Affordability is Access Act of 2023



<html><body><pre>[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3589 Introduced in House (IH)]

&lt;DOC&gt;






118th CONGRESS
  1st Session
                                H. R. 3589

To require group health plans and group or individual health insurance 
   coverage to provide coverage for over-the-counter contraceptives.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 22, 2023

 Ms. Pressley (for herself, Ms. Ocasio-Cortez, Mr. Bera, Ms. Crockett, 
 Mr. Doggett, Mr. Espaillat, Ms. Norton, Mr. Vargas, Ms. Brownley, Ms. 
Castor of Florida, Mr. Johnson of Georgia, Mr. Kilmer, Mrs. Napolitano, 
 Ms. Wilson of Florida, Ms. Chu, Mr. Bowman, Mrs. Watson Coleman, Mr. 
    Pocan, Mr. Blumenauer, Ms. Brown, Ms. McCollum, Mr. Casten, Ms. 
Williams of Georgia, Ms. Clarke of New York, Ms. Underwood, Mr. Trone, 
Ms. Garcia of Texas, Mr. Khanna, Mr. Gomez, Mr. Evans, Ms. Scanlon, Ms. 
Lee of California, Mr. Takano, Mrs. McBath, Ms. Jayapal, Ms. Tlaib, Mr. 
Carter of Louisiana, Ms. Lois Frankel of Florida, Ms. DeLauro, Ms. Lee 
of Pennsylvania, Mr. Connolly, Mr. Peters, Mr. Cartwright, Mr. Mullin, 
and Mr. Menendez) introduced the following bill; which was referred to 
the Committee on Energy and Commerce, and in addition to the Committees 
on Education and the Workforce, and Ways and Means, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
  of such provisions as fall within the jurisdiction of the committee 
                               concerned

_______________________________________________________________________

                                 A BILL


 
To require group health plans and group or individual health insurance 
   coverage to provide coverage for over-the-counter contraceptives.

    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 ``Affordability is Access Act of 
2023''.

SEC. 2. PURPOSE.

    The purpose of this Act is to ensure timely access to affordable 
birth control by requiring coverage without cost-sharing for 
contraceptives that are approved, granted, or cleared by, or otherwise 
legally marketed under regulation by, the Food and Drug Administration 
for use without a prescription.

SEC. 3. FINDINGS.

    Congress finds the following:
            (1) Birth control is critical health care that almost all 
        women, as well as many trans men and nonbinary people, will use 
        at some point in their lifetimes.
            (2) Access to the full range of reproductive health care, 
        including birth control coverage as guaranteed under Federal 
        law, provides individuals with the opportunity to lead healthy 
        lives and get the care they need to reach their goals.
            (3) Contraceptive access is associated with health benefits 
        for women, newborns, families, and communities and can lower 
        the risk of harm to maternal and infant health.
            (4) An estimated 73 million women of reproductive age (ages 
        15 through 49) live in the United States. Among the 46 million 
        of such women who are sexually active and not seeking children, 
        89 percent use a form of birth control.
            (5) The birth control benefit enacted under the Patient 
        Protection and Affordable Care Act (Public Law 111-148) has 
        been a crucial step forward in advancing access to birth 
        control and has helped ensure 58 million women have the power 
        to decide for themselves if and when to become pregnant.
            (6) Despite legal requirements for birth control coverage 
        and access to services, gaps remain for millions of 
        individuals. Nearly 1 in 5 women are not using their preferred 
        method of contraception, and of those women, a quarter say it 
        is because of cost. As a result, many women have gone without 
        the birth control they want to use, also creating inconsistent 
        use. Access to birth control is particularly difficult for the 
        19 million women of reproductive age with lower incomes who 
        live in contraceptive deserts and lack reasonable access to a 
        health center that offers the full range of contraceptive 
        methods.
            (7) Due to systemic discrimination, people paid low wages, 
        people of color, LGBTQ+ individuals, immigrants, and people 
        with disabilities are more likely to face barriers to, and lack 
        access to, health coverage and health care providers.
            (8) There are numerous social and economic factors that 
        make it harder to access birth control, including rising income 
        and wealth inequality, gaps in insurance coverage, and barriers 
        to accessing health providers.
            (9) Leading health experts support over-the-counter birth 
        control pills.

SEC. 4. SENSE OF CONGRESS.

    It is the sense of Congress that--
            (1) in order to increase access to oral birth control, such 
        birth control must be both easier to obtain and affordable and, 
        to make such birth control either easier to obtain or more 
        affordable, but not both, is to leave unacceptable barriers in 
        place;
            (2) it is imperative that the entities that research and 
        develop oral birth control and whose medical and scientific 
        experts have developed clinical and other evidence that oral 
        birth control for routine, daily use is safe and effective when 
        sold without a prescription, apply to the Food and Drug 
        Administration for review and approval for sale of such birth 
        control without a prescription;
            (3) upon the receipt of such an application, the Food and 
        Drug Administration should determine whether the oral birth 
        control meets the rigorous safety, efficacy, and quality 
        standards for over-the-counter use under the Federal Food, 
        Drug, and Cosmetic Act (21 U.S.C. 301 et seq.), and if the 
        product meets those standards, the Food and Drug Administration 
        should approve the application without delay; and
            (4) if and when the Food and Drug Administration approves 
        an oral birth control that is available over-the-counter, such 
        birth control should be covered by health insurance, without a 
        prescription and without cost-sharing.

SEC. 5. CLARIFYING COVERAGE REQUIREMENTS.

    The Secretaries of Health and Human Services, Labor, and the 
Treasury shall clarify that coverage of contraceptives pursuant to 
section 2713(a)(4) of the Public Health Service Act (42 U.S.C. 300gg-
13(a)(4)) includes coverage of over-the-counter contraceptives 
approved, granted authorization for emergency use, or cleared by the 
Food and Drug Administration, even if the enrollee does not have a 
prescription for the contraceptive.

SEC. 6. RULES OF CONSTRUCTION.

    (a) Non-Interference With FDA Regulation.--Nothing in this Act 
shall be construed to modify or interfere with Food and Drug 
Administration processes to review, approve, clear, or authorize for 
emergency use, or otherwise determine the safety and efficacy of, and 
make available, non-prescription drugs or devices, modify or interfere 
with the scientific and medical considerations of the Food and Drug 
Administration, or alter any other authority of the Food and Drug 
Administration.
    (b) Non-Preemption.--Nothing in this Act preempts any provision of 
Federal or State law to the extent that such Federal or State law 
provides protections for consumers that are greater than the 
protections provided for in this Act.

SEC. 7. DUTIES OF RETAILERS TO ENSURE ACCESS TO CONTRACEPTION FOR USE 
              WITHOUT A PRESCRIPTION.

    (a) In General.--Any retailer that stocks contraception that is 
approved, granted authorization for emergency use, or cleared by, or 
otherwise legally marketed under regulation by, the Food and Drug 
Administration for use without a prescription may not interfere with an 
individual's access to or purchase of such contraception or access to 
medically accurate, comprehensive information about such contraception.
    (b) Limitation.--Nothing in this section shall prohibit a retailer 
that stocks over-the-counter contraceptive products from refusing to 
provide an individual with such contraceptive product that is approved, 
granted, or cleared by, or otherwise legally marketed under regulation 
by, the Food and Drug Administration if the individual is unable to pay 
for the contraceptive product, directly, through insurance coverage, or 
through other payment mechanism.
                                 &lt;all&gt;
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