II 

113TH CONGRESS 

2D SESSION S. 2876 

To establish a public education and awareness and access program relating 

to emergency contraception. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 18, 2014 

Mrs. MURRAY (for herself, Mrs. BOXER, Ms. WARREN, Mr. BLUMENTHAL, 

and Mr. BOOKER) introduced the following bill; which was read twice and 

referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To establish a public education and awareness and access 

program relating to emergency contraception. 

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 ‘‘Emergency Contracep5 tion Access and Education Act of 2014’’. 

6 SEC. 2. FINDINGS. 

7 Congress makes the following findings: 

8 (1) Each year 3,400,000 pregnancies, or one9 half of all pregnancies, in the United States are unVerDate Sep 11 2014 00:08 Oct 02, 2014 Jkt 049200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S2876.IS S2876

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1 intended, and 4 in 10 of these unintended preg2 nancies end in abortion. 

3 (2) The Food and Drug Administration has de4 clared emergency contraception to be safe and effec5 tive in preventing unintended pregnancy for women 

6 of reproductive potential and has approved certain 

7 forms of emergency contraceptive for unrestricted 

8 sale on pharmacy shelves to women of all ages. 

9 (3) Research indicates that emergency contra10 ception reduces the risk of pregnancy by up to 95 

11 percent and emergency IUD insertion reduces the 

12 risk by 99 percent. Although more effective the 

13 sooner it is taken, medical evidence indicates that 

14 emergency contraception can be effective up to 5 

15 days after unprotected intercourse or contraceptive 

16 failure. 

17 (4) Emergency contraception is a responsible 

18 means of preventing pregnancy that works like other 

19 hormonal contraceptives by suppressing or delaying 

20 ovulation, which makes fertilization from unpro21 tected intercourse unlikely if the medication is taken 

22 within 120 hours. Emergency contraception does not 

23 terminate an established pregnancy. 


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1 (5) Most brands of emergency contraception 

2 consist of the same hormones found in other hor3 monal birth control. 

4 (6) The percentage of sexually experienced 

5 women aged 15 to 44 in the United States who have 

6 ever used emergency contraception increased from 

7 4.2 percent in 2002 to 11 percent in years 2006 

8 through 2010. 

9 (7) A recent study by the Guttmacher Institute 

10 demonstrates that the rate of teen pregnancy in the 

11 United States has reached a historic low, declining 

12 51 percent since its peak in 1990. From 2008 to 

13 2010, increasing proportions of women aged 18 and 

14 19 reported becoming sexually active, yet fewer of 

15 them got pregnant during this time period than in 

16 previous studies. Research suggests that increasing 

17 rates of contraceptive use may be associated with 

18 the decline in teen pregnancy. 

19 (8) Despite an increase in use, significant dis20 parities exist for young, urban, minority women who 

21 lack general knowledge about emergency contracep22 tion. In fact, 1 in 4 teens remain completely un23 aware of the method and its use. 

24 (9) Although the American College of Obstetri25 cians and Gynecologists (ACOG) recommends that 


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1 doctors routinely discuss emergency contraception 

2 with women of reproductive age during their clinical 

3 visits only half of obstetricians/gynecologists offer 

4 emergency contraception to all of their patients in 

5 need suggesting that greater provider and patient 

6 awareness and education is needed. 

7 (10) Nearly 1 out of 5 American women is a 

8 victim of rape. It is estimated that 25,000 to 32,000 

9 women become pregnant each year as a result of 

10 rape, half of whom choose to terminate their preg11 nancy. The risk of pregnancy after sexual assault 

12 has been estimated to be 4.7 percent in adult sur13 vivors who were not protected by some form of con14 traception at the time of the attack. If used cor15 rectly, emergency contraception could help many of 

16 these rape survivors avoid the additional trauma of 

17 facing an unintended pregnancy. 

18 (11) Only 18 States and the District of Colum19 bia require hospital emergency rooms to provide 

20 emergency contraception-related services to survivors 

21 of sexual assault. Of those, only 13 States and the 

22 District of Columbia require hospital emergency 

23 rooms to provide emergency contraception upon re24 quest to survivors of sexual assault. Nine States 

25 have adopted restrictions on emergency contracepVerDate Sep 11 2014 00:08 Oct 02, 2014 Jkt 049200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S2876.IS S2876

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1 tion, and six States explicitly allow pharmacists to 

2 refuse to dispense emergency contraception. 

3 (12) In light of their safety and efficacy, the 

4 American Medical Association, American Academy 

5 of Pediatrics, American Women’s Medical Associa6 tion, Society for Adolescent Medicine, and the Amer7 ican College of Obstetricians and Gynecologists have 

8 endorsed more widespread availability of emergency 

9 contraceptives. 

10 (13) Healthy People 2020, published by the Of11 fice of Disease Prevention and Health Promotion 

12 (ODPHP), establishes a 10-year national public 

13 health goal of increasing the proportion of publicly 

14 funded health care providers who provide emergency 

15 contraception to their patients, and reducing the 

16 number of unintended pregnancies by 10 percent. 

17 (14) Public awareness campaigns targeting 

18 women and health care providers will help remove 

19 many of the barriers to emergency contraception and 

20 will help bring this important means of pregnancy 

21 prevention to women in the United States. 

22 SEC. 3. DEFINITIONS. 

23 In this Act: 

24 (1) EMERGENCY CONTRACEPTION.—The term 

25 ‘‘emergency contraception’’ means a drug or device 


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1 (as such terms are defined in section 201 of the 

2 Federal Food, Drug, and Cosmetic Act (21 U.S.C. 

3 321)), or drug regimen that— 

4 (A) is used postcoitally; 

5 (B) prevents pregnancy primarily by pre6 venting or delaying ovulation, and does not ter7 minate an established pregnancy; and 

8 (C) is approved by the Food and Drug Ad9 ministration. 

10 (2) HEALTH CARE PROVIDER.—The term 

11 ‘‘health care provider’’ means an individual who is li12 censed or certified under State law to provide health 

13 care services and who is operating within the scope 

14 of such license. Such term shall include a phar15 macist. 

16 (3) HOSPITAL.—The term ‘‘hospital’’ means— 

17 (A) a hospital as defined in section 

18 1861(e) of the Social Security Act (42 U.S.C. 

19 1395x(e)); and 

20 (B) a critical access hospital as defined in 

21 section 1861(mm)(1) of such Act (42 U.S.C. 

22 1395x(mm)(1)). 

23 (4) INSTITUTION OF HIGHER EDUCATION.—The 

24 term ‘‘institution of higher education’’ has the 


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1 meaning given such term in section 101(a) of the 

2 Higher Education Act of 1965 (20 U.S.C. 1001(a)). 

3 (5) SECRETARY.—The term ‘‘Secretary’’ means 

4 the Secretary of Health and Human Services. 

5 (6) SEXUAL ASSAULT.— 

6 (A) IN GENERAL.—The term ‘‘sexual as7 sault’’ means a sexual act (as defined in sub8 paragraphs (A) through (C) of section 2246(2) 

9 of title 18, United States Code) where the vic10 tim involved does not consent or lacks the ca11 pacity to consent. 

12 (B) APPLICATION OF PROVISIONS.—The 

13 definition in subparagraph (A) shall apply to all 

14 individuals. 

15 SEC. 4. SURVIVORS OF SEXUAL ASSAULT; PROVISION BY 

16 HOSPITALS OF EMERGENCY CONTRACEP17 TION WITHOUT CHARGE. 

18 (a) IN GENERAL.—Federal funds may not be pro19 vided to a hospital under title XVIII of the Social Security 

20 Act (42 U.S.C. 1395 et seq.) or to a State, with respect 

21 to services of a hospital, under title XIX of such Act (42 

22 U.S.C. 1396 et seq.), unless such hospital complies with 

23 the conditions specified in subsection (b) in the case of— 

24 (1) any woman who arrives at the hospital and 

25 states that she is a victim of sexual assault, or is acVerDate Sep 11 2014 00:08 Oct 02, 2014 Jkt 049200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S2876.IS S2876

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1 companied by someone who states she is a victim of 

2 sexual assault; and 

3 (2) any woman who arrives at the hospital 

4 whom hospital personnel have reason to believe is a 

5 victim of sexual assault. 

6 (b) ASSISTANCE FOR VICTIMS.—The conditions spec7 ified in this subsection regarding a hospital and a woman 

8 described in subsection (a) are as follows: 

9 (1) The hospital promptly provides the woman 

10 with medically and factually accurate and unbiased 

11 written and oral information about emergency con12 traception, including information explaining that— 

13 (A) emergency contraception has been ap14 proved by the Food and Drug Administration 

15 as an over-the-counter medication for all women 

16 without age restrictions and is a safe and effec17 tive way to prevent pregnancy after unprotected 

18 intercourse or contraceptive failure if taken in 

19 a timely manner; 

20 (B) emergency contraception is more effec21 tive the sooner it is taken; and 

22 (C) emergency contraception does not 

23 cause an abortion and cannot interrupt an es24 tablished pregnancy. 


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1 (2) The hospital promptly offers emergency 

2 contraception to the woman, and promptly provides 

3 such contraception to her at the hospital on her re4 quest. 

5 (3) The information provided pursuant to para6 graph (1) is in clear and concise language, is readily 

7 comprehensible, and meets such conditions regarding 

8 the provision of the information in languages other 

9 than English as the Secretary may establish. 

10 (4) The services described in paragraphs (1) 

11 through (3) are not denied because of the inability 

12 of the woman or her family to pay for the services. 

13 (c) EFFECTIVE DATE; AGENCY CRITERIA.—This sec14 tion shall take effect upon the expiration of the 180-day 

15 period beginning on the date of the enactment of this Act. 

16 Not later than 30 days prior to the expiration of such pe17 riod, the Secretary shall publish in the Federal Register 

18 criteria for carrying out this section. 

19 SEC. 5. EMERGENCY CONTRACEPTION EDUCATION AND IN20 FORMATION PROGRAMS. 

21 (a) EMERGENCY CONTRACEPTION PUBLIC EDU22 CATION PROGRAM.— 

23 (1) IN GENERAL.—The Secretary, acting 

24 through the Director of the Centers for Disease 

25 Control and Prevention, shall develop and dissemiVerDate Sep 11 2014 00:08 Oct 02, 2014 Jkt 049200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S2876.IS S2876

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1 nate to the public information on emergency contra2 ception. 

3 (2) DISSEMINATION.—The Secretary may dis4 seminate information on emergency contraception 

5 under paragraph (1) directly or through arrange6 ments with health agencies, professional and non7 profit organizations, consumer groups, institutions 

8 of higher education, clinics, the media, and Federal, 

9 State, and local agencies. 

10 (3) INFORMATION.—The information on emer11 gency contraception disseminated under paragraph 

12 (1) shall include, at a minimum, the most current 

13 evidence-based and evidence-informed standards of 

14 care with respect to emergency contraception and an 

15 explanation of the proper, use, safety, efficacy, coun16 seling and availability of such contraception. 

17 (b) EMERGENCY CONTRACEPTION INFORMATION

18 PROGRAM FOR HEALTH CARE PROVIDERS.— 

19 (1) IN GENERAL.—The Secretary, acting 

20 through the Administrator of the Health Resources 

21 and Services Administration and in consultation 

22 with major medical and public health organizations, 

23 shall develop and disseminate to health care pro24 viders information on emergency contraception. 


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1 (2) INFORMATION.—The information dissemi2 nated under paragraph (1) shall include, at a min3 imum— 

4 (A) information describing the most cur5 rent evidence-based and evidence-informed 

6 standards of care, proper use, safety, efficacy, 

7 counseling and availability of emergency contra8 ception; 

9 (B) a recommendation regarding the use of 

10 such contraception in appropriate cases; 

11 (C) recommendation for health care pro12 viders working in emergency rooms to consult 

13 with survivors of sexual assault once clinically 

14 stable regarding options for emergency contra15 ception and to provide any necessary follow-up 

16 care and referral services; and 

17 (D) information explaining how to obtain 

18 copies of the information developed under sub19 section (a) for distribution to the patients of 

20 the providers. 

21 (c) AUTHORIZATION OF APPROPRIATIONS.—There 

22 are authorized to be appropriated to carry out this section, 

23 such sums as may be necessary for each of the fiscal years 

24 2014 through 2018. 

Æ 


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