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[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[S. 957 Introduced in Senate (IS)]

<DOC>

115th CONGRESS
  1st Session
                                 S. 957

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 SENATE OF THE UNITED STATES

                             April 27, 2017

Mrs. Shaheen (for herself, Ms. Baldwin, Mr. Bennet, Mr. Blumenthal, Mr. 
  Booker, Mr. Brown, Ms. Cantwell, Mr. Cardin, Mr. Coons, Ms. Cortez 
 Masto, Mr. Durbin, Mrs. Feinstein, Mr. Franken, Mrs. Gillibrand, Ms. 
   Harris, Ms. Hassan, Mr. Heinrich, Ms. Hirono, Ms. Klobuchar, Mr. 
 Markey, Mr. Menendez, Mr. Merkley, Mr. Murphy, Mrs. Murray, Mr. Reed, 
Mr. Sanders, Ms. Stabenow, Mr. Tester, Mr. Van Hollen, Ms. Warren, Mr. 
   Whitehouse, Mr. Wyden, Mr. Kaine, and Mr. Peters) introduced the 
 following bill; which was read twice and 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 1,100,000 female 
        spouses and dependents of active duty military personnel are of 
        reproductive age.
            (3) TRICARE covered approximately 1,400,000 women of 
        reproductive age in 2015, including female spouses and 
        dependents of active duty military personnel. For approximately 
        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 Armed Forces.
            (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 more than 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)--
                    (A) in the subsection heading, by inserting ``for 
                Members and Former Members'' after ``Services 
                Available''; and
                    (B) in paragraph (1), by striking ``subsection 
                (b)'' and inserting ``subsection (d)'';
            (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 in 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), 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 described in paragraph (1) should use 
        the latest technology available to efficiently and effectively 
        deliver information to members of the Armed Forces.
    (b) Elements.--The uniform standard curriculum established 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.
            (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 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.

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 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 regulations prescribed pursuant to this section.
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