II 

Calendar No. 459 

113TH CONGRESS 

2D SESSION S. 2578 

To ensure that employers cannot interfere in their employees’ birth control 

and other health care decisions. 

IN THE SENATE OF THE UNITED STATES 

JULY 9, 2014 

Mrs. MURRAY (for herself, Mr. UDALL of Colorado, Ms. BALDWIN, Mr. 

BEGICH, Mr. BENNET, Mr. BLUMENTHAL, Mr. BOOKER, Mrs. BOXER, 

Mr. BROWN, Ms. CANTWELL, Mr. CARDIN, Mr. DURBIN, Mrs. FEINSTEIN, Mr. FRANKEN, Mrs. GILLIBRAND, Mrs. HAGAN, Mr. HARKIN, Mr. 

HEINRICH, Ms. HIRONO, Mr. JOHNSON of South Dakota, Mr. KAINE, 

Ms. KLOBUCHAR, Mr. LEVIN, Mr. MARKEY, Mr. MENENDEZ, Mr. 

MERKLEY, Ms. MIKULSKI, Mr. MURPHY, Mr. REID, Mr. SANDERS, Mr. 

SCHATZ, Mr. SCHUMER, Mrs. SHAHEEN, Ms. STABENOW, Mr. TESTER, 

Mr. UDALL of New Mexico, Mr. WALSH, Ms. WARREN, Mr. WHITEHOUSE, Mr. WYDEN, Mr. LEAHY, Mr. COONS, and Mr. WARNER) introduced the following bill; which was read the first time 

JULY 10, 2014 

Read the second time and placed on the calendar 

A BILL 

To ensure that employers cannot interfere in their employees’ 

birth control and other health care decisions. 

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 ‘‘Protect Women’s 

3 Health From Corporate Interference Act of 2014’’. 

4 SEC. 2. PURPOSE. 

5 The purpose of this Act is to ensure that employers 

6 that provide health benefits to their employees cannot 

7 deny any specific health benefits, including contraception 

8 coverage, to any of their employees or the covered depend9 ents of such employees entitled by Federal law to receive 

10 such coverage. 

11 SEC. 3. FINDINGS. 

12 Congress finds as follows: 

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

14 and preventive services, as guaranteed under Fed15 eral law or through Federal regulations, provides all 

16 Americans with the opportunity to lead healthier 

17 and more productive lives. 

18 (2) Birth control is a critical health care service 

19 for women. Ninety-nine percent of sexually active 

20 women use birth control at least once in their life21 times, and the Centers for Disease Control and Pre22 vention declared it one of the Ten Great Public 

23 Health Achievements of the 20th Century. While the 

24 most common reason women use contraception is to 

25 prevent pregnancy, 58 percent of oral contraceptive 

26 users cite noncontraceptive health benefits as reaVerDate Mar 15 2010 00:28 Jul 11, 2014 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S2578.PCS S2578

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1 sons for using the method. Fourteen percent of birth 

2 control pill users, more than 1,500,000 women, rely 

3 on birth control pills for noncontraceptive purposes 

4 only. 

5 (3) In addition to providing health benefits for 

6 women, access to birth control has been directly con7 nected to women’s economic success and ability to 

8 participate in society equally. Women with access to 

9 birth control are more likely to have higher edu10 cational achievement and career achievement, and to 

11 be paid higher wages. 

12 (4) The independent, nonprofit Institute of 

13 Medicine recommends, as part of its recommended 

14 preventive health measures, that women’s preventive 

15 health be covered by health plans with no cost-shar16 ing to promote optimal health of women. The Insti17 tute of Medicine noted that the contraceptive meth18 ods recommendation was one of the most important 

19 recommendations for women. 

20 (5) Affordability has long been a barrier to 

21 women being able to use birth control and other pre22 ventive health services effectively. A national survey 

23 of women who were currently using some form of 

24 contraception found that one-third would switch to a 

25 different method of contraception if they did not 


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1 have to worry about cost. Women citing cost con2 cerns were twice as likely as other women to rely on 

3 less effective methods of contraception. 

4 (6) Three separate studies have found that lack 

5 of health coverage is significantly associated with re6 duced use of prescription contraceptives. 

7 (7) Cost-sharing requirements can dramatically 

8 reduce the use of preventive health care measures, 

9 particularly among lower-income women. Studies 

10 have shown that eliminating cost-sharing for the 

11 most effective forms of contraception (intrauterine 

12 devices, implants, and injectables) leads to sizable 

13 increases in the use of these methods. 

14 (8) The Patient Protection and Affordable Care 

15 Act (Public Law 111–148) sought to remove the 

16 barrier to care by requiring all new health plans to 

17 cover recommended preventive services without cost18 sharing, which include women’s preventative serv19 ices. These services include all methods of contracep20 tion and sterilization approved by the Food and 

21 Drug Administration and related education and 

22 counseling, as prescribed by a health care provider. 

23 (9) The contraceptive coverage provision has 

24 been a success in increasing access to this critical 

25 health service for women. As of 2013, 47,000,000 


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1 women were covered by this requirement. Women 

2 have saved $483,000,000 in out-of-pocket costs for 

3 oral contraceptives with no copayments in 2013 

4 compared to 2012. 

5 (10) The Journal of the American Medical As6 sociation reports that 7 out of 10 people in the 

7 United States support coverage of contraception, 

8 with significantly higher support among women, 

9 Hispanic Americans, and Black Americans. 

10 (11) An estimated 76,000,000 people in the 

11 United States, including 30,000,000 women, are 

12 newly eligible for expanded preventive services cov13 erage under the Patient Protection and Affordable 

14 Care Act. A total of 48,500,000 women are esti15 mated to benefit from preventive services coverage 

16 without cost-sharing. 

17 (12) The most appropriate method of contra18 ception varies according to each individual woman’s 

19 needs and medical history. Women may have medical 

20 contraindications and thus not be able to use certain 

21 types of contraceptive methods. It is therefore vital 

22 that the full range of contraceptive methods ap23 proved by the Food and Drug Administration be 

24 available in order to ensure that each woman, in 


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1 consultation with her medical provider, can make ap2 propriate decisions about her health care. 

3 (13) Covering proven preventative services like 

4 contraception lowers health care spending as it im5 proves health. The Federal Government experienced 

6 no increase in costs at all after it began covering 

7 contraceptives for Federal employees. A study by the 

8 National Business Group on Health estimated that 

9 it costs employers 15 to 17 percent more to not pro10 vide contraceptive coverage in employee health plans, 

11 accounting for the employer’s direct medical costs of 

12 pregnancy and indirect costs related to employee ab13 sence and reduced productivity. 

14 (14) Dozens of cases have been filed in Federal 

15 court by employers that want to take this benefit 

16 away from their employees and the covered depend17 ents of such employees. 

18 (15) On June 30, 2014, the Supreme Court 

19 held, in Burwell v. Hobby Lobby Stores, Inc. and 

20 Conestoga Wood Specialties Corp. v. Burwell, that 

21 some for-profit corporations can take away the birth 

22 control coverage guaranteed to their employees and 

23 the covered dependents of such employees through 

24 their group health plan. 


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1 (16) In a dissent in those cases, Justice Ruth 

2 Bader Ginsburg states that in this ‘‘decision of star3 tling breadth . . . the exemption sought by Hobby 

4 Lobby and Conestoga . . . would deny legions of 

5 women who do not hold their employers’ beliefs ac6 cess to contraceptive coverage that the ACA would 

7 otherwise secure.’’ Justice Ginsburg also notes that 

8 the decision opens up the door to religiously ground9 ed employer objections to a whole host of health care 

10 services like ‘‘blood transfusions . . .. 

11 antidepressants . . . medications derived from pigs, 

12 including anesthesia . . . and vaccinations.’’. 

13 (17) The Supreme Court’s decision in those 

14 cases allows employers, that otherwise provide cov15 erage of preventive health services, to deny their em16 ployees and the covered dependents of such employ17 ees contraceptive coverage and to treat a critical 

18 women’s health service differently than other com19 parable services. Legislation is needed to clarify that 

20 employers may not discriminate against their em21 ployees and dependents. 

22 (18) It is imperative that Congress act to rein23 state contraception coverage and to protect employ24 ees and the covered dependents of such employees 

25 from other attempts to take away coverage for other 


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1 health benefits to which such employees and depend2 ents are entitled under Federal law. 

3 (19) This Act is intended to be consistent with 

4 the Congressional intent in enacting the Religious 

5 Freedom and Restoration Act of 1993 (Public Law 

6 103–141), and with the exemption for houses of 

7 worship, and an accommodation for religiously-affili8 ated nonprofit organizations with objections to con9 traceptive coverage. 

10 SEC. 4. ENSURING COVERAGE OF SPECIFIC BENEFITS. 

11 (a) IN GENERAL.—An employer that establishes or 

12 maintains a group health plan for its employees (and any 

13 covered dependents of such employees) shall not deny cov14 erage of a specific health care item or service with respect 

15 to such employees (or dependents) where the coverage of 

16 such item or service is required under any provision of 

17 Federal law or the regulations promulgated thereunder. 

18 A group health plan, as defined in section 733(a) of the 

19 Employee Retirement Income Security Act of 1974 (29 

20 U.S.C. 1191b(a)), sponsored by an employer, employee or21 ganization, or both, and any health insurance coverage, 

22 as defined in section 2791(b) of the Public Health Service 

23 Act (42 U.S.C. 300gg–91) is required to provide coverage 

24 required under the Public Health Service Act, including 


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1 section 2713 of such Act (42 U.S.C. 300gg–13), in addi2 tion to other applicable requirements. 

3 (b) APPLICATION.—Subsection (a) shall apply not4 withstanding any other provision of Federal law, including 

5 Public Law 103–141. 

6 (c) REGULATIONS.—The regulations contained in 

7 sections 54.9815-2713A of title 26, 2590.715-2713A of 

8 title 29, and 147.131 of title 45, Code of Federal Regula9 tions, shall apply with respect to this section. The Depart10 ments of Labor, Health and Human Services, and the 

11 Treasury may modify such regulations consistent with the 

12 purpose and findings of this Act. 

13 (d) ENFORCEMENT.—The provisions of this Act shall 

14 apply to plan sponsors, group health plans, and health in15 surance issuers as if enacted in the Employee Retirement 

16 Income Security Act of 1974 (29 U.S.C. 1001 et seq.), 

17 the Public Health Service Act (42 U.S.C. 201 et seq.), 

18 and the Internal Revenue Code of 1986. Any failure by 

19 a plan sponsor, group health plan, or health insurance 

20 issuer to comply with the provisions of this Act shall be 

21 subject to enforcement through part 5 of subtitle B of title 

22 I of the Employee Retirement Income Security Act of 

23 1974 (29 U.S.C. 1131 et seq.), section 2723 of the Public 

24 Health Service Act (42 U.S.C. 300gg–22), and section 

25 4980D of the Internal Revenue Code of 1986. 


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Calendar No. 459 

113TH CONGRESS 

2D SESSION S. 2578 

A BILL 

To ensure that employers cannot interfere in their 

decisions. employees’ birth control and other health care 

JULY 10, 2014 

Read the second time and placed on the calendar 


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