I 

117TH CONGRESS 

1ST SESSION H. R. 2216 

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

screening. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 26, 2021 

Mr. GOMEZ (for himself, Ms. BARRAGA ́N, Mr. BLUMENAUER, Ms. BROWNLEY, 

Ms. CLARKE of New York, Mr. COHEN, Mr. DANNY K. DAVIS of Illinois, 

Mrs. FLETCHER, Mr. GRIJALVA, Mr. HASTINGS, Mrs. HAYES, Mr. HIGGINS of New York, Ms. NORTON, Ms. JACKSON LEE, Mr. JOHNSON of 

Georgia, Mr. LAWSON of Florida, Mrs. CAROLYN B. MALONEY of New 

York, Ms. MCCOLLUM, Mr. NADLER, Ms. PRESSLEY, Miss RICE of New 

York, Ms. SCANLON, Mr. SOTO, Ms. VELA ́ZQUEZ, Mrs. WATSON COLEMAN, Mr. WELCH, Ms. SA ́NCHEZ, and Ms. WASSERMAN SCHULTZ) introduced the following bill; which was referred to the Committee on Energy 

and Commerce 

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 ‘‘Jeanette Acosta Invest 

5 in Women’s Health Act of 2021’’. 


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1 SEC. 2. PURPOSE. 

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

3 increased access to preventive and life-saving cancer 

4 screening, including clinical breast exams and cervical, 

5 ovarian, uterine, vaginal, and vulvar cancer screening, pro6 vided by leading women’s health care providers who— 

7 (1) serve populations most at risk; and 

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

9 detection of cancer in order to serve the goal of in10 creasing access to quality health screenings, care, 

11 and services, reducing health care disparities and 

12 mortality rates among low-income women and 

13 women of color, decreasing health care spending, 

14 and expanding health literacy, access, and education 

15 about the benefits of regular preventive cancer 

16 screening for women. 

17 SEC. 3. FINDINGS. 

18 Congress finds as follows: 

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

20 death in women under the age of 54, and the Amer21 ican Cancer Society recommends that women in 

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

23 least every 3 years. 

24 (2) Ovarian cancer causes more deaths than 

25 any other cancer of the female reproductive system, 


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1 but it accounts for only about 3 percent of all can2 cers in women. 

3 (3) The cancers that most frequently impact 

4 women include breast, uterine, ovarian, and cervical 

5 cancer, and there were 341,171 new cases of these 

6 cancers in 2017. 

7 (4) Rates of incidence and death for gynecologic 

8 cancers by race and ethnicity show that, while for 

9 some cancers, like ovarian cancer, the rates of inci10 dence and death are similar among all races, for 

11 other cancers, like cervical cancer, women of color 

12 have disproportionate incidence and mortality rates. 

13 While the incidence of uterine cancer is similar for 

14 White women and Women of Color, rates of death 

15 for uterine cancer are 2 times higher for Black 

16 women than for White women. 

17 (5) Cervical cancer incidence and mortality 

18 rates are higher for women living in rural and un19 derserved regions in the United States. Women liv20 ing in these areas face unique barriers in accessing 

21 reproductive health care services to prevent and 

22 treat cervical cancer, including a lack of practicing 

23 gynecologists in rural areas and challenges around 

24 transportation to preventive and follow-up appoint25 ments. 


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1 (6) Prevention and cancer screening are the 

2 best approaches to protecting women from cancer 

3 and ensuring early detection and life-saving treat4 ment. Many deaths from breast and cervical cancers 

5 could be avoided if cancer screening rates and diag6 nostic care and services increased among women at 

7 risk. Deaths from these cancers occur disproportion8 ately among women who are uninsured or under9 insured. 

10 (7) Due to enhanced screening, cervical cancer, 

11 which used to be the leading cause of cancer death 

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

13 preventable and treatable cancer. It is also highly 

14 curable when found and treated early. 

15 (8) Increased access to education, information, 

16 including information on the human papillomavirus 

17 vaccine, and preventive cancer screening increase 

18 women’s ability to survive cancer. 

19 (9) While more than 15 percent of cases of cer20 vical cancer are found in women over the age of 65, 

21 it becomes less likely that women are tested for cer22 vical cancer ever or within the previous 5 years as 

23 their age increases. 

24 (10) Women’s health care providers that are 

25 primarily engaged in family planning services, such 


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1 as Planned Parenthood health centers, provide nec2 essary screening tests, education, and information to 

3 women, especially women of color who face the high4 est risks of breast cancer and other gynecologic can5 cers. 

6 (11) Access to preventive gynecological screen7 ing is also critical for transgender men who have 

8 comparable rates of susceptibility to cervical cancer 

9 as cisgender women, but often have less access to 

10 preventive screenings. 

11 (12) Discrimination and racism in health care 

12 continues to contribute to disparate rates of gyneco13 logical cancer in non-White women. Black, Indige14 nous, and other Women of Color die at higher rates 

15 from cervical cancer than White women, even though 

16 fewer women overall die from cervical cancer. 

17 (13) Black women with endometrial cancer 

18 often receive surgery less often than White women 

19 and are more likely to be diagnosed at an advanced 

20 stage of the disease, contributing to disparities in 

21 mortality in Black women. 


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1 SEC. 4. STRENGTHENING ACCESS TO CANCER SCREENING 

2 FOR WOMEN. 

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

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

5 by inserting after section 317P the following: 

6 ‘‘SEC. 317P–1. GRANTS FOR WOMEN’S HEALTH CARE PRO7 VIDERS. 

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

9 make grants and to enter into contracts with public or 

10 nonprofit private entities to expand preventive health serv11 ices, as provided for in the Preventive Services Guidelines 

12 of the Health Resources and Service Administration that 

13 were in effect on October 30, 2017, with an emphasis on 

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

15 Pap tests, human papillomavirus vaccination, and diag16 nostic tests for women with cancer symptoms, particularly 

17 Women of Color. 

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

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

20 $20,000,000 for each of fiscal years 2022 through 2024.’’. 

21 (b) FUNDING.—There is authorized to be appro22 priated to carry out programs related to breast and 

23 gynecologic cancers under title XIX of the Social Security 

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

25 Health Service Act (42 U.S.C. 300 et seq.), and the Na26 tional Breast and Cervical Cancer Early Detection ProVerDate Sep 11 2014 04:37 May 25, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2216.IH H2216

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1 gram, such sums as may be necessary for each of fiscal 

2 years 2020 through 2023. 

3 SEC. 5. EXPAND CANCER SCREENING PROVIDER TRAINING. 

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

5 (42 U.S.C. 243 et seq.), as amended by section 4, is fur6 ther amended by inserting after section 317P–1 the fol7 lowing: 

8 ‘‘SEC. 317P–2. WOMEN’S HEALTH CARE PROVIDERS DEM9 ONSTRATION TRAINING PROJECT. 

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

11 shall establish a demonstration program (referred to in 

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

13 eligible entities for the training of physicians, nurse practi14 tioners, and other health care providers related to life-sav15 ing breast and gynecologic cancer screening for women. 

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

17 enable each grant recipient to— 

18 ‘‘(1) provide to licensed physicians, nurse prac19 titioners, and other health care providers, through 

20 clinical training, education, and practice, the most 

21 up-to-date clinical guidelines, research, and rec22 ommendations adopted by the United States Preven23 tive Services Task Force in the area of preventive 

24 cancer screening for breast and gynecologic cancers; 


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1 ‘‘(2) establish a model of training for physi2 cians, nurse practitioners, and other health care pro3 viders that specializes in women’s health care, with 

4 a specific focus on breast and gynecologic cancer 

5 screening, that may be replicated nationwide; 

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

7 other health care providers to serve rural and under8 served communities, low-income communities, and 

9 communities of color in breast and gynecologic can10 cer screening; and 

11 ‘‘(4) provide implicit bias, cultural competency, 

12 and patient-centered communication training cov13 ering the ways in which structural racism and dis14 crimination manifest within the medical field and 

15 perpetuate racial disparities in gynecologic cancer in16 cidence and death rates and how to communicate 

17 with patients through a knowledgeable and culturally 

18 empathetic lens. 

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, as de24 fined in section 156.235 of title 45, Code of Federal 


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1 Regulations (or any successor regulations), that is 

2 primarily engaged in family planning; 

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, employment status, race, 

2 ethnicity, and status of insurance 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) an analysis of the awareness and availability 

9 of breast, cervical, ovarian, and other gynecological 

10 cancer screening options for women with dispropor11 tionate rates of gynecological cancers, including Afri12 can-American women, Hispanic and Latina women, 

13 women living in rural and underserved areas, and 

14 other disproportionately impacted groups, according 

15 to the 50-State analyses described in paragraphs (1) 

16 and (2); 

17 (4) an analysis of how structural racism im18 pacts access to cancer screening services, its correla19 tion to the development of breast, cervical, ovarian, 

20 and other gynecological cancers, and how it exacer21 bates health care disparities for African-American, 

22 Hispanic and Latina women, and other Women of 

23 Color; 

24 (5) in consultation with the Comptroller Gen25 eral of the United States, estimated Federal savings 


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1 achieved through early detection of breast and 

2 gynecologic cancer; 

3 (6) an analysis of how access to health care 

4 providers trained under the program described in 

5 section 317P–2 of the Public Health Service Act, as 

6 added by section 5, in comparison to other health 

7 care providers, increased early detection of cancer 

8 and quality of cancer care for women who are less 

9 likely to receive care, including African-American 

10 women, Hispanic and Latina women, older women, 

11 uninsured and underinsured women, and women liv12 ing in rural and underserved areas; 

13 (7) recommendations by the Secretary with re14 spect to the need for continued increased access to 

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

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

17 Service Act, as added by section 4, who provide pre18 ventive care, including life-saving cancer screening; 

19 and 

20 (8) recommendations for increasing screening 

21 rates for women who are less likely to be screened 

22 or treated for breast, cervical, ovarian, and other 

23 gynecological cancers, including African-American 

24 women, Hispanic and Latina women, older women, 


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1 uninsured and underinsured women, and women liv2 ing in rural and underserved areas. 

3 SEC. 7. DEMONSTRATION PROJECT ON CO-TESTING FOR 

4 HUMAN PAPILLOMAVIRUS AND CERVICAL 

5 CANCER. 

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

7 (42 U.S.C. 243 et seq.), as amended by section 5, is fur8 ther amended by inserting after section 317P–2 the fol9 lowing: 

10 ‘‘SEC. 317P–3. DEMONSTRATION PROJECT ON CO-TESTING 

11 FOR HUMAN PAPILLOMAVIRUS AND CER12 VICAL CANCER. 

13 ‘‘(a) IN GENERAL.—The Secretary, in coordination 

14 with the Director of the Centers for Disease Control and 

15 Prevention and the Administrator of the Health Resources 

16 and Services Administration, shall establish a 2-year dem17 onstration project on increasing the co-testing of human 

18 papillomavirus and cervical cancer screenings to develop 

19 models for increasing the rates of co-testing among women 

20 with disproportionate rates of cervical cancer, including 

21 African-American and Hispanic and Latina women. 

22 ‘‘(b) USE OF FUNDS.—Entities receiving funds under 

23 this section shall use such funds to— 

24 ‘‘(1) increase access to co-testing of human 

25 papillomavirus and cervical cancer among patients 


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1 with disproportionate rates of cervical cancer, in2 cluding African-American and Hispanic and Latina 

3 women; 

4 ‘‘(2) support culturally- and linguistically-ap5 propriate delivery models to such patients, including 

6 through the provision of interpretation services; or 

7 ‘‘(3) provide other services to improve health 

8 outcomes with respect to such patients. 

9 ‘‘(c) PRIORITIZATION.—Priority for funding available 

10 under this section shall be given to entities serving low11 income, uninsured, and medically underserved populations 

12 or populations with historically low rates of such co-test13 ing, such as older women. 

14 ‘‘(d) ELIGIBLE ENTITIES.—To be eligible to receive 

15 a grant under this section, an entity shall be an entity 

16 described in section 317P–2(c).’’. 

Æ 


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