II 

114TH CONGRESS 

1ST SESSION S. 358 

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 

FEBRUARY 4, 2015 

Mrs. SHAHEEN (for herself, Mr. REID, Mrs. MURRAY, Mr. BROWN, Mr. BENNET, Mr. BLUMENTHAL, Mr. WHITEHOUSE, Mr. MARKEY, Mrs. GILLIBRAND, Ms. BALDWIN, Mr. DURBIN, Mr. COONS, Mr. SANDERS, Ms. 

STABENOW, Mrs. BOXER, Ms. WARREN, Mrs. FEINSTEIN, Ms. CANTWELL, Mr. MENENDEZ, Mr. TESTER, Mr. CARDIN, Ms. HIRONO, Mr. 

FRANKEN, and Mr. SCHATZ) 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, 


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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 2015’’. 

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 Sep 11 2014 22:26 Feb 11, 2015 Jkt 049200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S358.IS S358

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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 Sep 11 2014 22:26 Feb 11, 2015 Jkt 049200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S358.IS S358

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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) Research studies based on the Department 

23 of Defense Survey of Health Related Behaviors 

24 Among Active Duty Military Personnel found a high 

25 unintended rate of pregnancy among servicewomen. 


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1 Adjusting for the difference between age distribu2 tions in the Armed Forces and the general popu3 lation, the rate of unintended pregnancy among 

4 servicewomen is higher than among the general pop5 ulation. 

6 (12) With the integrated use of electronic med7 ical records throughout the Department of Defense, 

8 the technological infrastructure exists to develop 

9 clinical decision support tools. These tools, which are 

10 incorporated into the electronic medical record, allow 

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

12 enhance patient decisionmaking, case and patient 

13 management, and care coordination. Benefits of clin14 ical decision support tools include increased quality 

15 of care and enhanced health outcomes, improved ef16 ficiency, and provider and patient satisfaction. 

17 (13) The Defense Advisory Committee on 

18 Women in the Services (DACOWITS) has rec19 ommended that all the Armed Forces, to the extent 

20 that they have not already, implement initiatives 

21 that inform servicemembers of the importance of 

22 family planning, educate them on methods of contra23 ception, and make various methods of contraception 

24 available, based on the finding that family planning 


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1 can increase the overall readiness and quality of life 

2 of all members of the military. 

3 (14) Health care, including family planning for 

4 survivors of sexual assault in the Armed Forces is 

5 a critical issue. Servicewomen on active duty report 

6 rates of unwanted sexual contact at approximately 

7 16 times those of the comparable general population 

8 of women in the United States. Through regulations, 

9 the Department of Defense already supports a policy 

10 of ensuring that servicewomen who are sexually as11 saulted have access to emergency contraception. 

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 subsection (a), by inserting ‘‘FOR MEM17 BERS AND FORMER MEMBERS’’ after ‘‘SERVICES

18 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) of this 

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

6 be imposed or collected for care related to the prevention 

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

8 including for any method of contraception provided, 

9 whether provided through a facility of the uniformed serv10 ices, the TRICARE retail pharmacy program, or the na11 tional mail-order pharmacy program.’’. 

12 (b) CARE RELATED TO PREVENTION OF PREG13 NANCY.—Subsection (d)(3) of such section, as redesig14 nated by subsection (a)(2) of this section, is further 

15 amended by inserting before the period at the end the fol16 lowing: ‘‘(including all methods of contraception approved 

17 by the Food and Drug Administration, sterilization proce18 dures, and patient education and counseling in connection 

19 therewith)’’. 

20 (c) CONFORMING AMENDMENT.—Section 

21 1077(a)(13) of such title is amended by striking ‘‘section 

22 1074d(b)’’ and inserting ‘‘section 1074d(d)’’. 


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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 Sep 11 2014 22:26 Feb 11, 2015 Jkt 049200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S358.IS S358

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1 partment of Defense who provide care for members of the 

2 Armed Forces, including general practitioners, are pro3 vided, through clinical practice guidelines, the most cur4 rent evidence-based and evidence-informed standards of 

5 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 members of the Armed Forces. 

15 (2) SOURCES.—The Secretary shall compile 

16 clinical practice guidelines under this subsection 

17 from among clinical practice guidelines established 

18 by appropriate health agencies and professional or19 ganizations, including the following: 

20 (A) The United States Preventive Services 

21 Task Force. 

22 (B) The Centers for Disease Control and 

23 Prevention. 

24 (C) The Office of Population Affairs of the 

25 Department of Health and Human Services. 


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1 (D) The American College of Obstetricians 

2 and Gynecologists. 

3 (E) The Association of Reproductive 

4 Health Professionals. 

5 (F) The American Academy of Family 

6 Physicians. 

7 (G) The Agency for Healthcare Research 

8 and Quality. 

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

10 to time update the list of clinical practice guidelines 

11 compiled under this subsection to incorporate into 

12 such guidelines new or updated standards of care 

13 with respect to methods of contraception and coun14 seling on methods of contraception. 

15 (4) DISSEMINATION.— 

16 (A) INITIAL DISSEMINATION.—As soon as 

17 practicable after the compilation of clinical 

18 practice guidelines pursuant to paragraph (1), 

19 but commencing not later than one year after 

20 the date of the enactment of this Act, the Sec21 retary shall provide for rapid dissemination of 

22 the clinical practice guidelines to health care 

23 providers described in subsection (a). 

24 (B) UPDATES.—As soon as practicable 

25 after the adoption under paragraph (3) of any 


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1 update to the clinical practice guidelines com2 piled pursuant to this subsection, the Secretary 

3 shall provide for the rapid dissemination of 

4 such clinical practice guidelines, as so updated, 

5 to health care providers described in subsection 

6 (a). 

7 (C) PROTOCOLS.—Clinical practice guide8 lines, and any updates to such guidelines, shall 

9 be disseminated under this paragraph in ac10 cordance with administrative protocols devel11 oped by the Secretary for that purpose. 

12 (c) CLINICAL DECISION SUPPORT TOOLS.— 

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

14 after the date of the enactment of this Act, the Sec15 retary shall, in order to assist health care providers 

16 described in subsection (a), develop and implement 

17 clinical decision support tools that reflect, through 

18 the clinical practice guidelines compiled pursuant to 

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

20 evidence-informed standards of care with respect to 

21 methods of contraception and counseling on methods 

22 of contraception. 

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

24 to time update the clinical decision support tools de25 veloped under this subsection to incorporate into 


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1 such tools new or updated guidelines on methods of 

2 contraception and counseling on methods of contra3 ception. 

4 (3) DISSEMINATION.—Clinical decision support 

5 tools, and any updates to such tools, shall be dis6 seminated under this subsection in accordance with 

7 administrative protocols developed by the Secretary 

8 for that purpose. Such protocols shall be similar to 

9 the administrative protocols developed under sub10 section (b)(4)(C). 

11 (d) ACCESS TO CONTRACEPTION COUNSELING.—As 

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

13 Act, the Secretary shall ensure that women members of 

14 the Armed Forces have access to comprehensive coun15 seling on the full range of methods of contraception pro16 vided by health care providers described in subsection (a) 

17 during health care visits, including, but not limited to, vis18 its as follows: 

19 (1) During predeployment health care visits, in20 cluding counseling that provides specific information 

21 women need regarding the interaction between an22 ticipated deployment conditions and various methods 

23 of contraception. 

24 (2) During health care visits during deploy25 ment. 


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1 (3) During annual physical examinations. 

2 (e) INCORPORATION INTO SURVEYS OF QUESTIONS

3 ON SERVICEWOMEN EXPERIENCES WITH FAMILY PLAN4 NING SERVICES AND COUNSELING.— 

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

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

7 shall integrate into the Department of Defense sur8 veys specified in paragraph (2) questions designed to 

9 obtain information on the experiences of women 

10 members of the Armed Forces— 

11 (A) in accessing family planning services 

12 and counseling; 

13 (B) in using family planning methods, 

14 which method was preferred, and whether de15 ployment conditions affected the decision on 

16 which family planning method or methods to be 

17 used; and 

18 (C) if pregnant, whether the pregnancy 

19 was intended. 

20 (2) COVERED SURVEYS.—The surveys into 

21 which questions shall be integrated as described in 

22 paragraph (1) are the following: 

23 (A) The Health Related Behavior Survey 

24 of Active Duty Military Personnel. 


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1 (B) The Health Care Survey of Depart2 ment of Defense Beneficiaries. 

3 SEC. 6. EDUCATION ON FAMILY PLANNING FOR MEMBERS 

4 OF THE ARMED FORCES. 

5 (a) EDUCATION PROGRAMS.— 

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

7 after the date of the enactment of this Act, the Sec8 retary of Defense shall establish a uniform standard 

9 curriculum that will be used in education programs 

10 on family planning for all members of the Armed 

11 Forces, including both men and women members. 

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

13 Congress that the education programs should use 

14 the latest technology available to efficiently and ef15 fectively deliver information to members of the 

16 Armed Forces. 

17 (b) ELEMENTS.—The uniform standard curriculum 

18 under subsection (a) shall include the following: 

19 (1) Information for members of the Armed 

20 Forces on active duty to make informed decisions re21 garding family planning. 

22 (2) Information about the prevention of unin23 tended pregnancy and sexually transmitted infec24 tions, including human immunodeficiency virus 

25 (HIV). 


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1 (3) Information on the importance of providing 

2 comprehensive family planning for members of the 

3 Armed Forces, and their commanding officers, and 

4 on the positive impact family planning can have on 

5 the health and readiness of the Armed Forces. 

6 (4) Current, medically accurate information. 

7 (5) Clear, user-friendly information on the full 

8 range of methods of contraception and where mem9 bers of the Armed Forces can access their chosen 

10 method of contraception. 

11 (6) Information on all applicable laws and poli12 cies so that members are informed of their rights 

13 and obligations. 

14 (7) Information on patients’ rights to confiden15 tiality. 

16 (8) Information on the unique circumstances 

17 encountered by members of the Armed Forces, and 

18 the effects of such circumstances on the use of con19 traception. 

20 SEC. 7. PREGNANCY PREVENTION ASSISTANCE AT MILI21 TARY TREATMENT FACILITIES FOR WOMEN 

22 WHO ARE SEXUAL ASSAULT SURVIVORS. 

23 (a) PURPOSE.—The purpose of this section is to pro24 vide in statute, and to enhance, existing regulations that 

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1 ties to consult with survivors of sexual assault once clini2 cally stable regarding options for emergency contraception 

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

4 of the emergency contraception. 

5 (b) IN GENERAL.—The assistance specified in sub6 section (c) shall be provided at every military treatment 

7 facility to the following: 

8 (1) Any woman who presents at a military 

9 treatment facility and states to personnel of the fa10 cility that she is a victim of sexual assault or is ac11 companied by another individual who states that the 

12 woman is a victim of sexual assault. 

13 (2) Any woman who presents at a military 

14 treatment facility and is reasonably believed by per15 sonnel of such facility to be a survivor of sexual as16 sault. 

17 (c) ASSISTANCE.— 

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

19 this subsection shall include the following: 

20 (A) The prompt provision by appropriate 

21 staff of the military treatment facility of com22 prehensive, medically and factually accurate, 

23 and unbiased written and oral information 

24 about all methods of emergency contraception 


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1 approved by the Food and Drug Administra2 tion. 

3 (B) The prompt provision by such staff of 

4 emergency contraception to a woman upon her 

5 request. 

6 (C) Notification to the woman of her right 

7 to confidentiality in the receipt of care and 

8 services pursuant to this section. 

9 (2) NATURE OF INFORMATION.—The informa10 tion provided pursuant to paragraph (1)(A) shall be 

11 provided in language that is clear and concise, is 

12 readily comprehensible, and meets such conditions 

13 (including conditions regarding the provision of in14 formation in languages other than English) as the 

15 Secretary may provide in the regulations under this 

16 section. 

Æ 


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