I 
117TH CONGRESS 
1ST SESSION H. R. 2216 
To provide women with increased access to preventive and life-saving cancer 
screening. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 26, 2021 
Mr. GOMEZ (for himself, Ms. BARRAGA´N, Mr. BLUMENAUER, Ms. BROWNLEY, 
Ms. CLARKE of New York, Mr. COHEN, Mr. DANNY K. DAVIS of Illinois, 
Mrs. FLETCHER, Mr. GRIJALVA, Mr. HASTINGS, Mrs. HAYES, Mr. HIG-
GINS of New York, Ms. NORTON, Ms. JACKSON LEE, Mr. JOHNSON of 
Georgia, Mr. LAWSON of Florida, Mrs. CAROLYN B. MALONEY of New 
York, Ms. MCCOLLUM, Mr. NADLER, Ms. PRESSLEY, Miss RICE of New 
York, Ms. SCANLON, Mr. SOTO, Ms. VELA´ZQUEZ, Mrs. WATSON COLE-
MAN, Mr. WELCH, Ms. SA´NCHEZ, and Ms. WASSERMAN SCHULTZ) intro-
duced the following bill; which was referred to the Committee on Energy 
and Commerce 
A BILL 
To provide women with increased access to preventive and 
life-saving cancer screening. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Jeanette Acosta Invest 
in Women’s Health Act of 2021’’. 
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SEC. 2. PURPOSE. 
It is the purpose of this Act to provide women with 
increased access to preventive and life-saving cancer 
screening, including clinical breast exams and cervical, 
ovarian, uterine, vaginal, and vulvar cancer screening, pro-
vided by leading women’s health care providers who— 
(1) serve populations most at risk; and 
(2) play an outsized role in the prevention and 
detection of cancer in order to serve the goal of in-
creasing access to quality health screenings, care, 
and services, reducing health care disparities and 
mortality rates among low-income women and 
women of color, decreasing health care spending, 
and expanding health literacy, access, and education 
about the benefits of regular preventive cancer 
screening for women. 
SEC. 3. FINDINGS. 
Congress finds as follows: 
(1) Breast cancer is the leading cause of cancer 
death in women under the age of 54, and the Amer-
ican Cancer Society recommends that women in 
their 20s and 30s have a clinical breast exam at 
least every 3 years. 
(2) Ovarian cancer causes more deaths than 
any other cancer of the female reproductive system, 
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but it accounts for only about 3 percent of all can-
cers in women. 
(3) The cancers that most frequently impact 
women include breast, uterine, ovarian, and cervical 
cancer, and there were 341,171 new cases of these 
cancers in 2017. 
(4) Rates of incidence and death for gynecologic 
cancers by race and ethnicity show that, while for 
some cancers, like ovarian cancer, the rates of inci-
dence and death are similar among all races, for 
other cancers, like cervical cancer, women of color 
have disproportionate incidence and mortality rates. 
While the incidence of uterine cancer is similar for 
White women and Women of Color, rates of death 
for uterine cancer are 2 times higher for Black 
women than for White women. 
(5) Cervical cancer incidence and mortality 
rates are higher for women living in rural and un-
derserved regions in the United States. Women liv-
ing in these areas face unique barriers in accessing 
reproductive health care services to prevent and 
treat cervical cancer, including a lack of practicing 
gynecologists in rural areas and challenges around 
transportation to preventive and follow-up appoint-
ments. 
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(6) Prevention and cancer screening are the 
best approaches to protecting women from cancer 
and ensuring early detection and life-saving treat-
ment. Many deaths from breast and cervical cancers 
could be avoided if cancer screening rates and diag-
nostic care and services increased among women at 
risk. Deaths from these cancers occur disproportion-
ately among women who are uninsured or under-
insured. 
(7) Due to enhanced screening, cervical cancer, 
which used to be the leading cause of cancer death 
for women in the United States, is now a much more 
preventable and treatable cancer. It is also highly 
curable when found and treated early. 
(8) Increased access to education, information, 
including information on the human papillomavirus 
vaccine, and preventive cancer screening increase 
women’s ability to survive cancer. 
(9) While more than 15 percent of cases of cer-
vical cancer are found in women over the age of 65, 
it becomes less likely that women are tested for cer-
vical cancer ever or within the previous 5 years as 
their age increases. 
(10) Women’s health care providers that are 
primarily engaged in family planning services, such 
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as Planned Parenthood health centers, provide nec-
essary screening tests, education, and information to 
women, especially women of color who face the high-
est risks of breast cancer and other gynecologic can-
cers. 
(11) Access to preventive gynecological screen-
ing is also critical for transgender men who have 
comparable rates of susceptibility to cervical cancer 
as cisgender women, but often have less access to 
preventive screenings. 
(12) Discrimination and racism in health care 
continues to contribute to disparate rates of gyneco-
logical cancer in non-White women. Black, Indige-
nous, and other Women of Color die at higher rates 
from cervical cancer than White women, even though 
fewer women overall die from cervical cancer. 
(13) Black women with endometrial cancer 
often receive surgery less often than White women 
and are more likely to be diagnosed at an advanced 
stage of the disease, contributing to disparities in 
mortality in Black women. 
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SEC. 4. STRENGTHENING ACCESS TO CANCER SCREENING 
FOR WOMEN. 
(a) IN GENERAL.—Part B of title III of the Public 
Health Service Act (42 U.S.C. 243 et seq.) is amended 
by inserting after section 317P the following: 
‘‘SEC. 317P–1. GRANTS FOR WOMEN’S HEALTH CARE PRO-
VIDERS. 
‘‘(a) IN GENERAL.—The Secretary is authorized to 
make grants and to enter into contracts with public or 
nonprofit private entities to expand preventive health serv-
ices, as provided for in the Preventive Services Guidelines 
of the Health Resources and Service Administration that 
were in effect on October 30, 2017, with an emphasis on 
increasing access to critical, life-saving cancer screening, 
Pap tests, human papillomavirus vaccination, and diag-
nostic tests for women with cancer symptoms, particularly 
Women of Color. 
‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section, 
$20,000,000 for each of fiscal years 2022 through 2024.’’. 
(b) FUNDING.—There is authorized to be appro-
priated to carry out programs related to breast and 
gynecologic cancers under title XIX of the Social Security 
Act (42 U.S.C. 1396 et seq.) and title X of the Public 
Health Service Act (42 U.S.C. 300 et seq.), and the Na-
tional Breast and Cervical Cancer Early Detection Pro-
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gram, such sums as may be necessary for each of fiscal 
years 2020 through 2023. 
SEC. 5. EXPAND CANCER SCREENING PROVIDER TRAINING. 
Part B of title III of the Public Health Service Act 
(42 U.S.C. 243 et seq.), as amended by section 4, is fur-
ther amended by inserting after section 317P–1 the fol-
lowing: 
‘‘SEC. 317P–2. WOMEN’S HEALTH CARE PROVIDERS DEM-
ONSTRATION TRAINING PROJECT. 
‘‘(a) ESTABLISHMENT OF PROGRAM.—The Secretary 
shall establish a demonstration program (referred to in 
this section as the ‘program’) to award 3-year grants to 
eligible entities for the training of physicians, nurse practi-
tioners, and other health care providers related to life-sav-
ing breast and gynecologic cancer screening for women. 
‘‘(b) PURPOSE.—The purpose of the program is to 
enable each grant recipient to— 
‘‘(1) provide to licensed physicians, nurse prac-
titioners, and other health care providers, through 
clinical training, education, and practice, the most 
up-to-date clinical guidelines, research, and rec-
ommendations adopted by the United States Preven-
tive Services Task Force in the area of preventive 
cancer screening for breast and gynecologic cancers; 
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‘‘(2) establish a model of training for physi-
cians, nurse practitioners, and other health care pro-
viders that specializes in women’s health care, with 
a specific focus on breast and gynecologic cancer 
screening, that may be replicated nationwide; 
‘‘(3) train physicians, nurse practitioners, and 
other health care providers to serve rural and under-
served communities, low-income communities, and 
communities of color in breast and gynecologic can-
cer screening; and 
‘‘(4) provide implicit bias, cultural competency, 
and patient-centered communication training cov-
ering the ways in which structural racism and dis-
crimination manifest within the medical field and 
perpetuate racial disparities in gynecologic cancer in-
cidence and death rates and how to communicate 
with patients through a knowledgeable and culturally 
empathetic lens. 
‘‘(c) ELIGIBLE ENTITIES.—To be eligible to receive 
a grant under this section, an entity shall be— 
‘‘(1) an entity that receives funding under sec-
tion 1001; 
‘‘(2) an essential community provider, as de-
fined in section 156.235 of title 45, Code of Federal 
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Regulations (or any successor regulations), that is 
primarily engaged in family planning; 
‘‘(3) an entity that furnishes items or services 
to individuals who are eligible for medical assistance 
under title XIX of the Social Security Act; or 
‘‘(4) an entity that, at the time of application, 
provides cancer screening services under the Na-
tional Breast and Cervical Cancer Early Detection 
Program of the Centers for Disease Control and 
Prevention.’’. 
SEC. 6. STUDY AND REPORT TO CONGRESS ON INCREASED 
CANCER SCREENING FOR WOMEN. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (referred to in this section as the ‘‘Sec-
retary’’) shall conduct a study (and periodically update 
such study) on increased access to women’s preventive life- 
saving cancer screening across the United States, and, not 
later than January 1, 2025, and every 5 years thereafter, 
the Secretary shall submit a report to Congress on such 
study. 
(b) CONTENTS.—The study and reports under sub-
section (a) shall include— 
(1) 
a 
50-State 
analysis 
of 
breast 
and 
gynecologic cancer rates among women, including by 
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geographic area, income, employment status, race, 
ethnicity, and status of insurance coverage; 
(2) a 50-State analysis of cancer screening pro-
vided by women’s health care providers, including 
clinical breast exams, other screening for breast can-
cer, and screening for cervical cancer, ovarian can-
cer, and other gynecologic cancers; 
(3) an analysis of the awareness and availability 
of breast, cervical, ovarian, and other gynecological 
cancer screening options for women with dispropor-
tionate rates of gynecological cancers, including Afri-
can-American women, Hispanic and Latina women, 
women living in rural and underserved areas, and 
other disproportionately impacted groups, according 
to the 50-State analyses described in paragraphs (1) 
and (2); 
(4) an analysis of how structural racism im-
pacts access to cancer screening services, its correla-
tion to the development of breast, cervical, ovarian, 
and other gynecological cancers, and how it exacer-
bates health care disparities for African-American, 
Hispanic and Latina women, and other Women of 
Color; 
(5) in consultation with the Comptroller Gen-
eral of the United States, estimated Federal savings 
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achieved through early detection of breast and 
gynecologic cancer; 
(6) an analysis of how access to health care 
providers trained under the program described in 
section 317P–2 of the Public Health Service Act, as 
added by section 5, in comparison to other health 
care providers, increased early detection of cancer 
and quality of cancer care for women who are less 
likely to receive care, including African-American 
women, Hispanic and Latina women, older women, 
uninsured and underinsured women, and women liv-
ing in rural and underserved areas; 
(7) recommendations by the Secretary with re-
spect to the need for continued increased access to 
women’s health care providers, such as the entities 
described in section 317P–2(c) of the Public Health 
Service Act, as added by section 4, who provide pre-
ventive care, including life-saving cancer screening; 
and 
(8) recommendations for increasing screening 
rates for women who are less likely to be screened 
or treated for breast, cervical, ovarian, and other 
gynecological cancers, including African-American 
women, Hispanic and Latina women, older women, 
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