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[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 1049 Introduced in Senate (IS)]

<DOC>

116th CONGRESS
  1st Session
                                S. 1049

 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 SENATE OF THE UNITED STATES

                             April 4, 2019

Mrs. Shaheen (for herself, Ms. Baldwin, Mr. Bennet, Mr. Blumenthal, Mr. 
  Booker, Mr. Brown, Mr. Coons, Ms. Cortez Masto, Ms. Duckworth, Mrs. 
   Gillibrand, Ms. Hirono, Ms. Klobuchar, Mr. Leahy, Mr. Markey, Mr. 
  Menendez, Mr. Reed, Mr. Sanders, Ms. Stabenow, Mr. Van Hollen, Mr. 
   Whitehouse, Mr. Wyden, Mr. Kaine, Mrs. Feinstein, Mr. Cardin, Mr. 
 Durbin, Ms. Harris, Mr. Merkley, Mr. Murphy, Mrs. Murray, Mr. Peters, 
 Ms. Rosen, Mr. Tester, and Ms. Warren) 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 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.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Access to Contraception for 
Servicemembers and Dependents Act of 2019''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) Women are serving in the Armed Forces at increasing 
        rates, playing a critical role in the national security of the 
        United States. Women comprise more than 17 percent of members 
        of the Armed Forces and as of 2018, nearly 350,000 women serve 
        on active duty in the Armed Forces or in the Selected Reserve 
        of the Ready Reserve of the reserve components of the Armed 
        Forces.
            (2) Ninety-five percent of women serving in the Armed 
        Forces are of reproductive age and as of 2017, more than 
        700,000 female spouses and dependents of members of the Armed 
        Forces on active duty are of reproductive age.
            (3) The TRICARE program covered 1,563,727 women of 
        reproductive age in 2017, including female spouses and 
        dependents of members of the Armed Forces on active duty.
            (4) The benefits of contraception are widely recognized and 
        include improved health and well-being, reduced global maternal 
        mortality, health benefits of pregnancy spacing for maternal 
        and child health, and greater educational and professional 
        opportunities and increased lifetime earnings for women.
            (5) Studies have shown that when cost barriers to the full 
        range of methods of contraception are eliminated, and women 
        receive comprehensive counseling on the various methods of 
        contraception (including highly effective and more expensive 
        long-acting reversible contraceptives), rates of unintended 
        pregnancy decline.
            (6) Research has also shown that investments in effective 
        contraception save public and private dollars.
            (7) In order to fill gaps in coverage and access to 
        preventive care critical for women's health, the Patient 
        Protection and Affordable Care Act (Public Law 111-148) 
        requires all non-grandfathered individual and group health 
        plans to cover without cost-sharing preventive services, 
        including a set of evidence-based preventive services for women 
        supported by the Health Resources and Services Administration 
        of the Department of Health and Human Services. These women's 
        preventive services include the full range of female-controlled 
        contraceptive methods, effective family planning practices, and 
        sterilization procedures approved by the Food and Drug 
        Administration. The Health Resources and Services 
        Administration has affirmed that contraceptive care includes 
        contraceptive counseling, initiation of contraceptive use, and 
        follow-up care (such as management, evaluation, and changes to 
        and removal or discontinuation of the contraceptive method).
            (8) Under the TRICARE program, women members of the Armed 
        Forces on active duty have full coverage of all prescription 
        drugs, including contraception, without cost-sharing 
        requirements, which is consistent with requirements under the 
        Patient Protection and Affordable Care Act (Public Law 111-
        148), which requires coverage of all contraceptive methods 
        approved by the Food and Drug Administration for women and 
        related services and education and counseling. However, women 
        members not on active duty and female dependents of members do 
        not have similar coverage of all prescription methods of 
        contraception approved by the Food and Drug Administration 
        without cost-sharing when filling a prescription outside of a 
        military medical treatment facility.
            (9) Studies indicate that women members of the Armed Forces 
        need comprehensive counseling for pregnancy prevention and the 
        lack thereof is contributing to unintended pregnancies among 
        such women members. Additionally, they need counseling on and 
        availability of contraception for non-contraceptive benefits 
        (for example, menstrual suppression and predictable menstrual 
        patterns), which is important in ensuring readiness for 
        deployment to remote or operational theaters.
            (10) Research studies based on the Department of Defense 
        Survey of Health Related Behaviors Among Active Duty Military 
        Personnel found a high rate of unintended pregnancy among women 
        members of the Armed Forces. Adjusting for the difference 
        between age distributions in the Armed Forces and the general 
        population, the rate of unintended pregnancy among women 
        members of the Armed Forces is higher than among the general 
        population.
            (11) The Defense Advisory Committee on Women in the 
        Services has recommended that all the Armed Forces, to the 
        extent that they have not already, implement initiatives that 
        inform members of the Armed Forces of the importance of family 
        planning, educate them on methods of contraception, and make 
        various methods of contraception available, based on the 
        finding that family planning can increase the overall readiness 
        and quality of life of all members of the Armed Forces.
            (12) The military departments received more than 6,700 
        reports of sexual assaults involving members of the Armed 
        Forces as victims or subjects during fiscal year 2017. Through 
        regulations, the Department of Defense already supports a 
        policy of ensuring that women members of the Armed Forces who 
        are sexually assaulted have access to emergency contraception, 
        and the initiation of contraception if desired and medically 
        appropriate.

SEC. 3. CONTRACEPTION COVERAGE PARITY UNDER THE TRICARE PROGRAM.

    (a) In General.--Section 1074d of title 10, United States Code, is 
amended--
            (1) in the header for subsection (a), by inserting ``for 
        Members and Former Members'' after ``Services Available'';
            (2) by redesignating subsection (b) as subsection (d); and
            (3) by inserting after subsection (a) the following new 
        subsections:
    ``(b) Care Related to Prevention of Pregnancy.--Female covered 
beneficiaries shall be entitled to care related to the prevention of 
pregnancy described by subsection (d)(3).
    ``(c) Prohibition on Cost-Sharing for Certain Services.--
Notwithstanding section 1074g(a)(6), section 1075, or section 1075a of 
this title or any other provision of law, cost-sharing may not be 
imposed or collected for care related to the prevention of pregnancy 
provided pursuant to subsection (a) or (b), including for any method of 
contraception provided, whether provided through a facility of the 
uniformed services, the TRICARE retail pharmacy program, or the 
national mail-order pharmacy program.''.
    (b) Care Related to Prevention of Pregnancy.--Subsection (d)(3) of 
such section, as redesignated by subsection (a)(2) of this section, is 
further amended by inserting before the period at the end the 
following: ``(including all methods of contraception approved by the 
Food and Drug Administration, contraceptive care (including with 
respect to insertion, removal, and follow up), sterilization 
procedures, and patient education and counseling in connection 
therewith)''.
    (c) Conforming Amendment.--Section 1077(a)(13) of such title is 
amended by striking ``section 1074d(b)'' and inserting ``section 
1074d(d)''.

SEC. 4. PREGNANCY PREVENTION ASSISTANCE AT MILITARY MEDICAL TREATMENT 
              FACILITIES FOR SEXUAL ASSAULT SURVIVORS.

    (a) In General.--Chapter 55 of title 10, United States Code, is 
amended by inserting after section 1074o the following new section:
``Sec. 1074p. Provision of pregnancy prevention assistance at military 
              medical treatment facilities
    ``(a) Information and Assistance.--The Secretary of Defense shall 
promptly furnish to sexual assault survivors at each military medical 
treatment facility the following:
            ``(1) Comprehensive, medically and factually accurate, and 
        unbiased written and oral information about all methods of 
        emergency contraception approved by the Food and Drug 
        Administration.
            ``(2) Notification of the right of the sexual assault 
        survivor to confidentiality with respect to the information and 
        care and services furnished under this section.
            ``(3) Upon request by the sexual assault survivor, 
        emergency contraception or, if applicable, a prescription for 
        emergency contraception.
    ``(b) Information.--The Secretary shall ensure that information 
provided pursuant to subsection (a) is provided in language that--
            ``(1) is clear and concise;
            ``(2) is readily comprehensible; and
            ``(3) meets such conditions (including conditions regarding 
        the provision of information in languages other than English) 
        as the Secretary may prescribe in regulations to carry out this 
        section.
    ``(c) Definitions.--In this section:
            ``(1) The term `sexual assault' means the conduct described 
        in section 1565b(c)(1) of this title that may result in 
        pregnancy.
            ``(2) The term `sexual assault survivor' means any 
        individual who presents at a military medical treatment 
        facility and--
                    ``(A) states to personnel of the facility that the 
                individual experienced a sexual assault;
                    ``(B) is accompanied by another person who states 
                that the individual experienced a sexual assault; or
                    ``(C) whom the personnel of the facility reasonably 
                believes to be a survivor of sexual assault.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by inserting after the item relating to section 
1074o the following new item:

``1074p. Provision of pregnancy prevention assistance at military 
                            medical treatment facilities.''.

SEC. 5. EDUCATION ON FAMILY PLANNING FOR MEMBERS OF THE ARMED FORCES.

    (a) Education Programs.--
            (1) In general.--Not later than one year after the date of 
        the enactment of this Act, the Secretary of Defense shall 
        establish a uniform standard curriculum to be used in education 
        programs on family planning for all members of the Armed 
        Forces, including both men and women members, during the 
        following periods:
                    (A) The first year of service.
                    (B) When a member is in training to assume command.
                    (C) When an enlisted member becomes a senior 
                enlisted member.
            (2) Sense of congress.--It is the sense of Congress that 
        the education programs under paragraph (1) should be evidence-
        informed and use the latest technology available to efficiently 
        and effectively deliver information to members of the Armed 
        Forces.
    (b) Elements.--The uniform standard curriculum under subsection (a) 
shall include the following:
            (1) Information for members of the Armed Forces on active 
        duty to make informed decisions regarding family planning.
            (2) Information about the prevention of unintended 
        pregnancy and sexually transmitted infections, including human 
        immunodeficiency virus (commonly known as ``HIV'').
            (3) Information on--
                    (A) the importance of providing comprehensive 
                family planning for members of the Armed Forces, 
                including commanding officers; and
                    (B) the positive impact family planning can have on 
                the health and readiness of the Armed Forces.
            (4) Current, medically accurate information.
            (5) Clear, user-friendly information on--
                    (A) the full range of methods of contraception 
                approved by the Food and Drug Administration; and
                    (B) where members of the Armed Forces can access 
                their chosen method of contraception.
            (6) Information on all applicable laws and policies so that 
        members of the Armed Forces are informed of their rights and 
        obligations.
            (7) Information on the rights of patients to 
        confidentiality.
            (8) Information on the unique circumstances encountered by 
        members of the Armed Forces and the effects of such 
        circumstances on the use of contraception.
                                 <all>
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