[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2180 Introduced in House (IH)]
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115th CONGRESS
1st Session
H. R. 2180
To amend title 10, United States Code, to ensure that women members of
the Armed Forces and their families have access to the contraception
they need in order to promote the health and readiness of all members
of the Armed Forces, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
April 26, 2017
Ms. Speier (for herself, Ms. Norton, Ms. DelBene, Miss Rice of New
York, Mr. Grijalva, Mrs. Napolitano, Mr. Foster, Mr. Cicilline, Mr.
Takano, Ms. Slaughter, Mr. Lowenthal, Ms. Sinema, Ms. Bonamici, Ms.
Jayapal, Ms. Tsongas, Ms. Meng, Mr. McNerney, Mr. Heck, Ms. McCollum,
Mr. Kilmer, Mr. Hastings, Mr. Ellison, Ms. DeGette, Ms. DeLauro, Mr.
Blumenauer, Ms. Brownley of California, Ms. Pingree, Mr. Aguilar, Ms.
Roybal-Allard, Mr. Yarmuth, Ms. Moore, Ms. Schakowsky, Mr. Welch, Mr.
Bera, Ms. Eshoo, Mr. Larsen of Washington, Mr. DeFazio, Mr. Himes, Mr.
Brady of Pennsylvania, Mr. Ryan of Ohio, Mr. Sherman, Mr. Price of
North Carolina, Mr. Raskin, Ms. Judy Chu of California, Ms. Lee, Ms.
Clark of Massachusetts, Ms. Wasserman Schultz, Mr. Delaney, Ms. Esty of
Connecticut, Ms. Titus, Mr. Peters, Mr. Cohen, Mr. Correa, Mr.
Espaillat, Ms. Matsui, and Mr. Swalwell of California) introduced the
following bill; which was referred to the Committee on Armed Services
_______________________________________________________________________
A BILL
To amend title 10, United States Code, to ensure that women members of
the Armed Forces and their families have access to the contraception
they need in order to promote the health and readiness of all members
of the Armed Forces, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Access to Contraception for Women
Servicemembers and Dependents Act of 2017''.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) Women are serving in the Armed Forces at increasing
rates, playing a critical role in the national security of the
United States. Women comprise just over 15 percent of military
service members and more than 200,000 women serve on active
duty in the Armed Forces or in the Selected Reserve.
(2) More than 95 percent of women serving in the military
are of reproductive age. And approximately 1.1 million female
spouses and dependents of active duty military personnel are of
reproductive age.
(3) TRICARE covered 1.4 million women of reproductive age
in 2015, including female spouses and dependents of active duty
military personnel. For 900,000 of these women, TRICARE was
their only source of coverage.
(4) Contraception is critical for women's health and is
highly effective at reducing unintended pregnancy. The Centers
for Disease Control and Prevention describe contraception as
one of the 10 greatest public health achievements of the
twentieth century.
(5) Contraceptive access is strongly connected to women's
greater educational and professional opportunities and
increased lifetime earnings. Increased wages and increased
control over reproductive decisions provide women with
educational and professional opportunities that have increased
gender equality over the decades since contraception was
introduced.
(6) Studies have shown that when cost barriers to the full
range of methods of contraception are eliminated, and women
receive comprehensive counseling on the various methods of
contraception (including highly effective and more expensive
Long-Acting Reversible Contraceptives (LARCs)), rates of
unintended pregnancy decline. Costs can be prohibitive,
particularly for LARCs which can have high upfront costs.
(7) Research has also shown that investments in effective
contraception save public and private dollars.
(8) In order to fill gaps in coverage and access to
preventive care critical for women's health, the Affordable
Care Act (ACA) requires, all non-grandfathered individual and
group health plans to cover without cost-sharing preventive
services, including a set of evidence-based preventive services
for women supported by the Health Resources and Services
Administration (HRSA). These women's preventive services
include the full range of female-controlled U.S. Food and Drug
Administration-approved contraceptive methods, effective family
planning practices, and sterilization procedures. HRSA has
affirmed that contraceptive care includes contraceptive
counseling, initiation of contraceptive use, and follow-up care
(e.g., management, and evaluation as well as changes to and
removal or discontinuation of the contraceptive method).
(9) Under the TRICARE program, servicewomen on active duty
have full coverage of all prescription drugs, including
contraception, without cost-sharing requirements. However,
servicewomen not on active duty and female dependents of
members of the Armed Forces do not have similar coverage of all
prescription methods of contraception approved by the Food and
Drug Administration without cost-sharing.
(10) Studies indicate that servicewomen need comprehensive
counseling for pregnancy prevention, particularly in their
predeployment preparations, and the lack thereof is
contributing to unintended pregnancies among servicewomen.
(11) Research studies based on the Department of Defense
Survey of Health Related Behaviors Among Active Duty Military
Personnel found a high unintended rate of pregnancy among
servicewomen. Adjusting for the difference between age
distributions in the Armed Forces and the general population,
the rate of unintended pregnancy among servicewomen is higher
than among the general population.
(12) The Defense Advisory Committee on Women in the
Services (DACOWITS) has recommended that all the Armed Forces,
to the extent that they have not already, implement initiatives
that inform servicemembers of the importance of family
planning, educate them on methods of contraception, and make
various methods of contraception available, based on the
finding that family planning can increase the overall readiness
and quality of life of all members of the military.
(13) Health care, including family planning for survivors
of sexual assault in the Armed Forces is a critical issue,
particularly given the prevalence of sexual assault in the
military. Recent data show that women in the military are five
times more likely to be victims of sexual assault than men.
Servicewomen who are survivors of sexual assault should not be
treated differently from civilian survivors. The Department of
Defense reported that there were over 3,000 reported sexual
assaults involving service members in fiscal year 2011.
(14) Servicewomen on active duty report rates of unwanted
sexual contact at approximately 16 times those of the
comparable general population of women in the United States.
Through regulations, the Department of Defense already supports
a policy of ensuring that servicewomen who are sexually
assaulted have access to emergency contraception.
SEC. 3. CONTRACEPTION COVERAGE PARITY UNDER THE TRICARE PROGRAM.
(a) In General.--Section 1074d of title 10, United States Code, is
amended--
(1) in subsection (a), by inserting ``for Members and
Former Members'' after ``Services Available'';
(2) by redesignating subsection (b) as subsection (d); and
(3) by inserting after subsection (a) the following new
subsections:
``(b) Care Related to Prevention of Pregnancy.--Female covered
beneficiaries shall be entitled to care related to the prevention of
pregnancy described by subsection (d)(3).
``(c) Prohibition on Cost-Sharing for Certain Services.--
Notwithstanding section 1074g(a)(6), section 1075, or section 1075a of
this title or any other provision of law, cost-sharing may not be
imposed or collected for care related to the prevention of pregnancy
provided pursuant to subsection (a) or (b), including for any method of
contraception provided, whether provided through a facility of the
uniformed services, the TRICARE retail pharmacy program, or the
national mail-order pharmacy program.''.
(b) Care Related to Prevention of Pregnancy.--Subsection (d)(3) of
such section, as redesignated by subsection (a)(2) of this section, is
further amended by inserting before the period at the end the
following: ``(including all methods of contraception approved by the
Food and Drug Administration, contraceptive care (including with
respect to insertion, removal, and follow up), sterilization
procedures, and patient education and counseling in connection
therewith)''.
(c) Conforming Amendment.--Section 1077(a)(13) of such title is
amended by striking ``section 1074d(b)'' and inserting ``section
1074d(d)''.
SEC. 4. EDUCATION ON FAMILY PLANNING FOR MEMBERS OF THE ARMED FORCES.
(a) Education Programs.--
(1) In general.--Not later than one year after the date of
the enactment of this Act, the Secretary of Defense shall
establish a uniform standard curriculum that will be used in
education programs on family planning for all members of the
Armed Forces, including both men and women members.
(2) Sense of congress.--It is the sense of Congress that
the education programs should use the latest technology
available to efficiently and effectively deliver information to
members of the Armed Forces.
(b) Elements.--The uniform standard curriculum under subsection (a)
shall include the following:
(1) Information for members of the Armed Forces on active
duty to make informed decisions regarding family planning.
(2) Information about the prevention of unintended
pregnancy and sexually transmitted infections, including human
immunodeficiency virus (HIV).
(3) Information on the importance of providing
comprehensive family planning for members of the Armed Forces,
and their commanding officers, and on the positive impact
family planning can have on the health and readiness of the
Armed Forces.
(4) Current, medically accurate information.
(5) Clear, user-friendly information on the full range of
methods of contraception and where members of the Armed Forces
can access their chosen method of contraception.
(6) Information on all applicable laws and policies so that
members are informed of their rights and obligations.
(7) Information on patients' rights to confidentiality.
(8) Information on the unique circumstances encountered by
members of the Armed Forces, and the effects of such
circumstances on the use of contraception.
SEC. 5. PREGNANCY PREVENTION ASSISTANCE AT MILITARY TREATMENT
FACILITIES FOR WOMEN WHO ARE SEXUAL ASSAULT SURVIVORS.
(a) Purpose.--The purpose of this section is to provide in statute,
and to enhance, existing regulations that require health care providers
at military treatment facilities to consult with survivors of sexual
assault once clinically stable regarding options for emergency
contraception and any necessary follow-up care, including the provision
of the emergency contraception.
(b) In General.--The assistance specified in subsection (c) shall
be provided at every military treatment facility to the following:
(1) Any woman who presents at a military treatment facility
and states to personnel of the facility that she is a victim of
sexual assault or is accompanied by another individual who
states that the woman is a victim of sexual assault.
(2) Any woman who presents at a military treatment facility
and is reasonably believed by personnel of such facility to be
a survivor of sexual assault.
(c) Assistance.--
(1) In general.--The assistance specified in this
subsection shall include the following:
(A) The prompt provision by appropriate staff of
the military treatment facility of comprehensive,
medically and factually accurate, and unbiased written
and oral information about all methods of emergency
contraception approved by the Food and Drug
Administration.
(B) The prompt provision by such staff of emergency
contraception to a woman upon her request.
(C) Notification to the woman of her right to
confidentiality in the receipt of care and services
pursuant to this section.
(2) Nature of information.--The information provided
pursuant to paragraph (1)(A) shall be provided in language that
is clear and concise, is readily comprehensible, and meets such
conditions (including conditions regarding the provision of
information in languages other than English) as the Secretary
may provide in the regulations under this section.
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