II 

114TH CONGRESS 

1ST SESSION S. 1532 

To ensure timely access to affordable birth control for women. 

IN THE SENATE OF THE UNITED STATES 

JUNE 9, 2015 

Mrs. MURRAY (for herself, Mrs. BOXER, Mrs. SHAHEEN, Mr. REID, Mr. 

BLUMENTHAL, Ms. BALDWIN, Mr. BENNET, Mr. BOOKER, Mr. BROWN, 

Ms. CANTWELL, Mr. CARDIN, Mr. DURBIN, Mrs. FEINSTEIN, Mrs. GILLIBRAND, Mr. HEINRICH, Ms. HIRONO, Mr. KAINE, Ms. KLOBUCHAR, Mr. 

LEAHY, Mrs. MCCASKILL, Mr. MERKLEY, Ms. MIKULSKI, Mr. MURPHY, 

Mr. SANDERS, Mr. SCHATZ, Mr. SCHUMER, Mr. FRANKEN, Ms. STABENOW, Ms. WARREN, Mr. WYDEN, and Mr. MENENDEZ) introduced the 

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

Health, Education, Labor, and Pensions 

A BILL 

To ensure timely access to affordable birth control for 

women. 

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 ‘‘Affordability Is Access 

5 Act’’. 


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1 SEC. 2. PURPOSE. 

2 The purpose of this Act is to ensure timely access 

3 to affordable birth control by requiring coverage without 

4 cost-sharing for oral birth control for routine, daily use 

5 that is approved by, or otherwise legally marketed under 

6 regulation by, the Food and Drug Administration for use 

7 by women without a prescription. 

8 SEC. 3. FINDINGS. 

9 Congress makes the following findings: 

10 (1) Access to the full range of health benefits 

11 and preventive services, including access to birth 

12 control, as guaranteed under Federal law, provides 

13 all people of the United States with the opportunity 

14 to lead healthier and more productive lives. 

15 (2) Birth control is a critical health care benefit 

16 and service for women. Almost all women use birth 

17 control at some point in their lifetimes. The Centers 

18 for Disease Control and Prevention declared it one 

19 of the Ten Great Public Health Achievements of the 

20 20th Century. 

21 (3) Birth control prevents and reduces unin22 tended pregnancies and provides many health and 

23 socioeconomic benefits for women. Women with ac24 cess to birth control are more likely to have higher 

25 educational and career achievement, and to earn 

26 higher wages. 


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1 (4) Affordability and timely access have long 

2 been barriers for women being able to use birth con3 trol. Many women struggle to obtain the birth con4 trol they need because of cost or other access bar5 riers, which has contributed to the high unintended 

6 pregnancy rate in the United States. A national sur7 vey found that 1 in 3 women have struggled to af8 ford birth control at some point in their lives, and 

9 as a result, have used birth control inconsistently. 

10 The rate is even higher for young women who are 

11 most likely to experience an unintended pregnancy. 

12 (5) Three separate studies have found that lack 

13 of health coverage is significantly associated with re14 duced use of prescription contraceptive methods, in15 cluding birth control. 

16 (6) The Patient Protection and Affordable Care 

17 Act (Public Law 111–148) sought to remove bar18 riers to care and improve access by requiring all new 

19 health plans to cover recommended preventive serv20 ices without cost-sharing, which include women’s 

21 preventive services, including all contraceptive meth22 ods, including birth control and sterilization for 

23 women approved by the Food and Drug Administra24 tion and related education and counseling. 


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1 (7) The Patient Protection and Affordable Care 

2 Act women’s preventive services benefit has signifi3 cantly improved women’s access to birth control, in4 cluding oral birth control for routine, daily use. The 

5 Department of Health and Human Services has re6 ported that, as of 2014, more than 55,000,000 

7 women are benefitting from coverage without cost8 sharing for women’s preventive services, including 

9 birth control, under the Patient Protection and Af10 fordable Care Act. Women have saved more than 

11 $483,000,000 in out-of-pocket costs for birth control 

12 with no copayments in 2012 compared to 2013, an 

13 average savings of $269 per woman. 

14 (8) The most appropriate method of birth con15 trol varies according to each individual woman’s 

16 needs, medical history, and stage of life. For in17 stance, women may have medical contraindications 

18 that limit their ability to use certain birth control 

19 methods. It is critical that the full range of birth 

20 control methods approved by the Food and Drug 

21 Administration are available and covered without 

22 cost-sharing in order to ensure that each woman has 

23 access to the birth control method that best meet 

24 her needs. 


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1 (9) The determination as to whether a drug 

2 should be available for use without a prescription is 

3 appropriately and solely made by the Food and Drug 

4 Administration. To ensure the safety and efficacy of 

5 a drug, including a drug available for over-the6 counter use, the appropriate scientific and medical 

7 personnel at the Food and Drug Administration, 

8 often with input from independent advisory panels of 

9 experts, review clinical and other data relating to the 

10 safety and efficacy of the drug. This scientific and 

11 medical review can occur as part of the Food and 

12 Drug Administration’s over-the-counter drug review 

13 for potential inclusion in a monograph as generally 

14 recognized as safe and effective, or as part of the re15 view of a new drug application (or an abbreviated 

16 new drug application). As part of these regulatory 

17 processes, the appropriate scientific and medical per18 sonnel review clinical and other data, including data 

19 generated in controlled clinical trials. The Food and 

20 Drug Administration also reviews consumer studies 

21 and monitors post-marketing safety data. All of 

22 these processes ensure that the appropriate scientific 

23 and medical personnel make the determination of 

24 safety, quality, and efficacy of drugs marketed to 

25 the people of the United States. 


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1 (10) Leading women’s health experts, providers, 

2 and medical associations, including the American 

3 College of Obstetricians and Gynecologists and the 

4 American Academy of Family Physicians, support 

5 full insurance coverage and increased access to oral 

6 birth control over-the-counter. In 2012, the Amer7 ican College of Obstetricians and Gynecologists 

8 issued a Committee Opinion recommending approval 

9 by the Food and Drug Administration of certain 

10 forms of birth control for over-the-counter use to in11 crease timely access to birth control. Furthermore, 

12 data demonstrates that birth control that is available 

13 over-the-counter has public support and would in14 crease birth control usage and continuation. The 

15 Committee Opinion followed similar recommenda16 tions made by leading reproductive health experts 

17 and published in the American Journal of Public 

18 Health. 

19 (11) Research shows that birth control available 

20 over-the-counter, as an addition to, not a substitute 

21 for, the women’s preventive health benefit under the 

22 Patient Protection and Affordable Care Act, would 

23 increase accessibility for oral birth control for rou24 tine, daily use. 


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1 SEC. 4. SENSE OF THE SENATE. 

2 It is the sense of the Senate that— 

3 (1) in order to increase women’s access to oral 

4 birth control, it must be both easier to obtain and 

5 affordable and, to make it either easier to obtain or 

6 more affordable, but not both, is to leave unaccept7 able barriers in place for women; 

8 (2) it is imperative that the entities that re9 search and develop oral birth control and whose 

10 medical and scientific experts have developed clinical 

11 and other evidence that oral birth control for rou12 tine, daily use is safe and effective for women when 

13 sold without a prescription, apply to the Food and 

14 Drug Administration for review and approval for 

15 sale of such birth control without a prescription; 

16 (3) upon the receipt of such an application, the 

17 Food and Drug Administration should determine 

18 whether the oral birth control meets the rigorous 

19 safety, efficacy, and quality standards for over-the20 counter use under the Federal Food, Drug, and Cos21 metic Act (21 U.S.C. 301 et seq.), and if the prod22 uct meets those standards, the Food and Drug Ad23 ministration should approve the application without 

24 delay; and 

25 (4) if and when the Food and Drug Adminis26 tration approves an oral birth control that is availVerDate Sep 11 2014 23:06 Jun 09, 2015 Jkt 049200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1532.IS S1532

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1 able over-the-counter, such birth control should be 

2 covered by health insurance, without a prescription 

3 and without cost-sharing. 

4 SEC. 5. ENSURING COVERAGE OF ORAL BIRTH CONTROL 

5 FOR USE WITHOUT A PRESCRIPTION. 

6 Section 2713(a)(4) of the Public Health Service Act 

7 (42 U.S.C. 300gg–13(a)(4)) is amended by inserting ‘‘(in8 cluding oral contraceptives for routine, daily use approved 

9 by the Food and Drug Administration for use without a 

10 prescription, even if the individual does not have a pre11 scription for such contraceptive)’’ after ‘‘additional pre12 ventive care’’. 

13 SEC. 6. RULES OF CONSTRUCTION. 

14 (a) NON-INTERFERENCE WITH FDA REGULA15 TION.—Nothing in this Act (or the amendment made by 

16 this Act) shall be construed to modify or interfere with 

17 Food and Drug Administration processes to review or ap18 prove, or otherwise determine the safety and efficacy of, 

19 and make available, non-prescription drugs or devices, 

20 modify or interfere with the scientific and medical consid21 erations of the Food and Drug Administration, or alter 

22 any other authority of the Food and Drug Administration. 

23 (b) NON-PREEMPTION.—Nothing in this Act (or the 

24 amendment made by this Act) preempts any provision of 

25 Federal or State law to the extent that such Federal or 


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1 State law provides protections for consumers that are 

2 greater than the protections provided for in this Act. 

3 SEC. 7. DUTIES OF RETAILERS TO ENSURE ACCESS TO 

4 ORAL BIRTH CONTROL FOR USE WITHOUT A 

5 PRESCRIPTION. 

6 (a) IN GENERAL.—Any retailer that stocks oral birth 

7 control for routine, daily use that is approved by, or other8 wise legally marketed under regulation by, the Food and 

9 Drug Administration for use without a prescription may 

10 not interfere with an individual’s access to or purchase 

11 of such birth control or access to medically accurate, com12 prehensive information about such birth control. 

13 (b) LIMITATION.—Nothing in this section shall pro14 hibit a retailer that stocks oral birth control for routine, 

15 daily use from refusing to provide an individual with such 

16 oral birth control that is approved by, or otherwise legally 

17 marketed under regulation by, the Food and Drug Admin18 istration if the individual is unable to pay for the birth 

19 control, directly or through insurance coverage. 

Æ 


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