II 

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. 

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 ‘‘Access to Contracep3 tion for Servicemembers and Dependents Act of 2019’’. 

4 SEC. 2. FINDINGS. 

5 Congress finds the following: 

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

7 increasing rates, playing a critical role in the na8 tional security of the United States. Women com9 prise more than 17 percent of members of the 

10 Armed Forces and as of 2018, nearly 350,000 

11 women serve on active duty in the Armed Forces or 

12 in the Selected Reserve of the Ready Reserve of the 

13 reserve components of the Armed Forces. 

14 (2) Ninety-five percent of women serving in the 

15 Armed Forces are of reproductive age and as of 

16 2017, more than 700,000 female spouses and de17 pendents of members of the Armed Forces on active 

18 duty are of reproductive age. 

19 (3) The TRICARE program covered 1,563,727 

20 women of reproductive age in 2017, including female 

21 spouses and dependents of members of the Armed 

22 Forces on active duty. 

23 (4) The benefits of contraception are widely rec24 ognized and include improved health and well-being, 

25 reduced global maternal mortality, health benefits of 

26 pregnancy spacing for maternal and child health, 


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1 and greater educational and professional opportuni2 ties and increased lifetime earnings for women. 

3 (5) Studies have shown that when cost barriers 

4 to the full range of methods of contraception are 

5 eliminated, and women receive comprehensive coun6 seling on the various methods of contraception (in7 cluding highly effective and more expensive long-act8 ing reversible contraceptives), rates of unintended 

9 pregnancy decline. 

10 (6) Research has also shown that investments 

11 in effective contraception save public and private 

12 dollars. 

13 (7) In order to fill gaps in coverage and access 

14 to preventive care critical for women’s health, the 

15 Patient Protection and Affordable Care Act (Public 

16 Law 111–148) requires all non-grandfathered indi17 vidual and group health plans to cover without cost18 sharing preventive services, including a set of evi19 dence-based preventive services for women supported 

20 by the Health Resources and Services Administra21 tion of the Department of Health and Human Serv22 ices. These women’s preventive services include the 

23 full range of female-controlled contraceptive meth24 ods, effective family planning practices, and steriliza25 tion procedures approved by the Food and Drug AdVerDate Sep 11 2014 00:02 Apr 10, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1049.IS S1049

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1 ministration. The Health Resources and Services 

2 Administration has affirmed that contraceptive care 

3 includes contraceptive counseling, initiation of con4 traceptive use, and follow-up care (such as manage5 ment, evaluation, and changes to and removal or dis6 continuation of the contraceptive method). 

7 (8) Under the TRICARE program, women 

8 members of the Armed Forces on active duty have 

9 full coverage of all prescription drugs, including con10 traception, without cost-sharing requirements, which 

11 is consistent with requirements under the Patient 

12 Protection and Affordable Care Act (Public Law 

13 111–148), which requires coverage of all contracep14 tive methods approved by the Food and Drug Ad15 ministration for women and related services and 

16 education and counseling. However, women members 

17 not on active duty and female dependents of mem18 bers do not have similar coverage of all prescription 

19 methods of contraception approved by the Food and 

20 Drug Administration without cost-sharing when fill21 ing a prescription outside of a military medical 

22 treatment facility. 

23 (9) Studies indicate that women members of 

24 the Armed Forces need comprehensive counseling for 

25 pregnancy prevention and the lack thereof is contribVerDate Sep 11 2014 00:02 Apr 10, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1049.IS S1049

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1 uting to unintended pregnancies among such women 

2 members. Additionally, they need counseling on and 

3 availability of contraception for non-contraceptive 

4 benefits (for example, menstrual suppression and 

5 predictable menstrual patterns), which is important 

6 in ensuring readiness for deployment to remote or 

7 operational theaters. 

8 (10) Research studies based on the Department 

9 of Defense Survey of Health Related Behaviors 

10 Among Active Duty Military Personnel found a high 

11 rate of unintended pregnancy among women mem12 bers of the Armed Forces. Adjusting for the dif13 ference between age distributions in the Armed 

14 Forces and the general population, the rate of unin15 tended pregnancy among women members of the 

16 Armed Forces is higher than among the general 

17 population. 

18 (11) The Defense Advisory Committee on 

19 Women in the Services has recommended that all 

20 the Armed Forces, to the extent that they have not 

21 already, implement initiatives that inform members 

22 of the Armed Forces of the importance of family 

23 planning, educate them on methods of contraception, 

24 and make various methods of contraception avail25 able, based on the finding that family planning can 


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1 increase the overall readiness and quality of life of 

2 all members of the Armed Forces. 

3 (12) The military departments received more 

4 than 6,700 reports of sexual assaults involving mem5 bers of the Armed Forces as victims or subjects dur6 ing fiscal year 2017. Through regulations, the De7 partment of Defense already supports a policy of en8 suring that women members of the Armed Forces 

9 who are sexually assaulted have access to emergency 

10 contraception, and the initiation of contraception if 

11 desired and medically appropriate. 

12 SEC. 3. CONTRACEPTION COVERAGE PARITY UNDER THE 

13 TRICARE PROGRAM. 

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

15 States Code, is amended— 

16 (1) in the header for subsection (a), by insert17 ing ‘‘FOR MEMBERS AND FORMER MEMBERS’’ after 

18 ‘‘SERVICES AVAILABLE’’; 

19 (2) by redesignating subsection (b) as sub20 section (d); and 

21 (3) by inserting after subsection (a) the fol22 lowing new subsections: 

23 ‘‘(b) CARE RELATED TO PREVENTION OF PREG24 NANCY.—Female covered beneficiaries shall be entitled to 


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1 care related to the prevention of pregnancy described by 

2 subsection (d)(3). 

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

4 SERVICES.—Notwithstanding section 1074g(a)(6), section 

5 1075, or section 1075a of this title or any other provision 

6 of law, cost-sharing may not be imposed or collected for 

7 care related to the prevention of pregnancy provided pur8 suant to subsection (a) or (b), including for any method 

9 of contraception provided, whether provided through a fa10 cility of the uniformed services, the TRICARE retail phar11 macy program, or the national mail-order pharmacy pro12 gram.’’. 

13 (b) CARE RELATED TO PREVENTION OF PREG14 NANCY.—Subsection (d)(3) of such section, as redesig15 nated by subsection (a)(2) of this section, is further 

16 amended by inserting before the period at the end the fol17 lowing: ‘‘(including all methods of contraception approved 

18 by the Food and Drug Administration, contraceptive care 

19 (including with respect to insertion, removal, and follow 

20 up), sterilization procedures, and patient education and 

21 counseling in connection therewith)’’. 

22 (c) CONFORMING AMENDMENT.—Section 

23 1077(a)(13) of such title is amended by striking ‘‘section 

24 1074d(b)’’ and inserting ‘‘section 1074d(d)’’. 


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1 SEC. 4. PREGNANCY PREVENTION ASSISTANCE AT MILI2 TARY MEDICAL TREATMENT FACILITIES FOR 

3 SEXUAL ASSAULT SURVIVORS. 

4 (a) IN GENERAL.—Chapter 55 of title 10, United 

5 States Code, is amended by inserting after section 1074o 

6 the following new section: 

7 ‘‘§ 1074p. Provision of pregnancy prevention assist8 ance at military medical treatment facili9 ties 

10 ‘‘(a) INFORMATION AND ASSISTANCE.—The Sec11 retary of Defense shall promptly furnish to sexual assault 

12 survivors at each military medical treatment facility the 

13 following: 

14 ‘‘(1) Comprehensive, medically and factually ac15 curate, and unbiased written and oral information 

16 about all methods of emergency contraception ap17 proved by the Food and Drug Administration. 

18 ‘‘(2) Notification of the right of the sexual as19 sault survivor to confidentiality with respect to the 

20 information and care and services furnished under 

21 this section. 

22 ‘‘(3) Upon request by the sexual assault sur23 vivor, emergency contraception or, if applicable, a 

24 prescription for emergency contraception. 


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1 ‘‘(b) INFORMATION.—The Secretary shall ensure that 

2 information provided pursuant to subsection (a) is pro3 vided in language that— 

4 ‘‘(1) is clear and concise; 

5 ‘‘(2) is readily comprehensible; and 

6 ‘‘(3) meets such conditions (including condi7 tions regarding the provision of information in lan8 guages other than English) as the Secretary may 

9 prescribe in regulations to carry out this section. 

10 ‘‘(c) DEFINITIONS.—In this section: 

11 ‘‘(1) The term ‘sexual assault’ means the con12 duct described in section 1565b(c)(1) of this title 

13 that may result in pregnancy. 

14 ‘‘(2) The term ‘sexual assault survivor’ means 

15 any individual who presents at a military medical 

16 treatment facility and— 

17 ‘‘(A) states to personnel of the facility that 

18 the individual experienced a sexual assault; 

19 ‘‘(B) is accompanied by another person 

20 who states that the individual experienced a 

21 sexual assault; or 

22 ‘‘(C) whom the personnel of the facility 

23 reasonably believes to be a survivor of sexual 

24 assault.’’. 


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1 (b) CLERICAL AMENDMENT.—The table of sections 

2 at the beginning of such chapter is amended by inserting 

3 after the item relating to section 1074o the following new 

4 item: 

‘‘1074p. Provision of pregnancy prevention assistance at military medical treatment facilities.’’. 

5 SEC. 5. EDUCATION ON FAMILY PLANNING FOR MEMBERS 

6 OF THE ARMED FORCES. 

7 (a) EDUCATION PROGRAMS.— 

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 a uniform standard 

11 curriculum to be used in education programs on 

12 family planning for all members of the Armed 

13 Forces, including both men and women members, 

14 during the following periods: 

15 (A) The first year of service. 

16 (B) When a member is in training to as17 sume command. 

18 (C) When an enlisted member becomes a 

19 senior enlisted member. 

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

21 Congress that the education programs under para22 graph (1) should be evidence-informed and use the 

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1 tively deliver information to members of the Armed 

2 Forces. 

3 (b) ELEMENTS.—The uniform standard curriculum 

4 under subsection (a) shall include the following: 

5 (1) Information for members of the Armed 

6 Forces on active duty to make informed decisions re7 garding family planning. 

8 (2) Information about the prevention of unin9 tended pregnancy and sexually transmitted infec10 tions, including human immunodeficiency virus 

11 (commonly known as ‘‘HIV’’). 

12 (3) Information on— 

13 (A) the importance of providing com14 prehensive family planning for members of the 

15 Armed Forces, including commanding officers; 

16 and 

17 (B) the positive impact family planning 

18 can have on the health and readiness of the 

19 Armed Forces. 

20 (4) Current, medically accurate information. 

21 (5) Clear, user-friendly information on— 

22 (A) the full range of methods of contracep23 tion approved by the Food and Drug Adminis24 tration; and 


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1 (B) where members of the Armed Forces 

2 can access their chosen method of contracep3 tion. 

4 (6) Information on all applicable laws and poli5 cies so that members of the Armed Forces are in6 formed of their rights and obligations. 

7 (7) Information on the rights of patients to 

8 confidentiality. 

9 (8) Information on the unique circumstances 

10 encountered by members of the Armed Forces and 

11 the effects of such circumstances on the use of con12 traception. 

Æ 


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