Access to Contraception for Servicemembers and Dependents Act of 2019

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. Short title This Act may be cited as the Access to Contraception for Servicemembers and Dependents Act of 2019 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. (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 active duty members are of reproductive age. (3) The TRICARE program covered 1,563,727 women of reproductive age in 2017, including female spouses and dependents of active duty members. (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 women’s greater educational and professional opportunities and increased lifetime earnings. (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 (8) Under the TRICARE program, women members on active duty have full coverage of all prescription drugs, including contraception, without cost-sharing requirements, in line with the Patient Protection and Affordable Care Act ( Public Law 111–148 (9) Studies indicate that women members need comprehensive counseling for pregnancy prevention and the lack thereof is contributing to unintended pregnancies among 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. Adjusting for the difference between age distributions in the Armed Forces and the general population, the rate of unintended pregnancy among women members 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 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 military. (12) The military departments received more than 6,700 reports of sexual assaults involving members as victims or subjects during fiscal year 2017. Through regulations, the Department of Defense already supports a policy of ensuring that women members who are sexually assaulted have access to emergency contraception, and the initiation of contraception if desired and medically appropriate. 3. Contraception coverage parity under the TRICARE program (a) In General Section 1074d of title 10, United States Code, is amended— (1) in subsection (a), by inserting for members and former members 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) section 1074d(d) 4. Pregnancy prevention assistance at military medical treatment facilities for sexual assault survivors (a) In general Chapter 55 section 1074o 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 survivor (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. (2) The term 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. . 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, 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 can access their chosen method of contraception. (6) Information on all applicable laws and policies so that members are informed of their rights and obligations. (7) Information on patients’ rights to confidentiality. (8) Information on the unique circumstances encountered by members and the effects of such circumstances on the use of contraception.

Summary: Access to Contraception for Servicemembers and Dependents Act of 2019 This bill addresses the access of military personnel and dependents to contraception and family planning information. The bill revises coverage of women's health services under the TRICARE program to (1) prohibit the imposition of cost-sharing for care related to the prevention of pregnancy, whether provided through a facility of the uniformed services, the TRICARE retail pharmacy program, or the national mail-order pharmacy program; and (2) include all methods of contraception approved by the Food and Drug Administration, contraceptive care, sterilization procedures, and patient education and counseling. The Department of Defense (DOD) must furnish to sexual assault survivors at military medical facilities clear and comprehensible information about all methods of approved emergency contraception, notification of the survivor's right to confidentiality, and, upon request, emergency contraception or a prescription for emergency contraception. DOD shall also establish a uniform standard curriculum for use in programs of family planning education during the first year of a member's service, when a member is in training to assume command, and when an enlisted member becomes a senior enlisted member.