases) against a provider based on the patient being a resident of a state where the service is illegal or based on out-of-state license revocation tied to reproductive health care activity.

The definition of 'reproductive health care services' was expanded to explicitly include telehealth, assisted reproduction technology, miscarriage management, and services supporting a person's alignment with gender identity (previously covered under the separate 'gender-affirming health care services' definition). A new definition for 'assisted reproductive technology' was added by reference to C.9:17-62.

The term 'legally protected health care activity' was replaced with 'reproductive health care activity,' which is broader in conduct covered (adds advising, aiding, facilitating, encouraging, referring for, providing material support for) but narrower in scope (excludes gender-affirming care).

The dispersal order section (introduced Section 9) was deleted. This had allowed law enforcement to order immediate dispersal of gatherings that substantially impeded access to reproductive or gender-affirming care facilities, with a 25-foot boundary and eight-hour duration.

The specific criminal provisions for videotaping/filming within 100 feet of a facility entrance without consent (introduced paragraph 5) and for disclosing/distributing such recordings (introduced paragraph 6) were removed from the interference crime.

A new paragraph was added to the interference crime covering conduct that causes a reasonable person to suffer damage to business or personal reputation, financial harm, or emotional harm on the basis that the person provides, volunteers with, assists with, or receives reproductive health care services.

Civil enforcement authority was expanded from only the Attorney General to also include county and municipal prosecutors who may bring civil actions for injunctions, compensatory damages, and civil penalties.

The repeal section (introduced Section 12) that would have repealed C.2A:65A-5 through C.2A:65A-7, C.9:17A-1.1 through C.9:17A-1.12, and C.30:4D-6.1 was removed.

The lengthy amendment to the medical examiner statute (C.26:6B-10) from the introduced version was removed entirely.

The licensing board protection (amending C.45:1-22) was strengthened with 'notwithstanding any provision of law to the contrary' language and changed from protecting against penalties based on providing/authorizing/participating in abortion or gender-affirming care for out-of-state residents, to a broader prohibition on any penalty based solely on engaging in reproductive health care activity as defined in the bill.