Emergency Contraception Access and Education Act of 2014

Summary: Emergency Contraception Access and Education Act of 2014 - Prohibits payment to a hospital under titles XVIII (Medicare) or XIX (Medicaid) of the Social Security Act unless the hospital promptly provides information about emergency contraception to any woman who arrives at the hospital and is stated to be, or hospital staff have reason to believe is, a victim of sexual assault. Requires the Director of the Centers for Disease Control and Prevention (CDC) to develop and disseminate information on emergency contraception. Directs the Administrator of the Health Resources and Services Administration (HRSA) to develop and disseminate to health care providers, including pharmacists, information on emergency contraception, including a recommendation for providers working in emergency rooms to consult with survivors of sexual assault regarding emergency contraception and provide follow-up care and referral services.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Emergency Contraception Access and 
Education Act of 2014''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) Each year 3,400,000 pregnancies, or one-half of all 
        pregnancies, in the United States are unintended, and 4 in 10 
        of these unintended pregnancies end in abortion.
            (2) The Food and Drug Administration has declared emergency 
        contraception to be safe and effective in preventing unintended 
        pregnancy for women of reproductive potential and has approved 
        certain forms of emergency contraceptive for unrestricted sale 
        on pharmacy shelves to women of all ages.
            (3) Research indicates that emergency contraception reduces 
        the risk of pregnancy by up to 95 percent and emergency IUD 
        insertion reduces the risk by 99 percent. Although more 
        effective the sooner it is taken, medical evidence indicates 
        that emergency contraception can be effective up to 5 days 
        after unprotected intercourse or contraceptive failure.
            (4) Emergency contraception is a responsible means of 
        preventing pregnancy that works like other hormonal 
        contraceptives by suppressing or delaying ovulation, which 
        makes fertilization from unprotected intercourse unlikely if 
        the medication is taken within 120 hours. Emergency 
        contraception does not terminate an established pregnancy.
            (5) Most brands of emergency contraception consist of the 
        same hormones found in other hormonal birth control.
            (6) The percentage of sexually experienced women aged 15 to 
        44 in the United States who have ever used emergency 
        contraception increased from 4.2 percent in 2002 to 11 percent 
        in years 2006 through 2010.
            (7) A recent study by the Guttmacher Institute demonstrates 
        that the rate of teen pregnancy in the United States has 
        reached a historic low, declining 51 percent since its peak in 
        1990. From 2008 to 2010, increasing proportions of women aged 
        18 and 19 reported becoming sexually active, yet fewer of them 
        got pregnant during this time period than in previous studies. 
        Research suggests that increasing rates of contraceptive use 
        may be associated with the decline in teen pregnancy.
            (8) Despite an increase in use, significant disparities 
        exist for young, urban, minority women who lack general 
        knowledge about emergency contraception. In fact, 1 in 4 teens 
        remain completely unaware of the method and its use.
            (9) Although the American College of Obstetricians and 
        Gynecologists (ACOG) recommends that doctors routinely discuss 
        emergency contraception with women of reproductive age during 
        their clinical visits only half of obstetricians/gynecologists 
        offer emergency contraception to all of their patients in need 
        suggesting that greater provider and patient awareness and 
        education is needed.
            (10) Nearly 1 out of 5 American women is a victim of rape. 
        It is estimated that 25,000 to 32,000 women become pregnant 
        each year as a result of rape, half of whom choose to terminate 
        their pregnancy. The risk of pregnancy after sexual assault has 
        been estimated to be 4.7 percent in adult survivors who were 
        not protected by some form of contraception at the time of the 
        attack. If used correctly, emergency contraception could help 
        many of these rape survivors avoid the additional trauma of 
        facing an unintended pregnancy.
            (11) Only 18 States and the District of Columbia require 
        hospital emergency rooms to provide emergency contraception-
        related services to survivors of sexual assault. Of those, only 
        13 States and the District of Columbia require hospital 
        emergency rooms to provide emergency contraception upon request 
        to survivors of sexual assault. Nine States have adopted 
        restrictions on emergency contraception, and six States 
        explicitly allow pharmacists to refuse to dispense emergency 
        contraception.
            (12) In light of their safety and efficacy, the American 
        Medical Association, American Academy of Pediatrics, American 
        Women's Medical Association, Society for Adolescent Medicine, 
        and the American College of Obstetricians and Gynecologists 
        have endorsed more widespread availability of emergency 
        contraceptives.
            (13) Healthy People 2020, published by the Office of 
        Disease Prevention and Health Promotion (ODPHP), establishes a 
        10-year national public health goal of increasing the 
        proportion of publicly funded health care providers who provide 
        emergency contraception to their patients, and reducing the 
        number of unintended pregnancies by 10 percent.
            (14) Public awareness campaigns targeting women and health 
        care providers will help remove many of the barriers to 
        emergency contraception and will help bring this important 
        means of pregnancy prevention to women in the United States.

SEC. 3. DEFINITIONS.

    In this Act:
            (1) Emergency contraception.--The term ``emergency 
        contraception'' means a drug or device (as such terms are 
        defined in section 201 of the Federal Food, Drug, and Cosmetic 
        Act (21 U.S.C. 321)), or drug regimen that--
                    (A) is used postcoitally;
                    (B) prevents pregnancy primarily by preventing or 
                delaying ovulation, and does not terminate an 
                established pregnancy; and
                    (C) is approved by the Food and Drug 
                Administration.
            (2) Health care provider.--The term ``health care 
        provider'' means an individual who is licensed or certified 
        under State law to provide health care services and who is 
        operating within the scope of such license. Such term shall 
        include a pharmacist.
            (3) Hospital.--The term ``hospital'' means--
                    (A) a hospital as defined in section 1861(e) of the 
                Social Security Act (42 U.S.C. 1395x(e)); and
                    (B) a critical access hospital as defined in 
                section 1861(mm)(1) of such Act (42 U.S.C. 
                1395x(mm)(1)).
            (4) Institution of higher education.--The term 
        ``institution of higher education'' has the meaning given such 
        term in section 101(a) of the Higher Education Act of 1965 (20 
        U.S.C. 1001(a)).
            (5) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
            (6) Sexual assault.--
                    (A) In general.--The term ``sexual assault'' means 
                a sexual act (as defined in subparagraphs (A) through 
                (C) of section 2246(2) of title 18, United States Code) 
                where the victim involved does not consent or lacks the 
                capacity to consent.
                    (B) Application of provisions.--The definition in 
                subparagraph (A) shall apply to all individuals.

SEC. 4. SURVIVORS OF SEXUAL ASSAULT; PROVISION BY HOSPITALS OF 
              EMERGENCY CONTRACEPTION WITHOUT CHARGE.

    (a) In General.--Federal funds may not be provided to a hospital 
under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) 
or to a State, with respect to services of a hospital, under title XIX 
of such Act (42 U.S.C. 1396 et seq.), unless such hospital complies 
with the conditions specified in subsection (b) in the case of--
            (1) any woman who arrives at the hospital and states that 
        she is a victim of sexual assault, or is accompanied by someone 
        who states she is a victim of sexual assault; and
            (2) any woman who arrives at the hospital whom hospital 
        personnel have reason to believe is a victim of sexual assault.
    (b) Assistance for Victims.--The conditions specified in this 
subsection regarding a hospital and a woman described in subsection (a) 
are as follows:
            (1) The hospital promptly provides the woman with medically 
        and factually accurate and unbiased written and oral 
        information about emergency contraception, including 
        information explaining that--
                    (A) emergency contraception has been approved by 
                the Food and Drug Administration as an over-the-counter 
                medication for all women without age restrictions and 
                is a safe and effective way to prevent pregnancy after 
                unprotected intercourse or contraceptive failure if 
                taken in a timely manner;
                    (B) emergency contraception is more effective the 
                sooner it is taken; and
                    (C) emergency contraception does not cause an 
                abortion and cannot interrupt an established pregnancy.
            (2) The hospital promptly offers emergency contraception to 
        the woman, and promptly provides such contraception to her at 
        the hospital on her request.
            (3) The information provided pursuant to paragraph (1) is 
        in clear and concise language, is readily comprehensible, and 
        meets such conditions regarding the provision of the 
        information in languages other than English as the Secretary 
        may establish.
            (4) The services described in paragraphs (1) through (3) 
        are not denied because of the inability of the woman or her 
        family to pay for the services.
    (c) Effective Date; Agency Criteria.--This section shall take 
effect upon the expiration of the 180-day period beginning on the date 
of the enactment of this Act. Not later than 30 days prior to the 
expiration of such period, the Secretary shall publish in the Federal 
Register criteria for carrying out this section.

SEC. 5. EMERGENCY CONTRACEPTION EDUCATION AND INFORMATION PROGRAMS.

    (a) Emergency Contraception Public Education Program.--
            (1) In general.--The Secretary, acting through the Director 
        of the Centers for Disease Control and Prevention, shall 
        develop and disseminate to the public information on emergency 
        contraception.
            (2) Dissemination.--The Secretary may disseminate 
        information on emergency contraception under paragraph (1) 
        directly or through arrangements with health agencies, 
        professional and nonprofit organizations, consumer groups, 
        institutions of higher education, clinics, the media, and 
        Federal, State, and local agencies.
            (3) Information.--The information on emergency 
        contraception disseminated under paragraph (1) shall include, 
        at a minimum, the most current evidence-based and evidence-
        informed standards of care with respect to emergency 
        contraception and an explanation of the proper, use, safety, 
        efficacy, counseling and availability of such contraception.
    (b) Emergency Contraception Information Program for Health Care 
Providers.--
            (1) In general.--The Secretary, acting through the 
        Administrator of the Health Resources and Services 
        Administration and in consultation with major medical and 
        public health organizations, shall develop and disseminate to 
        health care providers information on emergency contraception.
            (2) Information.--The information disseminated under 
        paragraph (1) shall include, at a minimum--
                    (A) information describing the most current 
                evidence-based and evidence-informed standards of care, 
                proper use, safety, efficacy, counseling and 
                availability of emergency contraception;
                    (B) a recommendation regarding the use of such 
                contraception in appropriate cases;
                    (C) recommendation for health care providers 
                working in emergency rooms to consult with survivors of 
                sexual assault once clinically stable regarding options 
                for emergency contraception and to provide any 
                necessary follow-up care and referral services; and
                    (D) information explaining how to obtain copies of 
                the information developed under subsection (a) for 
                distribution to the patients of the providers.
    (c) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section, such sums as may be necessary 
for each of the fiscal years 2014 through 2018.