II 

116TH CONGRESS 

1ST SESSION S. 1847 

To require group health plans and group or individual health insurance 

coverage to provide coverage for over-the-counter contraceptives. 

IN THE SENATE OF THE UNITED STATES 

JUNE 13, 2019 

Mrs. MURRAY (for herself, Mrs. SHAHEEN, Mr. BOOKER, Ms. BALDWIN, Mr. 

BROWN, Mr. LEAHY, Mr. REED, Mrs. FEINSTEIN, Mr. BLUMENTHAL, 

Mr. KAINE, Mr. SANDERS, Ms. HIRONO, Ms. DUCKWORTH, Mr. 

MERKLEY, Ms. WARREN, Ms. CANTWELL, Ms. HASSAN, Mr. MENENDEZ, 

Mr. MARKEY, Mr. PETERS, Mr. WYDEN, Ms. KLOBUCHAR, Mr. BENNET, 

Ms. STABENOW, Ms. HARRIS, Mr. VAN HOLLEN, Mrs. GILLIBRAND, and 

Ms. SMITH) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To require group health plans and group or individual health 

insurance coverage to provide coverage for over-thecounter contraceptives. 

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 The Senate finds the following: 

10 (1) Birth control is critical health care that al11 most all women will use at some point in their life12 times. 

13 (2) Access to the full range of reproductive 

14 health care, including birth control coverage as guar15 anteed under Federal law, provides women with the 

16 opportunity to lead healthy lives and get the care 

17 they need to reach their goals. 

18 (3) Family planning has well-documented 

19 health benefits for women, newborns, families, and 

20 communities and can lower the risk of harm to ma21 ternal and infant health. 

22 (4) An estimated 66,000,000 women of repro23 ductive age (ages 15 through 44) live in the United 

24 States, of which nearly 70 percent are at risk of 

25 having an unintended pregnancy. Sixty percent of 

26 women of reproductive age are using a contraceptive 


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1 method and 10 percent of women at risk for unin2 tended pregnancy are not using contraception. The 

3 rates of non-use of contraception are highest among 

4 those between 15 and 19 years old. 

5 (5) The birth control benefit enacted under the 

6 Patient Protection and Affordable Care Act (Public 

7 Law 111–148) has been a crucial step forward in 

8 advancing access to birth control and has helped en9 sure nearly 62,800,000 women have the power to de10 cide for themselves if and when to start a family. 

11 (6) Despite legal requirements for birth control 

12 coverage and access to services, gaps remain for mil13 lions of women. A national survey found that 1 in 

14 3 women have struggled to afford birth control at 

15 some point in their lives, and as a result, have used 

16 birth control inconsistently. Access to birth control is 

17 particularly difficult for women who live in contra18 ceptive deserts and lack reasonable access to a 

19 health center that offers the full range of contracep20 tive methods. 

21 (7) Health disparities persist among low-income 

22 women, women of color, and women who lack access 

23 to health coverage and health care providers. 

24 (8) There are numerous social and economic 

25 barriers that make it harder to access birth control, 


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1 including rising income and wealth inequality, gaps 

2 in insurance coverage and challenges accessing 

3 health providers. 

4 (9) Leading health experts support over-the5 counter birth control pills. 

6 SEC. 4. SENSE OF THE SENATE. 

7 It is the sense of the Senate that— 

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

9 birth control, such birth control must be both easier 

10 to obtain and affordable and, to make such birth 

11 control either easier to obtain or more affordable, 

12 but not both, is to leave unacceptable barriers in 

13 place for women; 

14 (2) it is imperative that the entities that re15 search and develop oral birth control and whose 

16 medical and scientific experts have developed clinical 

17 and other evidence that oral birth control for rou18 tine, daily use is safe and effective for women when 

19 sold without a prescription, apply to the Food and 

20 Drug Administration for review and approval for 

21 sale of such birth control without a prescription; 

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

23 Food and Drug Administration should determine 

24 whether the oral birth control meets the rigorous 

25 safety, efficacy, and quality standards for over-theVerDate Sep 11 2014 16:09 Jun 15, 2019 Jkt 034408 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1847.IS S1847

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1 counter use under the Federal Food, Drug, and Cos2 metic Act (21 U.S.C. 301 et seq.), and if the prod3 uct meets those standards, the Food and Drug Ad4 ministration should approve the application without 

5 delay; and 

6 (4) if and when the Food and Drug Adminis7 tration approves an oral birth control that is avail8 able over-the-counter, such birth control should be 

9 covered by health insurance, without a prescription 

10 and without cost-sharing. 

11 SEC. 5. CLARIFYING COVERAGE REQUIREMENTS. 

12 The Secretaries of Health and Human Services, 

13 Labor, and the Treasury shall clarify that coverage of con14 traceptives pursuant to section 2713(a)(4) of the Public 

15 Health Service Act (42 U.S.C. 300gg–13(a)(4)) includes 

16 coverage of over-the-counter contraceptive methods ap17 proved by the Food and Drug Administration, even if the 

18 enrollee does not have a prescription for the contraceptive. 

19 SEC. 6. RULES OF CONSTRUCTION. 

20 (a) NON-INTERFERENCE WITH FDA REGULA21 TION.—Nothing in this Act shall be construed to modify 

22 or interfere with Food and Drug Administration processes 

23 to review or approve, or otherwise determine the safety 

24 and efficacy of, and make available, non-prescription 

25 drugs or devices, modify or interfere with the scientific 


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1 and medical considerations of the Food and Drug Admin2 istration, or alter any other authority of the Food and 

3 Drug Administration. 

4 (b) NON-PREEMPTION.—Nothing in this Act pre5 empts any provision of Federal or State law to the extent 

6 that such Federal or State law provides protections for 

7 consumers that are greater than the protections provided 

8 for in this Act. 

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

10 ORAL BIRTH CONTROL FOR USE WITHOUT A 

11 PRESCRIPTION. 

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

13 control for routine, daily use that is approved by, or other14 wise legally marketed under regulation by, the Food and 

15 Drug Administration for use without a prescription may 

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

17 of such birth control or access to medically accurate, com18 prehensive information about such birth control. 

19 (b) LIMITATION.—Nothing in this section shall pro20 hibit a retailer that stocks oral birth control for routine, 

21 daily use from refusing to provide an individual with such 

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

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1 istration if the individual is unable to pay for the birth 

2 control, directly or through insurance coverage. 

Æ 


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