II 

113TH CONGRESS 

2D SESSION S. 2687 

To amend title 10, United States Code, to ensure that women 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 SENATE OF THE UNITED STATES 

JULY 30, 2014 

Mrs. SHAHEEN (for herself, Mr. REID, Mrs. MURRAY, Mr. BROWN, Mrs. 

GILLIBRAND, Mrs. BOXER, Mr. DURBIN, Ms. BALDWIN, Mr. 

BLUMENTHAL, Ms. STABENOW, Mrs. FEINSTEIN, Ms. HIRONO, Mr. 

FRANKEN, Mr. SCHATZ, Mr. TESTER, Mr. WYDEN, Ms. WARREN, and 

Mr. BEGICH) introduced the following bill; which was read twice and referred to the Committee on Armed Services 

A BILL 

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

women 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, 


jbell on DSK4SPTVN1PROD with BILLS
2 

•S 2687 IS

1 SECTION 1. SHORT TITLE. 

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

4 2014’’. 

5 SEC. 2. FINDINGS. 

6 Congress makes the following findings: 

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

8 increasing rates, playing a critical role in the na9 tional security of the United States. More than 

10 350,000 women serve on active duty in the Armed 

11 Forces or in the Selected Reserve. 

12 (2) Nearly 10,000,000 members of the Armed 

13 Forces (including members of the National Guard 

14 and Reserves), military retirees, their families, their 

15 survivors, and certain former spouses, including 

16 nearly 5,000,000 female beneficiaries, are eligible for 

17 health care through the Department of Defense. 

18 (3) Contraception is critical for women’s health 

19 and is highly effective at reducing unintended preg20 nancy. The Centers for Disease Control and Preven21 tion describe contraception as one of the 10 greatest 

22 public health achievements of the twentieth century. 

23 (4) Contraception has played a direct role in 

24 the greater participation of women in education and 

25 employment. Increased wages and increased control 

26 over reproductive decisions provide women with eduVerDate Mar 15 2010 04:57 Aug 05, 2014 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S2687.IS S2687

jbell on DSK4SPTVN1PROD with BILLS
3 

•S 2687 IS

1 cational and professional opportunities that have in2 creased gender equality over the decades since con3 traception was introduced. 

4 (5) Studies have shown that when cost barriers 

5 to the full range of methods of contraception are 

6 eliminated, and women receive comprehensive coun7 seling on the various methods of contraception (in8 cluding highly effective Long-Acting Reversible Con9 traceptives (LARCs)), rates of unintended preg10 nancy decline dramatically. 

11 (6) Research has also shown that investments 

12 in effective contraception save public and private 

13 dollars. 

14 (7) The 2011 recommendations of the Institute 

15 of Medicine on women’s preventive health services 

16 include recommendations that health insurance plans 

17 cover all methods of contraception approved by the 

18 Food and Drug Administration, sterilization proce19 dures, and patient education and counseling for all 

20 women with reproductive capacity without any cost21 sharing requirements. 

22 (8) The recommendations described in para23 graph (7) are reflected in provisions of the Patient 

24 Protection and Affordable Care Act (Public Law 

25 111–148), and thus group and individual health inVerDate Mar 15 2010 04:57 Aug 05, 2014 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S2687.IS S2687

jbell on DSK4SPTVN1PROD with BILLS
4 

•S 2687 IS

1 surance plans must provide such coverage. The rec2 ommendations have also been adopted by the Office 

3 of Personnel Management, and thus all health insur4 ance plans that are part of the Federal Employees 

5 Health Benefits Program must provide such cov6 erage. 

7 (9) Under the TRICARE program, service8 women on active duty have full coverage of all pre9 scription drugs, including contraception, without 

10 cost-sharing requirements. However, servicewomen 

11 not on active duty, and female dependents of mem12 bers of the Armed Forces, who receive health care 

13 through the TRICARE program do not have similar 

14 coverage of all prescription methods of contraception 

15 approved by the Food and Drug Administration 

16 without cost-sharing. 

17 (10) Studies indicate that servicewomen need 

18 comprehensive counseling for pregnancy prevention, 

19 particularly in their predeployment preparations, 

20 and the lack thereof is contributing to unintended 

21 pregnancies among servicewomen. 

22 (11) An analysis by Ibis Reproductive Health of 

23 the 2008 Survey of Health Related Behaviors among 

24 Active Duty Military Personnel found a high unin25 tended pregnancy rate among servicewomen. AdjustVerDate Mar 15 2010 04:57 Aug 05, 2014 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S2687.IS S2687

jbell on DSK4SPTVN1PROD with BILLS
5 

•S 2687 IS

1 ing for the difference between age distribution in the 

2 Armed Forces and the general population, the rate 

3 of unintended pregnancy among servicewomen is 

4 higher than for the general population. 

5 (12) With the integrated use of electronic med6 ical records throughout the Department of Defense, 

7 the technological infrastructure exists to develop 

8 clinical decision support tools. These tools, which are 

9 incorporated into the electronic medical record, allow 

10 for a point-of-care feedback loop that can be used to 

11 enhance patient decisionmaking, case and patient 

12 management, and care coordination. Benefits of clin13 ical decision support tools include increased quality 

14 of care and enhanced health outcomes, improved ef15 ficiency, and provider and patient satisfaction. 

16 (13) The Defense Advisory Committee on 

17 Women in the Services (DACOWITS) has rec18 ommended that all the Armed Forces, to the extent 

19 that they have not already, implement initiatives 

20 that inform servicemembers of the importance of 

21 family planning, educate them on methods of contra22 ception, and make various methods of contraception 

23 available, based on the finding that family planning 

24 can increase the overall readiness and quality of life 

25 of all members of the military. 


jbell on DSK4SPTVN1PROD with BILLS
6 

•S 2687 IS

1 (14) Health care, including family planning for 

2 survivors of sexual assault in the Armed Forces is 

3 a critical issue. Servicewomen on active duty report 

4 rates of unwanted sexual contact at approximately 

5 16 times those of the comparable general population 

6 of women in the United States. Through regulations, 

7 the Department of Defense already supports a policy 

8 of ensuring that servicewomen who are sexually as9 saulted have access to emergency contraception. 

10 SEC. 3. CONTRACEPTION COVERAGE PARITY UNDER THE 

11 TRICARE PROGRAM. 

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

13 States Code, is amended— 

14 (1) in subsection (a), by inserting ‘‘FOR MEM15 BERS AND FORMER MEMBERS’’ after ‘‘SERVICES

16 AVAILABLE’’; 

17 (2) by redesignating subsection (b) as sub18 section (d); and 

19 (3) by inserting after subsection (a) the fol20 lowing new subsections: 

21 ‘‘(b) CARE RELATED TO PREVENTION OF PREG22 NANCY.—Female covered beneficiaries shall be entitled to 

23 care related to the prevention of pregnancy described by 

24 subsection (d)(3). 


jbell on DSK4SPTVN1PROD with BILLS
7 

•S 2687 IS

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

2 SERVICES.—Notwithstanding section 1074g(a)(6) of this 

3 title or any other provision of law, cost-sharing may not 

4 be imposed or collected for care related to the prevention 

5 of pregnancy provided pursuant to subsection (a) or (b), 

6 including for any method of contraception provided, 

7 whether provided through a facility of the uniformed serv8 ices, the TRICARE retail pharmacy program, or the na9 tional mail-order pharmacy program.’’. 

10 (b) CARE RELATED TO PREVENTION OF PREG11 NANCY.—Subsection (d)(3) of such section, as redesig12 nated by subsection (a)(2) of this section, is further 

13 amended by inserting before the period at the end the fol14 lowing: ‘‘(including all methods of contraception approved 

15 by the Food and Drug Administration, sterilization proce16 dures, and patient education and counseling in connection 

17 therewith)’’. 

18 (c) CONFORMING AMENDMENT.—Section 

19 1077(a)(13) of such title is amended by striking ‘‘section 

20 1074d(b)’’ and inserting ‘‘section 1074d(d)’’. 


jbell on DSK4SPTVN1PROD with BILLS
8 

•S 2687 IS

1 SEC. 4. ACCESS TO BROAD RANGE OF METHODS OF CON2 TRACEPTION APPROVED BY THE FOOD AND 

3 DRUG ADMINISTRATION FOR MEMBERS OF 

4 THE ARMED FORCES AND MILITARY DEPEND5 ENTS AT MILITARY TREATMENT FACILITIES. 

6 (a) IN GENERAL.—Commencing not later than 180 

7 days after the date of the enactment of this Act, the Sec8 retary of Defense shall ensure that every military treat9 ment facility has a sufficient stock of a broad range of 

10 methods of contraception approved by the Food and Drug 

11 Administration, as recommended by the Centers for Dis12 ease Control and Prevention and the Office of Population 

13 Affairs of the Department of Health and Human Services, 

14 to be able to dispense at any time any such method of 

15 contraception to any women members of the Armed 

16 Forces and female covered beneficiaries who receive care 

17 through such facility. 

18 (b) COVERED BENEFICIARY DEFINED.—In this sec19 tion, the term ‘‘covered beneficiary’’ has the meaning 

20 given that term in section 1072(5) of title 10, United 

21 States Code. 

22 SEC. 5. COMPREHENSIVE STANDARDS AND ACCESS TO 

23 CONTRACEPTION COUNSELING FOR MEM24 BERS OF THE ARMED FORCES. 

25 (a) PURPOSE.—The purpose of this section is to en26 sure that all health care providers employed by the DeVerDate Mar 15 2010 04:57 Aug 05, 2014 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S2687.IS S2687

jbell on DSK4SPTVN1PROD with BILLS
9 

•S 2687 IS

1 partment of Defense who provide care for women members 

2 of the Armed Forces, including general practitioners, are 

3 provided, through clinical practice guidelines, the most 

4 current evidence-based and evidence-informed standards 

5 of care with respect to methods of contraception and coun6 seling on methods of contraception. 

7 (b) CLINICAL PRACTICE GUIDELINES.— 

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

9 after the date of the enactment of this Act, the Sec10 retary of Defense shall compile clinical practice 

11 guidelines for health care providers described in sub12 section (a) on standards of care with respect to 

13 methods of contraception and counseling on methods 

14 of contraception for women members of the Armed 

15 Forces. 

16 (2) SOURCES.—The Secretary shall compile 

17 clinical practice guidelines under this subsection 

18 from among clinical practice guidelines established 

19 by appropriate health agencies and professional or20 ganizations, including the following: 

21 (A) The United States Preventive Services 

22 Task Force. 

23 (B) The Centers for Disease Control and 

24 Prevention. 


jbell on DSK4SPTVN1PROD with BILLS
10 

•S 2687 IS

1 (C) The Office of Population Affairs of the 

2 Department of Health and Human Services. 

3 (D) The American College of Obstetricians 

4 and Gynecologists. 

5 (E) The Association of Reproductive 

6 Health Professionals. 

7 (F) The American Academy of Family 

8 Physicians. 

9 (G) The Agency for Healthcare Research 

10 and Quality. 

11 (3) UPDATES.—The Secretary shall from time 

12 to time update the list of clinical practice guidelines 

13 compiled under this subsection to incorporate into 

14 such guidelines new or updated standards of care 

15 with respect to methods of contraception and coun16 seling on methods of contraception. 

17 (4) DISSEMINATION.— 

18 (A) INITIAL DISSEMINATION.—As soon as 

19 practicable after the compilation of clinical 

20 practice guidelines pursuant to paragraph (1), 

21 but commencing not later than one year after 

22 the date of the enactment of this Act, the Sec23 retary shall provide for rapid dissemination of 

24 the clinical practice guidelines to health care 

25 providers described in subsection (a). 


jbell on DSK4SPTVN1PROD with BILLS
11 

•S 2687 IS

1 (B) UPDATES.—As soon as practicable 

2 after the adoption under paragraph (3) of any 

3 update to the clinical practice guidelines com4 piled pursuant to this subsection, the Secretary 

5 shall provide for the rapid dissemination of 

6 such clinical practice guidelines, as so updated, 

7 to health care providers described in subsection 

8 (a). 

9 (C) PROTOCOLS.—Clinical practice guide10 lines, and any updates to such guidelines, shall 

11 be disseminated under this paragraph in ac12 cordance with administrative protocols devel13 oped by the Secretary for that purpose. 

14 (c) CLINICAL DECISION SUPPORT TOOLS.— 

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

16 after the date of the enactment of this Act, the Sec17 retary shall, in order to assist health care providers 

18 described in subsection (a), develop and implement 

19 clinical decision support tools that reflect, through 

20 the clinical practice guidelines compiled pursuant to 

21 subsection (b), the most current evidence-based and 

22 evidence-informed standards of care with respect to 

23 methods of contraception and counseling on methods 

24 of contraception. 


jbell on DSK4SPTVN1PROD with BILLS
12 

•S 2687 IS

1 (2) UPDATES.—The Secretary shall from time 

2 to time update the clinical decision support tools de3 veloped under this subsection to incorporate into 

4 such tools new or updated guidelines on methods of 

5 contraception and counseling on methods of contra6 ception. 

7 (3) DISSEMINATION.—Clinical decision support 

8 tools, and any updates to such tools, shall be dis9 seminated under this subsection in accordance with 

10 administrative protocols developed by the Secretary 

11 for that purpose. Such protocols shall be similar to 

12 the administrative protocols developed under sub13 section (b)(4)(C). 

14 (d) ACCESS TO CONTRACEPTION COUNSELING.—As 

15 soon as practicable after the date of the enactment of this 

16 Act, the Secretary shall ensure that women members of 

17 the Armed Forces have access to counseling on the full 

18 range of methods of contraception provided by health care 

19 providers described in subsection (a) during health care 

20 visits, including, but not limited to, visits as follows: 

21 (1) During predeployment health care visits, 

22 with the counseling to be provided during such visits 

23 emphasizing the interaction between anticipated de24 ployment conditions and various methods of contra25 ception. 


jbell on DSK4SPTVN1PROD with BILLS
13 

•S 2687 IS

1 (2) During health care visits during deploy2 ment. 

3 (3) During annual physical examinations. 

4 (e) INCORPORATION INTO SURVEYS OF QUESTIONS

5 ON SERVICEWOMEN EXPERIENCES WITH FAMILY PLAN6 NING SERVICES AND COUNSELING.— 

7 (1) IN GENERAL.—Not later than 90 days after 

8 the date of the enactment of this Act, the Secretary 

9 shall integrate into the Department of Defense sur10 veys specified in paragraph (2) questions designed to 

11 obtain information on the experiences of women 

12 members of the Armed Forces— 

13 (A) in accessing family planning services 

14 and counseling; 

15 (B) in using family planning methods, 

16 which method was preferred and whether de17 ployment conditions affected the decision on 

18 which family planning method or methods to be 

19 used; and 

20 (C) if pregnant, whether the pregnancy 

21 was intended. 

22 (2) COVERED SURVEYS.—The surveys into 

23 which questions shall be integrated as described in 

24 paragraph (1) are the following: 


jbell on DSK4SPTVN1PROD with BILLS
14 

•S 2687 IS

1 (A) The Health Related Behavior Survey 

2 of Active Duty Military Personnel. 

3 (B) The Health Care Survey of Depart4 ment of Defense Beneficiaries. 

5 SEC. 6. EDUCATION ON FAMILY PLANNING FOR MEMBERS 

6 OF THE ARMED FORCES. 

7 (a) EDUCATION PROGRAM.— 

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

9 after the date of the enactment of this Act, the Sec10 retary of Defense shall establish an education pro11 gram for all members of the Armed Forces, includ12 ing both men and women members, consisting of a 

13 uniform standard curriculum on family planning. 

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

15 Congress that the standard curriculum should use 

16 the latest technology available to efficiently and ef17 fectively deliver information to members of the 

18 Armed Forces. 

19 (b) ELEMENTS.—The standard curriculum under 

20 subsection (a) shall include the following: 

21 (1) Information on the importance of providing 

22 comprehensive family planning for members of the 

23 Armed Forces, and their commanding officers, and 

24 on the positive impact family planning can have on 

25 the health and readiness of the Armed Forces. 


jbell on DSK4SPTVN1PROD with BILLS
15 

•S 2687 IS

1 (2) Current, medically accurate information. 

2 (3) Clear, user-friendly information on the full 

3 range of methods of contraception and where mem4 bers of the Armed Forces can access their chosen 

5 method of contraception. 

6 (4) Information on all applicable laws and poli7 cies so that members are informed of their rights 

8 and obligations. 

9 (5) Information on patients’ rights to confiden10 tiality. 

11 (6) Information on the unique circumstances 

12 encountered by members of the Armed Forces, and 

13 the effects of such circumstances on the use of con14 traception. 

15 SEC. 7. PREGNANCY PREVENTION ASSISTANCE AT MILI16 TARY TREATMENT FACILITIES FOR WOMEN 

17 WHO ARE SEXUAL ASSAULT SURVIVORS. 

18 (a) PURPOSE.—The purpose of this section is to pro19 vide in statute, and to enhance, existing regulations that 

20 require health care providers at military treatment facili21 ties to consult with survivors of sexual assault once clini22 cally stable regarding options for emergency contraception 

23 and any necessary follow-up care, including the provision 

24 of the emergency contraception. 


jbell on DSK4SPTVN1PROD with BILLS
16 

•S 2687 IS

1 (b) IN GENERAL.—The assistance specified in sub2 section (c) shall be provided at every military treatment 

3 facility to the following: 

4 (1) Any woman who presents at a military 

5 treatment facility and states to personnel of the fa6 cility that she is a victim of sexual assault or is ac7 companied by another individual who states that the 

8 woman is a victim of sexual assault. 

9 (2) Any woman who presents at a military 

10 treatment facility and is reasonably believed by per11 sonnel of such facility to be a survivor of sexual as12 sault. 

13 (c) ASSISTANCE.— 

14 (1) IN GENERAL.—The assistance specified in 

15 this subsection shall include the following: 

16 (A) The prompt provision by appropriate 

17 staff of the military treatment facility of com18 prehensive, medically and factually accurate, 

19 and unbiased written and oral information 

20 about all methods of emergency contraception 

21 approved by the Food and Drug Administra22 tion. 

23 (B) The prompt provision by such staff of 

24 emergency contraception to a woman upon her 

25 request. 


jbell on DSK4SPTVN1PROD with BILLS
17 

•S 2687 IS

1 (C) Notification to the woman of her right 

2 to confidentiality in the receipt of care and 

3 services pursuant to this section. 

4 (2) NATURE OF INFORMATION.—The informa5 tion provided pursuant to paragraph (1)(A) shall be 

6 provided in language that is clear and concise, is 

7 readily comprehensible, and meets such conditions 

8 (including conditions regarding the provision of in9 formation in languages other than English) as the 

10 Secretary may provide in the regulations under this 

11 section. 

Æ 


jbell on DSK4SPTVN1PROD with BILLS