I 
111TH CONGRESS 
1ST SESSION H. R. 3312 
To provide for programs that reduce the number of unplanned pregnancies, 
reduce the need for abortion, help women bear healthy children, and 
support new parents. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 23, 2009 
Mr. RYAN of Ohio (for himself, Ms. DELAURO, Ms. HERSETH SANDLIN, Mr. 
PERRIELLO, Mr. SMITH of Washington, Mr. FARR, Mr. CROWLEY, Mr. 
MCGOVERN, Mr. OBEY, Mr. MEEK of Florida, Mr. DAVIS of Alabama, 
Mr. DOYLE, and Mr. LANGEVIN) introduced the following bill; which was 
referred to the Committee on Energy and Commerce, and in addition to 
the Committees on Education and Labor, Ways and Means, the Judici-
ary, and Agriculture, 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 provide for programs that reduce the number of un-
planned pregnancies, reduce the need for abortion, help 
women bear healthy children, and support new parents. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Preventing Unintended Pregnancies, Reducing the Need 
for Abortion, and Supporting Parents Act’’. 
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(b) TABLE OF CONTENTS.—The table of contents for 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
Sec. 2. Findings; purpose. 
Sec. 3. Definitions. 
Sec. 4. Eligibility of Indian tribes for awards. 
TITLE I—EDUCATION PROGRAMS FOR PREVENTING TEEN 
PREGNANCIES 
Sec. 101. Findings. 
Sec. 102. Education programs for preventing teen pregnancies. 
TITLE II—REAUTHORIZATION OF CERTAIN AFTER-SCHOOL 
PROGRAMS 
Sec. 201. Findings. 
Sec. 202. Reauthorization of certain after-school programs. 
TITLE III—TEEN PREGNANCY PREVENTION INCENTIVE GRANTS 
Sec. 301. Teen pregnancy prevention incentive grants. 
Sec. 302. Establishing national goal to prevent teen pregnancy. 
TITLE IV—DEMONSTRATION GRANTS TO ENCOURAGE CREATIVE 
APPROACHES TO TEEN PREGNANCY PREVENTION 
Sec. 401. Demonstration grants to encourage creative approaches to teen preg-
nancy prevention. 
TITLE V—NATIONAL CAMPAIGN TO ENLIST PARENTS IN 
PREVENTING TEEN PREGNANCY 
Sec. 501. Findings. 
Sec. 502. Creating a national initiative to enlist parents of adolescents in pre-
venting teen pregnancy; provision of challenge grants for state 
and local programs. 
TITLE VI—PREVENTING UNPLANNED PREGNANCY AMONG 
COMMUNITY COLLEGE STUDENTS 
Sec. 601. Findings. 
Sec. 602. Demonstration grants to prevent unplanned pregnancy among com-
munity college students. 
TITLE VII—CLARIFICATION OF CONTINUED MEDICAID COVERAGE 
OF FAMILY PLANNING SERVICES 
Sec. 701. Clarification of continue Medicaid coverage of family planning serv-
ices. 
TITLE VIII—EXPANDED MEDICAID ELIGIBILITY FOR FAMILY 
PLANNING SERVICES 
Sec. 801. Expand Medicaid eligibility for family planning services. 
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TITLE IX—MEDICAID AND CHIP COVERAGE OF MOTHERS AND 
CHILDREN 
Sec. 901. Extending postpartum coverage for Medicaid and CHIP. 
Sec. 902. Coordination with the maternal and child health program. 
Sec. 903. Increase in SCHIP income eligibility. 
Sec. 904. Outreach program to encourage those eligible for services to enroll. 
TITLE X—TITLE X OF PUBLIC HEALTH SERVICE ACT 
Sec. 1001. Short title. 
Sec. 1002. Authorization of appropriations. 
TITLE XI—ENSURING COVERAGE OF MATERNITY CARE 
Sec. 1101. Removal of pregnancy as a preexisting condition under individual 
health insurance coverage. 
Sec. 1102. Coverage of maternity care in the individual market. 
TITLE XII—IMPROVING ACCESS TO PRENATAL ULTRASOUNDS 
Sec. 1201. Grants to health centers for purchase of ultrasound equipment. 
TITLE XIII—PREVENTING DOMESTIC VIOLENCE AND SEXUAL AS-
SAULT AND ADDRESSING THE LINK BETWEEN SUCH VIO-
LENCE AND UNINTENDED PREGNANCY 
Sec. 1301. Findings. 
Sec. 1302. Separate program to identify and treat women who are victims of 
or at risk of domestic violence, dating violence, sexual assault, 
sexual coercion, or stalking. 
Sec. 1303. Additional authorization of appropriations for public campaign to in-
crease public awareness. 
TITLE XIV—SUPPORT FOR PREGNANT AND PARENTING 
STUDENTS 
Sec. 1401. Support services for students. 
Sec. 1402. Child care access means parents in school program. 
TITLE XV—GRANTS FOR A NATIONAL INFORMATION CAMPAIGN 
ON ADOPTION 
Sec. 1501. Grants for a national information campaign on adoption. 
TITLE XVI—EXPANSION OF ADOPTION CREDIT AND ADOPTION 
ASSISTANCE PROGRAMS 
Sec. 1601. Expansion of adoption credit and adoption assistance programs. 
TITLE XVII—PROVIDING SUPPORT TO NEW PARENTS 
Sec. 1701. Increased support for WIC program. 
Sec. 1702. Nutritional support for low-income parents. 
Sec. 1703. Increased funding for the child care and development block grant 
program. 
Sec. 1704. Free home visits by trained home visitors for education on health 
and developmental needs of infants and toddlers for low-income 
families. 
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Sec. 1705. Grants to increase public awareness of resources available to new 
parents. 
TITLE XVIII—RESEARCH ON RESPONSES TO UNINTENDED 
PREGNANCIES 
Sec. 1801. Report on responses to unintended pregnancy. 
SEC. 2. FINDINGS; PURPOSE. 
(a) FINDINGS.—Congress makes the following find-
ings: 
(1) 49 percent of all pregnancies in America are 
unintended. Excluding miscarriages, 42 percent of 
unintended pregnancies end in abortion. 
(2) There are approximately 1,200,000 abor-
tions annually in America and one in five preg-
nancies ends in abortion. 
(3) 57 percent of women who have abortions 
have incomes below 200 percent of the poverty level. 
(4) Rates of unintended pregnancy in the 
United States increased by nearly 30 percent among 
low-income women between 1994 and 2001, and a 
low-income woman today is about 4 times as likely 
to have an unintended pregnancy as her higher in-
come counterpart. 
(5) Levels of contraceptive use among low-in-
come women at risk of unintended pregnancy de-
clined significantly between 1994 and 2001, from 92 
percent to 86 percent. 
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(6) By helping couples avoid unintended preg-
nancy, Medicaid-funded and title X contraceptive 
services are highly cost-effective, and every public 
dollar spent on family planning saves $4 in the cost 
of pregnancy-related care alone. 
(7) Abortion rates decreased among higher in-
come women but increased among low-income 
women between 1994 and 2001, and a low-income 
woman is more than 4 times as likely to have an 
abortion as her higher income counterpart. 
(8) Most women cite more than one reason for 
their decision to have an abortion. The most fre-
quently cited reasons were: ‘‘having a baby would 
dramatically change my life’’ (74 percent) by inter-
fering with educational and job prospects and re-
sponsibilities towards existing children and ‘‘cannot 
afford a baby now’’ (73 percent). 
(b) PURPOSE.—The purpose of this Act is to provide 
a comprehensive initiative to— 
(1) reduce the need for abortion by reducing 
the number of unintended pregnancies and sup-
porting women facing unplanned pregnancies; 
(2) prevent unintended pregnancies from occur-
ring in the first place— 
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(A) by reducing teen pregnancy through 
comprehensive education, after-school and other 
programs, and involving parents; and 
(B) by increasing support for family plan-
ning services under title X of the Public Health 
Service Act and extending Medicaid family 
planning services to more low-income women 
and men; and 
(3) support pregnant women, new parents, and 
their children, through measures that address do-
mestic violence and sexual assault, provide health 
care services, information about pregnancy, and 
other supportive services for pregnant women, and 
provide supportive services for new parents. 
SEC. 3. DEFINITIONS. 
For purposes of this Act: 
(1) The term ‘‘Secretary’’ means the Secretary 
of Health and Human Services. 
(2) Except as specified, the term ‘‘State’’ in-
cludes the 50 States, the District of Columbia, the 
Commonwealth of Puerto Rico, the Commonwealth 
of the Northern Mariana Islands, American Samoa, 
Guam, the Virgin Islands, and any other territory or 
possession of the United States. 
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SEC. 4. ELIGIBILITY OF INDIAN TRIBES FOR AWARDS. 
(a) IN GENERAL.—In the case of programs carried 
out pursuant to this Act that make awards of grants, co-
operative agreements, or contracts, Indian tribes are eligi-
ble for awards under the programs in accordance with 
such criteria as the Secretary may establish. 
(b) DEFINITIONS.—For purposes of this Act, the 
term ‘‘Indian tribe’’ has the meaning given such term in 
section 4 of the Indian Self-Determination and Education 
Assistance Act (25 U.S.C. 450b). 
TITLE 
I—EDUCATION 
PRO-
GRAMS 
FOR 
PREVENTING 
TEEN PREGNANCIES 
SEC. 101. FINDINGS. 
The Congress finds as follows: 
(1) The United States has the highest teen 
pregnancy rate and teen birth rate among com-
parable countries, costing the United States at least 
$9,000,000,000 annually. 
(2) Three out of ten young women in America 
become pregnant before they reach the age of 20. 
(3) According to the National Center on Health 
Statistics, the teen birth rate increased 5 percent be-
tween 2005 and 2007, reversing a 14-year decline. 
Teen birth rates increased significantly in over half 
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of states, representing nearly every region of the 
country. 
(4) Teen pregnancy has serious consequences 
for young parents, their children, and communities 
as a whole. Too-early childbearing increases the like-
lihood that a young woman will drop out of high 
school and that she and her child will live in poverty. 
(5) Statistically, the sons of teen mothers are 
more likely to be incarcerated. The daughters of teen 
mothers are more likely to become teen mothers too. 
(6) Teens that grow up in disadvantaged eco-
nomic, social, and family circumstances are more 
likely to engage in risky behavior and have a child 
during adolescence. 
(7) In a national survey on teen attitudes to-
wards teen pregnancy, 7 in 10 girls and 6 in 10 boys 
report that they wish they had waited until they 
were older to have sex. 
(8) Programs comprehensive in scope are effec-
tive in reducing risk behaviors by delaying or reduc-
ing sexual activity, reducing the number of sexual 
partners or increasing condom or contraceptive use. 
Reducing risky behaviors leads to reductions in un-
intended pregnancy and abortion and transmission 
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of sexually transmitted diseases (STDs), including 
HIV. 
(9) According to the results of a 2005–2006 
nationally representative survey of U.S. adults, more 
than 8 of 10 of those polled support comprehensive 
education. 
(10) Ethnic and racial minority groups have 
been disproportionately affected by early pregnancy 
and parenthood. Fifty-three percent of Latina teens 
and 51 percent of African-American young women 
will become pregnant at least once before they turn 
20, as compared to only 19 percent of non-Hispanic 
White young women. 
(11) Recent estimates suggest that while 15- to 
24-year-olds represent 25 percent of the sexually ac-
tive population, they acquire nearly half of all new 
STIs. Each year, one in four sexually active teen-
agers contracts a sexually transmitted infection. 
(12) Nearly 15 percent of the 56,000 annual 
new cases of HIV infections in the United States oc-
curred in youth ages 13 through 24 in 2006. An av-
erage of one young person every hour of every day 
is infected with HIV in the United States. 
(13) African-American and Latino youth have 
been disproportionately affected by the HIV/AIDS 
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epidemic. Although African-American adolescents 
ages 13 through 19 represent only 17 percent of the 
adolescent population in the United States, they ac-
counted for 70 percent of new HIV/AIDS cases re-
ported among teens in 2005. Latino adolescents 
ages 13 through 19 accounted for 17 percent of 
AIDS cases among teens, the same as their propor-
tion of the U.S. population in 2005. 
(14) Parental involvement is critical to any 
healthy relationship program. A major study showed 
that adolescents who reported feeling connected to 
parents and family were more likely than other teens 
to delay initiating sexual intercourse. Another study 
found that teens who reported previous discussions 
of sexuality with parents were seven times more like-
ly to feel able to communicate with a partner about 
HIV/AIDS than those who did not have such discus-
sions with their parents. Parental involvement is a 
leading protective factor for dating violence preven-
tion. 
(15) Comprehensive education programs respect 
the diversity of values and beliefs represented in the 
community and will complement and augment the 
education children receive from their families and 
faith communities. 
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(16) Incorporating teen dating violence preven-
tion into health education and comprehensive edu-
cation is imperative given the widespread experience 
of violence in dating relationships. Approximately 
one in three teens reports some kind of abuse in a 
romantic relationship, including emotional and 
verbal abuse. Young women who experience dating 
violence have sex earlier than their peers; are much 
less likely to use birth control; and engage in a wide 
variety of high-risk behaviors including multiple 
partners, sex with older men, and drug and alcohol 
abuse. Young women who are victims of dating vio-
lence are four to six times more likely than non- 
abused girls to become pregnant. 
SEC. 102. EDUCATION PROGRAMS FOR PREVENTING TEEN 
PREGNANCIES. 
(a) IN GENERAL.—The Secretary shall make grants 
to local educational agencies, State and local public health 
agencies, and nonprofit private entities for the purpose of 
carrying out projects to provide comprehensive education 
on preventing teen pregnancies. 
(b) PREFERENCE IN MAKING GRANTS.—In making 
grants under subsection (a), the Secretary shall give pref-
erence to applicants that will carry out the projects under 
such subsection in communities for which the rate of teen 
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pregnancy is significantly above the average rate of such 
pregnancies. 
(c) CERTAIN REQUIREMENTS.—A grant may be 
made under subsection (a) only if the applicant for the 
grant meets the following conditions with respect to the 
project involved: 
(1) The applicant agrees that information pro-
vided by the project will be age-appropriate, factu-
ally and medically accurate and complete, and sci-
entifically based. 
(2) The applicant agrees that strategies rep-
licate or substantially incorporate the elements of 
one or more comprehensive education programs that 
have been proven effective on the basis of rigorous 
scientific research to— 
(A) delay sexual intercourse or sexual ac-
tivity; 
(B) improve contraceptive use; 
(C) reduce the number of partners among 
those who are sexually active; or 
(D) reduce teenage pregnancy. 
(3) The applicant agrees that the project will 
not teach or promote religion. 
(4) The applicant agrees that the project will 
substantially incorporate the following elements— 
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(A) encourage teens to delay sexual activ-
ity; 
(B) provide comprehensive educational 
services and interventions, including informa-
tion about the risks and benefits of all contra-
ceptives as a means to prevent pregnancy and 
reduce the risk of contracting sexually trans-
mitted diseases, including HIV/AIDS; 
(C) educate both young men and women 
about the responsibilities and pressures that 
come along with parenting; 
(D) encourage family communication about 
sexuality; 
(E) teach young people the skills to make 
responsible decisions about sexuality, including 
how to avoid unwanted verbal, physical, and 
sexual advances and how avoid making un-
wanted verbal, physical, and sexual advances 
that are not wanted by the other party; 
(F) develop healthy relationships, including 
the prevention of dating and sexual violence; 
and 
(G) teach young people how alcohol and 
drug use can affect responsible decisionmaking. 
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(d) OPTIONAL ADDITIONAL ACTIVITIES.—In car-
rying out a comprehensive education program, a grant 
under this section may be expended to carry out, in addi-
tion to the services specified in subsection (c), educational 
and motivational activities that help young people to— 
(1) gain knowledge about the physical, emo-
tional, biological, and hormonal changes of adoles-
cence and subsequent stages of human maturation; 
(2) develop the knowledge and skills necessary 
to ensure and protect their sexual and reproductive 
health from unintended pregnancy and sexually 
transmitted disease, including HIV/AIDS through-
out their lifespan; 
(3) gain knowledge about the specific involve-
ment and responsibility of each individual in sexual 
decision making; 
(4) develop healthy attitudes and values about 
adolescent growth and development, body image, ra-
cial and ethnic diversity, and other related subjects; 
(5) develop and practice healthy life skills, in-
cluding goal-setting, decision making, negotiation, 
communication, and stress management; 
(6) promote self-esteem and positive inter-
personal skills focusing on relationship dynamics, in-
cluding, but not limited to, friendships, dating, ro-
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mantic involvement, marriage, and family inter-
actions; and 
(7) prepare for the adult world by focusing on 
educational and career success, including developing 
skills for employment, job seeking, independent liv-
ing, financial self-sufficiency, and workplace produc-
tivity. 
(e) MATCHING FUNDS.— 
(1) IN GENERAL.—With respect to the costs of 
the project to be carried out under subsection (a) by 
an applicant, a grant may be made under such sub-
section only if the applicant agrees to make available 
(directly or through donations from public or private 
entities) non-Federal contributions toward such 
costs in an amount that is not less than 25 percent 
of such costs ($1 for each $3 of Federal funds pro-
vided in the grant). 
(2) DETERMINATION
OF
AMOUNT
CONTRIB-
UTED.—Non-Federal contributions required in para-
graph (1) may be in cash or in kind, fairly evalu-
ated, including plant, equipment, or services. 
Amounts provided by the Federal Government, or 
services assisted or subsidized to any significant ex-
tent by the Federal Government, may not be in-
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cluded in determining the amount of such non-Fed-
eral contributions. 
(f) SUPPLEMENTATION OF FUNDS.—An applicant to 
which a grant is made under subsection (a) for a fiscal 
year shall use the grant to supplement and not supplant 
funds that would otherwise be available to the applicant 
for carrying out the purpose described in such subsection. 
(g) DATA REPORTING.—A State to which a grant is 
made under this paragraph for a fiscal year shall cooper-
ate with the Secretary to collect information and report 
on outcomes of programs funded under the grant, as spec-
ified by the Secretary. 
(h) APPLICATION
FOR GRANT.—A grant may be 
made under subsection (a) only if an application for the 
grant is submitted to the Secretary and the application 
is in such form, is made in such manner, and contains 
such agreements, assurances, and information, including 
the agreement under subsection (e), as the Secretary de-
termines to be necessary to carry out this section. 
(i) EVALUATION.— 
(1) IN GENERAL.—The Secretary shall commis-
sion a random assignment evaluation conducted by 
a third party of the programs of a few selected 
grantees under this section. 
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(2) ALLOCATION.—Of the amount appropriated 
to carry out this section, the Secretary may use not 
more than 10 percent of such amount for the pur-
pose of carrying out clause (i) for fiscal year 2010. 
Funds allocated under this paragraph are authorized 
to be appropriated to remain available for expendi-
ture through fiscal year 2015. 
(j) REPORT TO CONGRESS.—Not later than April 1, 
2015, the Secretary shall submit to the Congress a report 
describing the extent to which projects under subsection 
(a) have been successful in reducing teen pregnancy and 
achieving other evaluation outcomes in the communities 
in which the projects have been carried out. 
(k) DEFINITIONS.—For purposes of this section: 
(1) The term ‘‘age-appropriate’’, with respect to 
the information in pregnancy prevention, means top-
ics, messages, and teaching methods suitable to par-
ticular ages or age groups of children and adoles-
cents, based on developing cognitive, emotional, and 
behavioral capacity typical for the age or age group. 
(2) The term ‘‘factually and medically accurate 
and complete’’ means verified or supported by the 
weight of research conducted in compliance with ac-
cepted scientific methods and— 
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