I 
116TH CONGRESS 
1ST SESSION H. R. 3129 
To provide women with increased access to preventive and life-saving cancer 
screening. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 5, 2019 
Mr. GOMEZ (for himself, Mr. AGUILAR, Ms. BARRAGA´N, Ms. BROWNLEY of 
California, Mr. DANNY K. DAVIS of Illinois, Mrs. DEMINGS, Ms. 
ESCOBAR, Ms. HAALAND, Mr. HASTINGS, Ms. JACKSON LEE, Mr. 
KHANNA, Ms. LEE of California, Mr. LUJA´N, Mrs. CAROLYN B. MALO-
NEY of New York, Ms. MOORE, Mr. MORELLE, Mr. MOULTON, Ms. 
MUCARSEL-POWELL, Ms. NORTON, Mr. PETERS, Miss RICE of New 
York, Ms. SCHAKOWSKY, Mr. SOTO, Ms. VELA´ZQUEZ, Ms. WASSERMAN 
SCHULTZ, Mr. WELCH, Ms. PRESSLEY, Mr. BLUMENAUER, Mr. HIGGINS 
of New York, Mr. RASKIN, Mrs. FLETCHER, and Mr. GRIJALVA) 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 2019’’. 
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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 re-
ducing health care disparities among low-income 
women and women of color, decrease health care 
spending, and expand 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, 
but it accounts for only about 3 percent of all can-
cers in women. 
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(3) The cancers that most frequently impact 
women include breast, uterine, ovarian, and cervical 
cancer, and there were 331,394 new cases of these 
cancers in 2015. 
(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 a disproportionate rate of incidence. While the 
incidence of uterine cancer is similar for White 
women and women of color, rates of death for uter-
ine cancer are 2 times higher for Black women than 
for White women. 
(5) 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. 
(6) Due to enhanced screening, cervical cancer, 
which used to be the leading cause of cancer death 
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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. 
(7) Increased access to education, information, 
and preventive cancer screening increase women’s 
ability to survive cancer. 
(8) 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. 
(9) Women’s health care providers that are pri-
marily engaged in family planning services, such 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. 
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: 
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‘‘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 2020 through 2023.’’. 
(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-
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-
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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 and research adopted 
by the National Academies of Sciences, Engineering, 
and Medicine in the area of preventive cancer 
screening for breast and gynecologic cancers; 
‘‘(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; and 
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‘‘(3) train physicians, nurse practitioners, and 
other health care providers to serve rural commu-
nities, low-income communities, and communities of 
color in breast and gynecologic cancer screening. 
‘‘(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 primarily 
engaged in family planning, as defined in section 
156.235 of title 45, Code of Federal Regulations (or 
any successor regulations); 
‘‘(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 
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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 
geographic area, income, race, and status of insur-
ance 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 avail-
ability of breast, cervical, ovarian, and other gyneco-
logical cancer screening options for women with dis-
proportionate rates of gynecological cancers, includ-
ing African-American women, Hispanic and Latina 
women, and other disproportionately impacted 
groups, according to the 50-State analyses described 
in paragraphs (1) and (2). 
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(4) In consultation with the Comptroller Gen-
eral of the United States, estimated Federal savings 
achieved through early detection of breast and 
gynecologic cancer. 
(5) Analysis of how access to health care pro-
viders trained under the program described in sec-
tion 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 
for women. 
(6) 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. 
(7) 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, and older 
women. 
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SEC. 7. DEMONSTRATION PROJECT ON CO-TESTING FOR 
HUMAN PAPILLOMAVIRUS AND CERVICAL 
CANCER. 
Part B of title III of the Public Health Service Act 
(42 U.S.C. 243 et seq.), as amended by section 5, is fur-
ther amended by inserting after section 317P–2 the fol-
lowing: 
‘‘SEC. 317P–3. DEMONSTRATION PROJECT ON CO-TESTING 
FOR HUMAN PAPILLOMAVIRUS AND CER-
VICAL CANCER. 
‘‘(a) IN GENERAL.—The Secretary, in coordination 
with the Director of the Centers for Disease Control and 
Prevention and the Administrator of the Health Resources 
and Services Administration, shall establish a 2-year dem-
onstration project on increasing the co-testing of human 
papillomavirus and cervical cancer screenings to develop 
models for increasing the rates of co-testing among women 
with disproportionate rates of cervical cancer, including 
African-American and Hispanic and Latina women. 
‘‘(b) USE OF FUNDS.—Entities receiving funds under 
this section shall use such funds to— 
‘‘(1) increase access to co-testing of Human 
papillomavirus and cervical cancer among patients 
with disproportionate rates of cervical cancer, in-
cluding African-American and Hispanic and Latina 
women; 
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‘‘(2) support culturally and linguistically appro-
priate delivery models to such patients, including 
through the provision of interpretation services; or 
‘‘(3) provide other services to improve health 
outcomes with respect to such patients. 
‘‘(c) PRIORITIZATION.—Priority for funding available 
under this section shall be given to entities serving low- 
income, uninsured, and medically underserved populations 
or populations with historically low rates of such co-test-
ing, such as older women. 
‘‘(d) ELIGIBLE ENTITIES.—To be eligible to receive 
a grant under this section, an entity shall be an entity 
described in section 317P–2(c).’’. 
Æ 
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