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[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 9865 Introduced in House (IH)]

<DOC>

118th CONGRESS
  2d Session
                                H. R. 9865

 To amend title 10, United States Code, to ensure that 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

                           September 27, 2024

 Ms. Escobar (for herself, Ms. Strickland, Ms. Jacobs, Mr. Khanna, Ms. 
 McClellan, Ms. Slotkin, Mr. Ryan, Ms. Castor of Florida, Mr. Veasey, 
  Mr. McGovern, Mrs. Trahan, Mr. Himes, Ms. Tokuda, Ms. Kuster, Mrs. 
 Torres of California, Ms. Wilson of Florida, Mr. Landsman, Mr. Pocan, 
    Mr. Vargas, Mr. Johnson of Georgia, Ms. Wasserman Schultz, Mrs. 
Cherfilus-McCormick, Ms. Wild, Ms. Stevens, Mr. Kim of New Jersey, Mr. 
Peters, Mr. Carbajal, Mr. Lynch, Ms. Sherrill, Ms. Jayapal, Mr. Larson 
of Connecticut, Mr. Panetta, Mr. Evans, Ms. Brownley, Mrs. Ramirez, Ms. 
    Crockett, Mr. Carter of Louisiana, Ms. Ross, and Ms. McCollum) 
 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 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 
Servicemembers and Dependents Act of 2024''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (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 more than 18 percent of members 
        of the Armed Forces, and as of fiscal year 2019, over 390,000 
        women serve on active duty in the Armed Forces or in the 
        reserve components. An estimated several thousand transgender 
        men also serve on active duty in the Armed Forces and in the 
        reserve components, in addition to non-binary members and those 
        who identify with a different gender.
            (2) Ninety-five percent of women serving in the Armed 
        Forces are of reproductive age and as of 2019, more than 
        700,000 female spouses and dependents of members of the Armed 
        Forces on active duty are of reproductive age.
            (3) The TRICARE program covered more than 1,570,000 women 
        of reproductive age in 2019, including spouses and dependents 
        of members of the Armed Forces on active duty. Additionally, 
        thousands of transgender dependents of members of the Armed 
        Forces are covered by the TRICARE program.
            (4) Reproductive freedom, including the decision to use 
        birth control, allows people to exercise autonomy and make 
        decisions about their health care. Yet making meaningful 
        decisions requires access to the full spectrum of reproductive 
        health care ranging from contraception to abortion to maternity 
        care. Everyone should have access to the full range of this 
        care, free from unnecessary barriers.
            (5) The right to access contraception is grounded in the 
        principle that contraception and the ability to determine if 
        and when to have children are inextricably tied to one's well-
        being, equality, dignity, and ability to determine the course 
        of one's life. These protections have helped access to 
        contraception become a driving force in improving the health 
        and financial security of individuals and their families.
            (6) The Supreme Court has repeatedly recognized the 
        constitutional right to contraception, including in Griswold v. 
        Connecticut (381 U.S. 479 (1965)), Eisenstadt v. Baird (405 
        U.S. 438 (1972)), and Carey v. Population Services 
        International (431 U.S. 678 (1977)).
            (7) Access to contraception is critical to the health of 
        every individual capable of becoming pregnant. This Act is 
        intended to apply to all individuals with the capacity for 
        pregnancy, including cisgender women, transgender men, non-
        binary individuals, those who identify with a different gender, 
        and others.
            (8) Studies have shown that when cost barriers to the full 
        range of contraceptives are eliminated, patients are more 
        likely to use the contraceptive that meets their needs, and 
        therefore use contraception correctly and more consistently, 
        reducing the risk of unintended pregnancy. Moreover, cost 
        barriers to contraceptive care fall hardest on populations who 
        already face systemic barriers to achieving reproductive 
        access, such as military families of color, and families with 
        lower incomes.
            (9) Following the Supreme Court's decision in Dobbs v. 
        Jackson Women's Health Organization, States have moved to enact 
        bans and restrictions on reproductive health care including 
        abortion and contraception. The basic right to access 
        reproductive health care, including contraception, must be 
        available to all people, regardless of where they live or 
        whether they serve.
            (10) Under the TRICARE program, members of the Armed Forces 
        on active duty have full coverage of all prescription drugs, 
        including contraception, without cost-sharing requirements, in 
        line with the Patient Protection and Affordable Care Act 
        (Public Law 111-148), which requires coverage of all Food and 
        Drug Administration (FDA)-approved, -granted, or -cleared 
        contraceptives and related services and education and 
        counseling. However, members not on active duty and dependents 
        of members do not have similar coverage of all FDA-approved, -
        granted, or -cleared contraceptives without cost-sharing when 
        they obtain the contraceptive outside of a military medical 
        treatment facility.
            (11) In order to fill gaps in coverage and access to 
        preventive care critical for women's health, the Patient 
        Protection and Affordable Care Act (Public Law 111-148) 
        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 
        of the Department of Health and Human Services. These women's 
        preventive services include the full range of U.S. Food and 
        Drug Administration (FDA)-approved, -granted, or -cleared 
        contraceptives, effective family planning practices, and 
        sterilization procedures. The Health Resources and Services 
        Administration has affirmed that contraceptive care includes 
        contraceptive counseling, initiation of contraceptive use, and 
        follow-up care (such as management, evaluation, and changes to 
        and removal or discontinuation of the contraceptive).
            (12) In July 2022, the Department of Defense eliminated 
        copayments for medical contraceptive services (i.e., 
        intrauterine devices, birth control shot, birth control 
        implant, and diaphragm measurement and fitting), and effective 
        January 2023, certain TRICARE beneficiaries will no longer face 
        cost-sharing or copayments for tubal ligation (surgical 
        sterilization) services when obtaining care through a civilian 
        provider. However, congressional action is needed to completely 
        eliminate copayments for prescription contraceptives and ensure 
        that service members and their loved ones have equitable access 
        to all methods of contraception.
            (13) The Defense Advisory Committee on Women in the 
        Services has recommended that all the Armed Forces, to the 
        extent that they have not already, implement initiatives that 
        inform members of the Armed Forces 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 Armed Forces.
            (14) The military departments received more than 8,866 
        reports of sexual assaults during fiscal year 2021, an increase 
        of over one thousand reports compared to 2019. Through 
        regulations, the Department of Defense already supports a 
        policy of ensuring that members of the Armed Forces who are 
        sexually assaulted have access to emergency contraception, and 
        the initiation of contraception if desired and medically 
        appropriate.

SEC. 3. CONTRACEPTION COVERAGE PARITY UNDER THE TRICARE PROGRAM.

    (a) Pharmacy Benefits Program.--Section 1074g(a)(6) of title 10, 
United States Code, is amended by adding at the end the following new 
subparagraph:
    ``(D) Notwithstanding subparagraphs (A), (B), and (C), cost-sharing 
may not be imposed or collected with respect to any eligible covered 
beneficiary for any prescription contraceptive on the uniform formulary 
provided through a retail pharmacy described in paragraph (2)(E)(ii) or 
through the national mail-order pharmacy program.''.
    (b) TRICARE Select.--Section 1075 of such title is amended--
            (1) in subsection (c), by adding at the end the following 
        new paragraph:
            ``(4)(A) Notwithstanding any other provision under this 
        section, cost-sharing may not be imposed or collected with 
        respect to any beneficiary under this section for a service 
        described in subparagraph (B) that is provided by a network 
        provider.
            ``(B) A service described in this subparagraph is any Food 
        and Drug Administration-approved, -granted, or cleared- 
        contraceptive, any contraceptive care (including with respect 
        to insertion, removal, and follow up), any sterilization 
        procedure, or any patient education or counseling service 
        provided in connection with any such contraceptive, care, or 
        procedure.''; and
            (2) in subsection (f), by striking ``calculated as'' and 
        inserting ``calculated (except as provided in subsection 
        (c)(4)) as''.
    (c) TRICARE Prime.--Section 1075a of such title is amended by 
adding at the end the following new subsection:
    ``(d) Prohibition on Cost-Sharing for Certain Services.--(1) 
Notwithstanding subsections (a), (b), and (c), cost-sharing may not be 
imposed or collected with respect to any beneficiary under this section 
for a service described in paragraph (2) that is provided under TRICARE 
Prime.
    ``(2) A service described in this paragraph is any Food and Drug 
Administration-approved, -granted, or -cleared contraceptive, any 
contraceptive care (including with respect to insertion, removal, and 
follow up), any sterilization procedure, or any patient education or 
counseling service provided in connection with any such contraceptive, 
care, or procedure.''.

SEC. 4. PREGNANCY PREVENTION ASSISTANCE AT MILITARY MEDICAL TREATMENT 
              FACILITIES FOR SEXUAL ASSAULT SURVIVORS.

    (a) In General.--Chapter 55 of title 10, United States Code, is 
amended by inserting after section 1074o the following new section:
``Sec. 1074p. Provision of pregnancy prevention assistance at military 
              medical treatment facilities
    ``(a) Information and Assistance.--The Secretary of Defense shall 
promptly furnish to sexual assault survivors at each military medical 
treatment facility the following:
            ``(1) Comprehensive, medically and factually accurate, and 
        unbiased written and oral information about all emergency 
        contraceptives approved by the Food and Drug Administration.
            ``(2) Notification of the right of the sexual assault 
        survivor to confidentiality with respect to the information and 
        care and services furnished under this section.
            ``(3) Upon request by the sexual assault survivor, 
        emergency contraception or, if applicable, a prescription for 
        emergency contraception.
    ``(b) Information.--The Secretary shall ensure that information 
provided pursuant to subsection (a) is provided in language that--
            ``(1) is clear and concise;
            ``(2) is readily comprehensible; and
            ``(3) meets such conditions (including conditions regarding 
        the provision of information in languages other than English) 
        as the Secretary may prescribe in regulations to carry out this 
        section.
    ``(c) Definitions.--In this section:
            ``(1) The term `sexual assault survivor' means any 
        individual who presents at a military medical treatment 
        facility and--
                    ``(A) states to personnel of the facility that the 
                individual experienced a sexual assault;
                    ``(B) is accompanied by another person who states 
                that the individual experienced a sexual assault; or
                    ``(C) whom the personnel of the facility reasonably 
                believes to be a survivor of sexual assault.
            ``(2) The term `sexual assault' means the conduct described 
        in section 1565b(c) of this title that may result in 
        pregnancy.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by inserting after the item relating to section 
1074o the following new item:

``1074p. Provision of pregnancy prevention assistance at military 
                            medical treatment facilities.''.

SEC. 5. 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 to be used in education 
        programs on family planning for all members of the Armed 
        Forces.
            (2) Timing.--Education programs under paragraph (1) shall 
        be provided to members of the Armed Forces as follows:
                    (A) During the first year of service of the member.
                    (B) At such other times as each Secretary of a 
                military department determines appropriate with respect 
                to members of the Armed Forces under the jurisdiction 
                of such Secretary.
            (3) Sense of congress.--It is the sense of Congress that 
        the education programs under paragraph (1) should be evidence-
        informed and 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 (commonly known as ``HIV'').
            (3) Information on--
                    (A) the importance of providing comprehensive 
                family planning for members of the Armed Forces, 
                including commanding officers; and
                    (B) 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--
                    (A) all Food and Drug Administration-approved, -
                granted, or -cleared contraceptives; and
                    (B) where members of the Armed Forces can access 
                their chosen contraceptive.
            (6) Information on all applicable laws and policies so that 
        members of the Armed Forces 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.
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