I 

116TH CONGRESS 

1ST SESSION H. R. 3129 

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

screening. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 5, 2019 

Mr. GOMEZ (for himself, Mr. AGUILAR, Ms. BARRAGA ́N, Ms. BROWNLEY of 

California, Mr. DANNY K. DAVIS of Illinois, Mrs. DEMINGS, Ms. 

ESCOBAR, Ms. HAALAND, Mr. HASTINGS, Ms. JACKSON LEE, Mr. 

KHANNA, Ms. LEE of California, Mr. LUJA ́N, Mrs. CAROLYN B. MALONEY of New York, Ms. MOORE, Mr. MORELLE, Mr. MOULTON, Ms. 

MUCARSEL-POWELL, Ms. NORTON, Mr. PETERS, Miss RICE of New 

York, Ms. SCHAKOWSKY, Mr. SOTO, Ms. VELA ́ZQUEZ, Ms. WASSERMAN

SCHULTZ, Mr. WELCH, Ms. PRESSLEY, Mr. BLUMENAUER, Mr. HIGGINS

of New York, Mr. RASKIN, Mrs. FLETCHER, and Mr. GRIJALVA) 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 2019’’. 


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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 re10 ducing health care disparities among low-income 

11 women and women of color, decrease health care 

12 spending, and expand health literacy, access, and 

13 education about the benefits of regular preventive 

14 cancer screening for women. 

15 SEC. 3. FINDINGS. 

16 Congress finds as follows: 

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

18 death in women under the age of 54, and the Amer19 ican Cancer Society recommends that women in 

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

21 least every 3 years. 

22 (2) Ovarian cancer causes more deaths than 

23 any other cancer of the female reproductive system, 

24 but it accounts for only about 3 percent of all can25 cers in women. 


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1 (3) The cancers that most frequently impact 

2 women include breast, uterine, ovarian, and cervical 

3 cancer, and there were 331,394 new cases of these 

4 cancers in 2015. 

5 (4) Rates of incidence and death for gynecologic 

6 cancers by race and ethnicity show that, while for 

7 some cancers, like ovarian cancer, the rates of inci8 dence and death are similar among all races, for 

9 other cancers, like cervical cancer, women of color 

10 have a disproportionate rate of incidence. While the 

11 incidence of uterine cancer is similar for White 

12 women and women of color, rates of death for uter13 ine cancer are 2 times higher for Black women than 

14 for White women. 

15 (5) Prevention and cancer screening are the 

16 best approaches to protecting women from cancer 

17 and ensuring early detection and life-saving treat18 ment. Many deaths from breast and cervical cancers 

19 could be avoided if cancer screening rates and diag20 nostic care and services increased among women at 

21 risk. Deaths from these cancers occur disproportion22 ately among women who are uninsured or under23 insured. 

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

25 which used to be the leading cause of cancer death 


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

2 preventable and treatable cancer. It is also highly 

3 curable when found and treated early. 

4 (7) Increased access to education, information, 

5 and preventive cancer screening increase women’s 

6 ability to survive cancer. 

7 (8) While more than 15 percent of cases of cer8 vical cancer are found in women over the age of 65, 

9 it becomes less likely that women are tested for cer10 vical cancer ever or within the previous 5 years as 

11 their age increases. 

12 (9) Women’s health care providers that are pri13 marily engaged in family planning services, such as 

14 Planned Parenthood health centers, provide nec15 essary screening tests, education, and information to 

16 women, especially women of color who face the high17 est risks of breast cancer and other gynecologic can18 cers. 

19 SEC. 4. STRENGTHENING ACCESS TO CANCER SCREENING 

20 FOR WOMEN. 

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

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

23 by inserting after section 317P the following: 


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1 ‘‘SEC. 317P–1. GRANTS FOR WOMEN’S HEALTH CARE PRO2 VIDERS. 

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

4 make grants and to enter into contracts with public or 

5 nonprofit private entities to expand preventive health serv6 ices, as provided for in the Preventive Services Guidelines 

7 of the Health Resources and Service Administration that 

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

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

10 Pap tests, human papillomavirus vaccination, and diag11 nostic tests for women with cancer symptoms, particularly 

12 women of color. 

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

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

15 $20,000,000 for each of fiscal years 2020 through 2023.’’. 

16 (b) FUNDING.—There is authorized to be appro17 priated to carry out programs related to breast and 

18 gynecologic cancers under title XIX of the Social Security 

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

20 Health Service Act (42 U.S.C. 300 et seq.), and the Na21 tional Breast and Cervical Cancer Early Detection Pro22 gram, such sums as may be necessary for each of fiscal 

23 years 2020 through 2023. 

24 SEC. 5. EXPAND CANCER SCREENING PROVIDER TRAINING. 

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

26 (42 U.S.C. 243 et seq.), as amended by section 4, is furVerDate Sep 11 2014 19:50 Jun 12, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H3129.IH H3129

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1 ther amended by inserting after section 317P–1 the fol2 lowing: 

3 ‘‘SEC. 317P–2. WOMEN’S HEALTH CARE PROVIDERS DEM4 ONSTRATION TRAINING PROJECT. 

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

6 shall establish a demonstration program (referred to in 

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

8 eligible entities for the training of physicians, nurse practi9 tioners, and other health care providers related to life-sav10 ing breast and gynecologic cancer screening for women. 

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

12 enable each grant recipient to— 

13 ‘‘(1) provide to licensed physicians, nurse prac14 titioners, and other health care providers, through 

15 clinical training, education, and practice, the most 

16 up-to-date clinical guidelines and research adopted 

17 by the National Academies of Sciences, Engineering, 

18 and Medicine in the area of preventive cancer 

19 screening for breast and gynecologic cancers; 

20 ‘‘(2) establish a model of training for physi21 cians, nurse practitioners, and other health care pro22 viders that specializes in women’s health care, with 

23 a specific focus on breast and gynecologic cancer 

24 screening, that may be replicated nationwide; and 


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

2 other health care providers to serve rural commu3 nities, low-income communities, and communities of 

4 color in breast and gynecologic cancer screening. 

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

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

7 ‘‘(1) an entity that receives funding under sec8 tion 1001; 

9 ‘‘(2) an essential community provider primarily 

10 engaged in family planning, as defined in section 

11 156.235 of title 45, Code of Federal Regulations (or 

12 any successor regulations); 

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

14 to individuals who are eligible for medical assistance 

15 under title XIX of the Social Security Act; or 

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

17 provides cancer screening services under the Na18 tional Breast and Cervical Cancer Early Detection 

19 Program of the Centers for Disease Control and 

20 Prevention.’’. 

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

22 CANCER SCREENING FOR WOMEN. 

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

24 Human Services (referred to in this section as the ‘‘Sec25 retary’’) shall conduct a study (and periodically update 


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1 such study) on increased access to women’s preventive life2 saving cancer screening across the United States, and, not 

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

4 the Secretary shall submit a report to Congress on such 

5 study. 

6 (b) CONTENTS.—The study and reports under sub7 section (a) shall include: 

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

9 gynecologic cancer rates among women, including by 

10 geographic area, income, race, and status of insur11 ance coverage. 

12 (2) A 50-State analysis of cancer screening pro13 vided by women’s health care providers, including 

14 clinical breast exams, other screening for breast can15 cer, and screening for cervical cancer, ovarian can16 cer, and other gynecologic cancers. 

17 (3) An analysis of the awareness and avail18 ability of breast, cervical, ovarian, and other gyneco19 logical cancer screening options for women with dis20 proportionate rates of gynecological cancers, includ21 ing African-American women, Hispanic and Latina 

22 women, and other disproportionately impacted 

23 groups, according to the 50-State analyses described 

24 in paragraphs (1) and (2). 


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1 (4) In consultation with the Comptroller Gen2 eral of the United States, estimated Federal savings 

3 achieved through early detection of breast and 

4 gynecologic cancer. 

5 (5) Analysis of how access to health care pro6 viders trained under the program described in sec7 tion 317P–2 of the Public Health Service Act, as 

8 added by section 5, in comparison to other health 

9 care providers, increased early detection of cancer 

10 for women. 

11 (6) Recommendations by the Secretary with re12 spect to the need for continued increased access to 

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

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

15 Service Act, as added by section 4, who provide pre16 ventive care, including life-saving cancer screening. 

17 (7) Recommendations for increasing screening 

18 rates for women who are less likely to be screened 

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

20 gynecological cancers, including African-American 

21 women, Hispanic and Latina women, and older 

22 women. 


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

2 HUMAN PAPILLOMAVIRUS AND CERVICAL 

3 CANCER. 

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

5 (42 U.S.C. 243 et seq.), as amended by section 5, is fur6 ther amended by inserting after section 317P–2 the fol7 lowing: 

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

9 FOR HUMAN PAPILLOMAVIRUS AND CER10 VICAL CANCER. 

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

12 with the Director of the Centers for Disease Control and 

13 Prevention and the Administrator of the Health Resources 

14 and Services Administration, shall establish a 2-year dem15 onstration project on increasing the co-testing of human 

16 papillomavirus and cervical cancer screenings to develop 

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

18 with disproportionate rates of cervical cancer, including 

19 African-American and Hispanic and Latina women. 

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

21 this section shall use such funds to— 

22 ‘‘(1) increase access to co-testing of Human 

23 papillomavirus and cervical cancer among patients 

24 with disproportionate rates of cervical cancer, in25 cluding African-American and Hispanic and Latina 

26 women; 


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1 ‘‘(2) support culturally and linguistically appro2 priate delivery models to such patients, including 

3 through the provision of interpretation services; or 

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

5 outcomes with respect to such patients. 

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

7 under this section shall be given to entities serving low8 income, uninsured, and medically underserved populations 

9 or populations with historically low rates of such co-test10 ing, such as older women. 

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

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

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

Æ 


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