I 

116TH CONGRESS 

1ST SESSION H. R. 2091 

To amend title 10, United States Code, to ensure that 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 HOUSE OF REPRESENTATIVES 

APRIL 4, 2019 

Ms. SPEIER (for herself, Miss RICE of New York, Ms. MOORE, Mr. FOSTER, 

Mr. COHEN, Mr. CICILLINE, Ms. SCHAKOWSKY, Ms. DELAURO, Ms. 

WASSERMAN SCHULTZ, Mr. ESPAILLAT, Ms. JUDY CHU of California, 

Mr. VEASEY, Ms. JAYAPAL, Ms. NORTON, Mr. RASKIN, Mr. GALLEGO, 

Ms. DELBENE, Mr. GRIJALVA, Ms. DEGETTE, Ms. MATSUI, Mr. LARSEN

of Washington, Mr. POCAN, Mr. BERA, Mr. PASCRELL, Mr. TAKANO, Mr. 

HIMES, Mr. BLUMENAUER, Mr. PRICE of North Carolina, Mr. NADLER, 

Ms. BROWNLEY of California, Ms. LEE of California, Mr. SCHIFF, Ms. 

BONAMICI, Mr. MCGOVERN, Ms. MENG, Mrs. NAPOLITANO, Mr. 

DEUTCH, Mr. WELCH, Ms. HAALAND, Mr. KILMER, Mr. YARMUTH, Mr. 

HASTINGS, Mr. DEFAZIO, Mr. SHERMAN, Ms. ROYBAL-ALLARD, Mr. 

RYAN, Mr. AGUILAR, and Ms. TITUS) introduced the following bill; which 

was referred to the Committee on Armed Services 

A BILL 

To amend title 10, United States Code, to ensure that 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. 

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


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Access to Contracep3 tion for Servicemembers and Dependents Act of 2019’’. 

4 SEC. 2. FINDINGS. 

5 Congress finds the following: 

6 (1) Women are serving in the Armed Forces at 

7 increasing rates, playing a critical role in the na8 tional security of the United States. Women com9 prise more than 17 percent of members of the 

10 Armed Forces, and as of 2018 nearly 350,000 

11 women serve on active duty in the Armed Forces or 

12 in the Selected Reserve. 

13 (2) Ninety-five percent of women serving in the 

14 Armed Forces are of reproductive age. And as of 

15 2017, more than 700,000 female spouses and de16 pendents of active duty members are of reproductive 

17 age. 

18 (3) The TRICARE program covered 1,563,727 

19 women of reproductive age in 2017, including female 

20 spouses and dependents of active duty members. 

21 (4) The benefits of contraception are widely rec22 ognized and include improved health and well-being, 

23 reduced global maternal mortality, health benefits of 

24 pregnancy spacing for maternal and child health, 

25 and women’s greater educational and professional 

26 opportunities and increased lifetime earnings. 


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1 (5) Studies have shown that when cost barriers 

2 to the full range of methods of contraception are 

3 eliminated, and women receive comprehensive coun4 seling on the various methods of contraception (in5 cluding highly effective and more expensive long-act6 ing reversible contraceptives), rates of unintended 

7 pregnancy decline. 

8 (6) Research has also shown that investments 

9 in effective contraception save public and private 

10 dollars. 

11 (7) In order to fill gaps in coverage and access 

12 to preventive care critical for women’s health, the 

13 Patient Protection and Affordable Care Act (Public 

14 Law 111–148) requires all non-grandfathered indi15 vidual and group health plans to cover without cost16 sharing preventive services, including a set of evi17 dence-based preventive services for women supported 

18 by the Health Resources and Services Administra19 tion of the Department of Health and Human Serv20 ices. These women’s preventive services include the 

21 full range of female-controlled contraceptive meth22 ods, effective family planning practices, and steriliza23 tion procedures, approved by the Food and Drug 

24 Administration. The Health Resources and Services 

25 Administration has affirmed that contraceptive care 


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1 includes contraceptive counseling, initiation of con2 traceptive use, and follow-up care (such as manage3 ment, evaluation, and changes to and removal or dis4 continuation of the contraceptive method). 

5 (8) Under the TRICARE program, women 

6 members on active duty have full coverage of all pre7 scription drugs, including contraception, without 

8 cost-sharing requirements, in line with the Patient 

9 Protection and Affordable Care Act (Public Law 

10 111–148), which requires coverage of all contracep11 tive methods approved by the Food and Drug Ad12 ministration for women and related services and 

13 education and counseling. However, women members 

14 not on active duty and female dependents of mem15 bers do not have similar coverage of all prescription 

16 methods of contraception approved by the Food and 

17 Drug Administration without cost-sharing when they 

18 fill their prescriptions outside of a military medical 

19 treatment facility. 

20 (9) Studies indicate that women members need 

21 comprehensive counseling for pregnancy prevention 

22 and the lack thereof is contributing to unintended 

23 pregnancies among women members. Additionally, 

24 they need counseling on and availability of contra25 ception for non-contraceptive benefits (for example, 


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1 menstrual suppression and predictable menstrual 

2 patterns) which is important in ensuring readiness 

3 for deployment to remote or operational theaters. 

4 (10) Research studies based on the Department 

5 of Defense Survey of Health Related Behaviors 

6 Among Active Duty Military Personnel found a high 

7 rate of unintended pregnancy among women mem8 bers. Adjusting for the difference between age dis9 tributions in the Armed Forces and the general pop10 ulation, the rate of unintended pregnancy among 

11 women members is higher than among the general 

12 population. 

13 (11) The Defense Advisory Committee on 

14 Women in the Services has recommended that all 

15 the Armed Forces, to the extent that they have not 

16 already, implement initiatives that inform members 

17 of the importance of family planning, educate them 

18 on methods of contraception, and make various 

19 methods of contraception available, based on the 

20 finding that family planning can increase the overall 

21 readiness and quality of life of all members of the 

22 military. 

23 (12) The military departments received more 

24 than 6,700 reports of sexual assaults involving mem25 bers as victims or subjects during fiscal year 2017. 


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1 Through regulations, the Department of Defense al2 ready supports a policy of ensuring that women 

3 members who are sexually assaulted have access to 

4 emergency contraception, and the initiation of con5 traception if desired and medically appropriate. 

6 SEC. 3. CONTRACEPTION COVERAGE PARITY UNDER THE 

7 TRICARE PROGRAM. 

8 (a) IN GENERAL.—Section 1074d of title 10, United 

9 States Code, is amended— 

10 (1) in subsection (a), by inserting ‘‘FOR MEM11 BERS AND FORMER MEMBERS’’ after ‘‘SERVICES

12 AVAILABLE’’; 

13 (2) by redesignating subsection (b) as sub14 section (d); and 

15 (3) by inserting after subsection (a) the fol16 lowing new subsections: 

17 ‘‘(b) CARE RELATED TO PREVENTION OF PREG18 NANCY.—Female covered beneficiaries shall be entitled to 

19 care related to the prevention of pregnancy described by 

20 subsection (d)(3). 

21 ‘‘(c) PROHIBITION ON COST-SHARING FOR CERTAIN

22 SERVICES.—Notwithstanding section 1074g(a)(6), section 

23 1075, or section 1075a of this title or any other provision 

24 of law, cost-sharing may not be imposed or collected for 

25 care related to the prevention of pregnancy provided purVerDate Sep 11 2014 03:17 Apr 16, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2091.IH H2091

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1 suant to subsection (a) or (b), including for any method 

2 of contraception provided, whether provided through a fa3 cility of the uniformed services, the TRICARE retail phar4 macy program, or the national mail-order pharmacy pro5 gram.’’. 

6 (b) CARE RELATED TO PREVENTION OF PREG7 NANCY.—Subsection (d)(3) of such section, as redesig8 nated by subsection (a)(2) of this section, is further 

9 amended by inserting before the period at the end the fol10 lowing: ‘‘(including all methods of contraception approved 

11 by the Food and Drug Administration, contraceptive care 

12 (including with respect to insertion, removal, and follow 

13 up), sterilization procedures, and patient education and 

14 counseling in connection therewith)’’. 

15 (c) CONFORMING AMENDMENT.—Section 

16 1077(a)(13) of such title is amended by striking ‘‘section 

17 1074d(b)’’ and inserting ‘‘section 1074d(d)’’. 

18 SEC. 4. PREGNANCY PREVENTION ASSISTANCE AT MILI19 TARY MEDICAL TREATMENT FACILITIES FOR 

20 SEXUAL ASSAULT SURVIVORS. 

21 (a) IN GENERAL.—Chapter 55 of title 10, United 

22 States Code, is amended by inserting after section 1074o 

23 the following new section: 


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1 ‘‘§ 1074p. Provision of pregnancy prevention assist2 ance at military medical treatment facili3 ties 

4 ‘‘(a) INFORMATION AND ASSISTANCE.—The Sec5 retary of Defense shall promptly furnish to sexual assault 

6 survivors at each military medical treatment facility the 

7 following: 

8 ‘‘(1) Comprehensive, medically and factually ac9 curate, and unbiased written and oral information 

10 about all methods of emergency contraception ap11 proved by the Food and Drug Administration. 

12 ‘‘(2) Notification of the right of the sexual as13 sault survivor to confidentiality with respect to the 

14 information and care and services furnished under 

15 this section. 

16 ‘‘(3) Upon request by the sexual assault sur17 vivor, emergency contraception or, if applicable, a 

18 prescription for emergency contraception. 

19 ‘‘(b) INFORMATION.—The Secretary shall ensure that 

20 information provided pursuant to subsection (a) is pro21 vided in language that— 

22 ‘‘(1) is clear and concise; 

23 ‘‘(2) is readily comprehensible; and 

24 ‘‘(3) meets such conditions (including condi25 tions regarding the provision of information in lanVerDate Sep 11 2014 03:17 Apr 16, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H2091.IH H2091

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1 guages other than English) as the Secretary may 

2 prescribe in regulations to carry out this section. 

3 ‘‘(c) DEFINITIONS.—In this section: 

4 ‘‘(1) The term ‘sexual assault survivor’ means 

5 any individual who presents at a military medical 

6 treatment facility and— 

7 ‘‘(A) states to personnel of the facility that 

8 the individual experienced a sexual assault; 

9 ‘‘(B) is accompanied by another person 

10 who states that the individual experienced a 

11 sexual assault; or 

12 ‘‘(C) whom the personnel of the facility 

13 reasonably believes to be a survivor of sexual 

14 assault. 

15 ‘‘(2) The term ‘sexual assault’ means the con16 duct described in section 1565b(c) of this title that 

17 may result in pregnancy.’’. 

18 (b) CLERICAL AMENDMENT.—The table of sections 

19 at the beginning of such chapter is amended by inserting 

20 after the item relating to section 1074o the following new 

21 item: 

‘‘1074p. Provision of pregnancy prevention assistance at military medical treatment facilities.’’. 

22 SEC. 5. EDUCATION ON FAMILY PLANNING FOR MEMBERS 

23 OF THE ARMED FORCES. 

24 (a) EDUCATION PROGRAMS.— 


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1 (1) IN GENERAL.—Not later than one year 

2 after the date of the enactment of this Act, the Sec3 retary of Defense shall establish a uniform standard 

4 curriculum to be used in education programs on 

5 family planning for all members of the Armed 

6 Forces, including both men and women members, 

7 during the following periods: 

8 (A) The first year of service. 

9 (B) When a member is in training to as10 sume command. 

11 (C) When an enlisted member becomes a 

12 senior enlisted member. 

13 (2) SENSE OF CONGRESS.—It is the sense of 

14 Congress that the education programs under para15 graph (1) should be evidence-informed and use the 

16 latest technology available to efficiently and effec17 tively deliver information to members of the Armed 

18 Forces. 

19 (b) ELEMENTS.—The uniform standard curriculum 

20 under subsection (a) shall include the following: 

21 (1) Information for members of the Armed 

22 Forces on active duty to make informed decisions re23 garding family planning. 

24 (2) Information about the prevention of unin25 tended pregnancy and sexually transmitted infecVerDate Sep 11 2014 03:17 Apr 16, 2019 Jkt 089200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H2091.IH H2091

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1 tions, including human immunodeficiency virus 

2 (commonly known as ‘‘HIV’’). 

3 (3) Information on— 

4 (A) the importance of providing com5 prehensive family planning for members, includ6 ing commanding officers; and 

7 (B) the positive impact family planning 

8 can have on the health and readiness of the 

9 Armed Forces. 

10 (4) Current, medically accurate information. 

11 (5) Clear, user-friendly information on— 

12 (A) the full range of methods of contracep13 tion approved by the Food and Drug Adminis14 tration; and 

15 (B) where members can access their cho16 sen method of contraception. 

17 (6) Information on all applicable laws and poli18 cies so that members are informed of their rights 

19 and obligations. 

20 (7) Information on patients’ rights to confiden21 tiality. 

22 (8) Information on the unique circumstances 

23 encountered by members and the effects of such cir24 cumstances on the use of contraception. 

Æ 


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