II 

115TH CONGRESS 

1ST SESSION S. 689 

To provide women with increased access to preventive and life-saving cancer 

screening. 

IN THE SENATE OF THE UNITED STATES 

MARCH 21, 2017 

Mrs. MURRAY (for herself, Mrs. GILLIBRAND, and Ms. BALDWIN) introduced 

the following bill; which was read twice and referred to the Committee 

on Health, Education, Labor, and Pensions 

A BILL 

To provide women with increased access to preventive and 

life-saving cancer screening. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Invest in Women’s 

5 Health Act of 2017’’. 

6 SEC. 2. PURPOSE. 

7 It is the purpose of this Act to provide women with 

8 increased access to preventive and life-saving cancer 

9 screening, including clinical breast exams and cervical, 


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1 ovarian, uterine, vaginal, and vulvar cancer screening, pro2 vided by leading women’s health care providers who— 

3 (1) serve populations most at risk; and 

4 (2) play an outsized role in the prevention and 

5 detection of cancer in order to serve the goal of re6 ducing health care disparities among low-income 

7 women and women of color, decrease health care 

8 spending, and expand health literacy, access, and 

9 education about the benefits of regular preventive 

10 cancer screening for women. 

11 SEC. 3. FINDINGS. 

12 Congress finds as follows: 

13 (1) Breast cancer is the leading cause of cancer 

14 death in women under the age of 54, and the Amer15 ican Cancer Society recommends that women in 

16 their 20s and 30s have a clinical breast exam at 

17 least every 3 years. 

18 (2) Ovarian cancer causes more deaths than 

19 any other cancer of the female reproductive system, 

20 but it accounts for only about 3 percent of all can21 cers in women. 

22 (3) The cancers that most frequently impact 

23 women include breast, uterine, ovarian, and cervical 

24 cancer, and there were 314,257 new cases of these 

25 cancers in 2013. 


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1 (4) Rates of incidence and death for gynecologic 

2 cancers by race and ethnicity show that, while for 

3 some cancers, like ovarian cancer, the rates of inci4 dence and death are similar among all races, for 

5 other cancers, like cervical cancer, women of color 

6 have a disproportionate rate of incidence. While the 

7 incidence of uterine cancer is higher for White 

8 women than for women of color, rates of death for 

9 uterine cancer are 2 times higher for Black women 

10 than for White women. 

11 (5) Prevention and cancer screening are the 

12 best approaches to protecting women from cancer 

13 and ensuring early detection and life-saving treat14 ment. Many deaths from breast and cervical cancers 

15 could be avoided if cancer screening rates increased 

16 among women at risk. Deaths from these cancers 

17 occur disproportionately among women who are un18 insured or underinsured. 

19 (6) Due to enhanced screening, cervical cancer, 

20 which used to be the leading cause of cancer death 

21 for women in the United States, is now a much more 

22 preventable and treatable cancer. 

23 (7) Increased access to education, information, 

24 and preventive cancer screening increase women’s 

25 ability to survive cancer. 


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1 (8) Women’s health care providers that are pri2 marily engaged in family planning services, such as 

3 Planned Parenthood health centers, provide nec4 essary screening tests, education, and information to 

5 women, especially women of color who face the high6 est risks of breast cancer and other gynecologic can7 cers. 

8 SEC. 4. STRENGTHENING ACCESS TO CANCER SCREENING 

9 FOR WOMEN. 

10 (a) IN GENERAL.—Part B of title III of the Public 

11 Health Service Act (42 U.S.C. 243 et seq.) is amended 

12 by inserting after section 317P the following: 

13 ‘‘SEC. 317P–1. GRANTS FOR WOMEN’S HEALTH CARE PRO14 VIDERS. 

15 ‘‘(a) IN GENERAL.—The Secretary is authorized to 

16 make grants and to enter into contracts with public or 

17 nonprofit private entities to expand preventive health serv18 ices, as provided for in the Preventive Services Guidelines 

19 of the Health Resources and Service Administration that 

20 were in effect on January 1, 2017, with an emphasis on 

21 increasing access to critical, life-saving cancer screening, 

22 Pap tests, human papillomavirus vaccination, and diag23 nostic tests for women with cancer symptoms, particularly 

24 women of color. 


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1 ‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There 

2 is authorized to be appropriated to carry out this section, 

3 $200,000,000 for each of fiscal years 2017 through 

4 2020.’’. 

5 (b) FUNDING.—There is authorized to be appro6 priated to carry out programs related to breast and 

7 gynecologic cancers under title XIX of the Social Security 

8 Act (42 U.S.C. 1396 et seq.) and title X of the Public 

9 Health Service Act (42 U.S.C. 300 et seq.), and the Na10 tional Breast and Cervical Cancer Early Detection Pro11 gram, such sums as may be necessary for each of fiscal 

12 years 2017 through 2020. 

13 SEC. 5. EXPAND CANCER SCREENING PROVIDER TRAINING. 

14 Part B of title III of the Public Health Service Act 

15 (42 U.S.C. 243 et seq.), as amended by section 4, is fur16 ther amended by inserting after section 317P–1 the fol17 lowing: 

18 ‘‘SEC. 317P–2. WOMEN’S HEALTH CARE PROVIDERS DEM19 ONSTRATION TRAINING PROJECT. 

20 ‘‘(a) ESTABLISHMENT OF PROGRAM.—The Secretary 

21 shall establish a demonstration program (referred to in 

22 this section as the ‘program’) to award 3-year grants to 

23 eligible entities for the training of physicians, nurse practi24 tioners, and other health care providers related to life-sav25 ing breast and gynecologic cancer screening for women. 


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1 ‘‘(b) PURPOSE.—The purpose of the program is to 

2 enable each grant recipient to — 

3 ‘‘(1) provide to licensed physicians, nurse prac4 titioners, and other health care providers, through 

5 clinical training, education, and practice, the most 

6 up-to-date clinical guidelines and research adopted 

7 by the National Academies of Sciences, Engineering, 

8 and Medicine in the area of preventive cancer 

9 screening for breast and gynecologic cancers; 

10 ‘‘(2) establish a model of training for physi11 cians, nurse practitioners, and other health care pro12 viders that specializes in women’s health care, with 

13 a specific focus on breast and gynceologic cancer 

14 screening, that may be replicated nationwide; and 

15 ‘‘(3) train physicians, nurse practitioners, and 

16 other health care providers to serve rural commu17 nities, low-income communities, and communities of 

18 color in breast and gynecologic cancer screening. 

19 ‘‘(c) ELIGIBLE ENTITIES.—To be eligible to receive 

20 a grant under this section, an entity shall be— 

21 ‘‘(1) an entity that receives funding under sec22 tion 1001; 

23 ‘‘(2) an essential community provider primarily 

24 engaged in family planning, as defined in section 


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1 156.235 of title 45, Code of Federal Regulations (or 

2 any successor regulations); 

3 ‘‘(3) an entity that furnishes items or services 

4 to individuals who are eligible for medical assistance 

5 under title XIX of the Social Security Act; or 

6 ‘‘(4) an entity that, at the time of application, 

7 provides cancer screening services under the Na8 tional Breast and Cervical Cancer Early Detection 

9 Program of the Centers for Disease Control and 

10 Prevention.’’. 

11 SEC. 6. STUDY AND REPORT TO CONGRESS ON INCREASED 

12 CANCER SCREENING FOR WOMEN. 

13 (a) IN GENERAL.—The Secretary of Health and 

14 Human Services (referred to in this section as the ‘‘Sec15 retary’’) shall conduct a study (and periodically update 

16 such study) on increased access to women’s preventive life17 saving cancer screening across the United States, and, not 

18 later than January 1, 2025, and every 5 years thereafter, 

19 the Secretary shall submit a report to Congress on such 

20 study. 

21 (b) CONTENTS.—The study and reports under sub22 section (a) shall include: 

23 (1) A 50-State analysis of breast and 

24 gynecologic cancer rates among women, including by 


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1 geographic area, income, race, and status of insur2 ance coverage. 

3 (2) A 50-State analysis of cancer screening pro4 vided by women’s health care providers, including 

5 clinical breast exams, other screening for breast can6 cer, and screening for cervical cancer, ovarian can7 cer, and other gynecologic cancers. 

8 (3) In consultation with the Comptroller Gen9 eral of the United States, estimated Federal savings 

10 achieved through early detection of breast and 

11 gynecologic cancer. 

12 (4) Analysis of how access to health care pro13 viders trained under the program described in sec14 tion 317P–2 of the Public Health Service Act, as 

15 added by section 5, in comparison to other health 

16 care providers, increased early detection of cancer 

17 for women. 

18 (5) Recommendations by the Secretary with re19 spect to the need for continued increased access to 

20 women’s health care providers, such as the entities 

21 described in section 317P–2(c) of the Public Health 

22 Service Act, as added by section 4, who provide pre23 ventive care, including life-saving cancer screening. 

Æ 


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