I 
113TH CONGRESS 
2D SESSION 
H. R. 5524 
To amend title 10, United States Code, to ensure that women 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. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 17, 2014 
Ms. SPEIER (for herself, Ms. DEGETTE, Ms. SLAUGHTER, Ms. DELAURO, Ms. 
BROWN of Florida, Mr. RANGEL, Ms. CLARK of Massachusetts, Mr. 
MCGOVERN, Ms. JACKSON LEE, Mr. GRIJALVA, Ms. DELBENE, Mrs. 
NAPOLITANO, Ms. MCCOLLUM, Mr. HASTINGS of Florida, Ms. NORTON, 
Mrs. CAPPS, Ms. CLARKE of New York, Mr. BLUMENAUER, Mr. DEFA-
ZIO, Ms. LOFGREN, Ms. LINDA T. SA´NCHEZ of California, Mr. LARSEN 
of Washington, Ms. MOORE, Ms. HAHN, Mr. CARSON of Indiana, Mr. 
CICILLINE, Ms. LEE of California, Mr. BERA of California, Mr. COHEN, 
Mr. QUIGLEY, Ms. PINGREE of Maine, Mr. ELLISON, Ms. CASTOR of 
Florida, Mr. DELANEY, Ms. TSONGAS, Ms. BONAMICI, Mr. LOEBSACK, 
Ms. MATSUI, Mr. HONDA, Mr. POCAN, Ms. CHU, Mrs. CAROLYN B. 
MALONEY of New York, Mr. HIMES, Mr. LOWENTHAL, Mr. RUIZ, Mr. 
KILMER, Mr. PETERS of California, Ms. KUSTER, Ms. BROWNLEY of 
California, Mr. BISHOP of New York, Ms. ESTY, Ms. SCHAKOWSKY, Mr. 
TAKANO, Mr. JOHNSON of Georgia, Ms. TITUS, Ms. SHEA-PORTER, Ms. 
WASSERMAN SCHULTZ, Ms. FUDGE, Mr. SHERMAN, Mr. BRADY of Penn-
sylvania, and Mr. THOMPSON of California) introduced the following bill; 
which was referred to the Committee on Armed Services 
A BILL 
To amend title 10, United States Code, to ensure that 
women members of the Armed Forces and their families 
have access to the contraception they need in order to 
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promote the health and readiness of all members of 
the Armed Forces, and for other purposes. 
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 ‘‘Access to Contracep-
tion for Women Servicemembers and Dependents Act of 
2014’’. 
SEC. 2. FINDINGS. 
Congress makes the following findings: 
(1) Women are serving in the Armed Forces at 
increasing rates, playing a critical role in the na-
tional security of the United States. More than 
350,000 women serve on active duty in the Armed 
Forces or in the Selected Reserve. 
(2) Nearly 10,000,000 members of the Armed 
Forces (including members of the National Guard 
and Reserves), military retirees, their families, their 
survivors, and certain former spouses, including 
nearly 5,000,000 female beneficiaries, are eligible for 
health care through the Department of Defense. 
(3) Contraception is critical for women’s health 
and is highly effective at reducing unintended preg-
nancy. The Centers for Disease Control and Preven-
tion describe contraception as one of the 10 greatest 
public health achievements of the twentieth century. 
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(4) Contraception has played a direct role in 
the greater participation of women in education and 
employment. Increased wages and increased control 
over reproductive decisions provide women with edu-
cational and professional opportunities that have in-
creased gender equality over the decades since con-
traception was introduced. 
(5) Studies have shown that when cost barriers 
to the full range of methods of contraception are 
eliminated, and women receive comprehensive coun-
seling on the various methods of contraception (in-
cluding highly effective Long-Acting Reversible Con-
traceptives (LARCs)), rates of unintended preg-
nancy decline dramatically. 
(6) Research has also shown that investments 
in effective contraception save public and private 
dollars. 
(7) The 2011 recommendations of the Institute 
of Medicine on women’s preventive health services 
include recommendations that health insurance plans 
cover all methods of contraception approved by the 
Food and Drug Administration, sterilization proce-
dures, and patient education and counseling for all 
women with reproductive capacity without any cost- 
sharing requirements. 
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(8) The recommendations described in para-
graph (7) are reflected in provisions of the Patient 
Protection and Affordable Care Act (Public Law 
111–148), and thus group and individual health in-
surance plans must provide such coverage. The rec-
ommendations have also been adopted by the Office 
of Personnel Management, and thus all health insur-
ance plans that are part of the Federal Employees 
Health Benefits Program must provide such cov-
erage. 
(9) Under the TRICARE program, service-
women on active duty have full coverage of all pre-
scription drugs, including contraception, without 
cost-sharing requirements. However, servicewomen 
not on active duty, and female dependents of mem-
bers of the Armed Forces, who receive health care 
through the TRICARE program do not have similar 
coverage of all prescription methods of contraception 
approved by the Food and Drug Administration 
without cost-sharing. 
(10) Studies indicate that servicewomen need 
comprehensive counseling for pregnancy prevention, 
particularly in their predeployment preparations, 
and the lack thereof is contributing to unintended 
pregnancies among servicewomen. 
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(11) An analysis by Ibis Reproductive Health of 
the 2008 Survey of Health Related Behaviors among 
Active Duty Military Personnel found a high unin-
tended pregnancy rate among servicewomen. Adjust-
ing for the difference between age distribution in the 
Armed Forces and the general population, the rate 
of unintended pregnancy among servicewomen is 
higher than for the general population. 
(12) With the integrated use of electronic med-
ical records throughout the Department of Defense, 
the technological infrastructure exists to develop 
clinical decision support tools. These tools, which are 
incorporated into the electronic medical record, allow 
for a point-of-care feedback loop that can be used to 
enhance patient decisionmaking, case and patient 
management, and care coordination. Benefits of clin-
ical decision support tools include increased quality 
of care and enhanced health outcomes, improved ef-
ficiency, and provider and patient satisfaction. 
(13) The Defense Advisory Committee on 
Women in the Services (DACOWITS) has rec-
ommended that all the Armed Forces, to the extent 
that they have not already, implement initiatives 
that inform servicemembers of the importance of 
family planning, educate them on methods of contra-
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ception, 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. 
(14) Health care, including family planning for 
survivors of sexual assault in the Armed Forces is 
a critical issue. Servicewomen on active duty report 
rates of unwanted sexual contact at approximately 
16 times those of the comparable general population 
of women in the United States. Through regulations, 
the Department of Defense already supports a policy 
of ensuring that servicewomen who are sexually as-
saulted have access to emergency contraception. 
SEC. 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 MEM-
BERS
AND FORMER MEMBERS’’ after ‘‘SERVICES 
AVAILABLE’’; 
(2) by redesignating subsection (b) as sub-
section (d); and 
(3) by inserting after subsection (a) the fol-
lowing new subsections: 
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‘‘(b) CARE RELATED
TO PREVENTION
OF PREG-
NANCY.—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) 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 serv-
ices, the TRICARE retail pharmacy program, or the na-
tional mail-order pharmacy program.’’. 
(b) CARE RELATED
TO PREVENTION
OF PREG-
NANCY.—Subsection (d)(3) of such section, as redesig-
nated by subsection (a)(2) of this section, is further 
amended by inserting before the period at the end the fol-
lowing: ‘‘(including all methods of contraception approved 
by the Food and Drug Administration, sterilization proce-
dures, 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)’’ and inserting ‘‘section 1074d(d)’’. 
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SEC. 4. ACCESS TO BROAD RANGE OF METHODS OF CON-
TRACEPTION APPROVED BY THE FOOD AND 
DRUG ADMINISTRATION FOR MEMBERS OF 
THE ARMED FORCES AND MILITARY DEPEND-
ENTS AT MILITARY TREATMENT FACILITIES. 
(a) IN GENERAL.—Commencing not later than 180 
days after the date of the enactment of this Act, the Sec-
retary of Defense shall ensure that every military treat-
ment facility has a sufficient stock of a broad range of 
methods of contraception approved by the Food and Drug 
Administration, as recommended by the Centers for Dis-
ease Control and Prevention and the Office of Population 
Affairs of the Department of Health and Human Services, 
to be able to dispense at any time any such method of 
contraception to any women members of the Armed 
Forces and female covered beneficiaries who receive care 
through such facility. 
(b) COVERED BENEFICIARY DEFINED.—In this sec-
tion, the term ‘‘covered beneficiary’’ has the meaning 
given that term in section 1072(5) of title 10, United 
States Code. 
SEC. 5. COMPREHENSIVE STANDARDS AND ACCESS TO 
CONTRACEPTION COUNSELING FOR MEM-
BERS OF THE ARMED FORCES. 
(a) PURPOSE.—The purpose of this section is to en-
sure that all health care providers employed by the De-
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partment of Defense who provide care for women members 
of the Armed Forces, including general practitioners, are 
provided, through clinical practice guidelines, the most 
current evidence-based and evidence-informed standards 
of care with respect to methods of contraception and coun-
seling on methods of contraception. 
(b) CLINICAL PRACTICE GUIDELINES.— 
(1) IN
GENERAL.—Not later than one year 
after the date of the enactment of this Act, the Sec-
retary of Defense shall compile clinical practice 
guidelines for health care providers described in sub-
section (a) on standards of care with respect to 
methods of contraception and counseling on methods 
of contraception for women members of the Armed 
Forces. 
(2) SOURCES.—The Secretary shall compile 
clinical practice guidelines under this subsection 
from among clinical practice guidelines established 
by appropriate health agencies and professional or-
ganizations, including the following: 
(A) The United States Preventive Services 
Task Force. 
(B) The Centers for Disease Control and 
Prevention. 
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(C) The Office of Population Affairs of the 
Department of Health and Human Services. 
(D) The American College of Obstetricians 
and Gynecologists. 
(E) The Association of Reproductive 
Health Professionals. 
(F) The American Academy of Family 
Physicians. 
(G) The Agency for Healthcare Research 
and Quality. 
(3) UPDATES.—The Secretary shall from time 
to time update the list of clinical practice guidelines 
compiled under this subsection to incorporate into 
such guidelines new or updated standards of care 
with respect to methods of contraception and coun-
seling on methods of contraception. 
(4) DISSEMINATION.— 
(A) INITIAL DISSEMINATION.—As soon as 
practicable after the compilation of clinical 
practice guidelines pursuant to paragraph (1), 
but commencing not later than one year after 
the date of the enactment of this Act, the Sec-
retary shall provide for rapid dissemination of 
the clinical practice guidelines to health care 
providers described in subsection (a). 
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(B) UPDATES.—As soon as practicable 
after the adoption under paragraph (3) of any 
update to the clinical practice guidelines com-
piled pursuant to this subsection, the Secretary 
shall provide for the rapid dissemination of 
such clinical practice guidelines, as so updated, 
to health care providers described in subsection 
(a). 
(C) PROTOCOLS.—Clinical practice guide-
lines, and any updates to such guidelines, shall 
be disseminated under this paragraph in ac-
cordance with administrative protocols devel-
oped by the Secretary for that purpose. 
(c) CLINICAL DECISION SUPPORT TOOLS.— 
(1) IN
GENERAL.—Not later than one year 
after the date of the enactment of this Act, the Sec-
retary shall, in order to assist health care providers 
described in subsection (a), develop and implement 
clinical decision support tools that reflect, through 
the clinical practice guidelines compiled pursuant to 
subsection (b), the most current evidence-based and 
evidence-informed standards of care with respect to 
methods of contraception and counseling on methods 
of contraception. 
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(2) UPDATES.—The Secretary shall from time 
to time update the clinical decision support tools de-
veloped under this subsection to incorporate into 
such tools new or updated guidelines on methods of 
contraception and counseling on methods of contra-
ception. 
(3) DISSEMINATION.—Clinical decision support 
tools, and any updates to such tools, shall be dis-
seminated under this subsection in accordance with 
administrative protocols developed by the Secretary 
for that purpose. Such protocols shall be similar to 
the administrative protocols developed under sub-
section (b)(4)(C). 
(d) ACCESS TO CONTRACEPTION COUNSELING.—As 
soon as practicable after the date of the enactment of this 
Act, the Secretary shall ensure that women members of 
the Armed Forces have access to counseling on the full 
range of methods of contraception provided by health care 
providers described in subsection (a) during health care 
visits, including, but not limited to, visits as follows: 
(1) During predeployment health care visits, 
with the counseling to be provided during such visits 
emphasizing the interaction between anticipated de-
ployment conditions and various methods of contra-
ception. 
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(2) During health care visits during deploy-
ment. 
(3) During annual physical examinations. 
(e) INCORPORATION INTO SURVEYS OF QUESTIONS 
ON SERVICEWOMEN EXPERIENCES WITH FAMILY PLAN-
NING SERVICES AND COUNSELING.— 
(1) IN GENERAL.—Not later than 90 days after 
the date of the enactment of this Act, the Secretary 
shall integrate into the Department of Defense sur-
veys specified in paragraph (2) questions designed to 
obtain information on the experiences of women 
members of the Armed Forces— 
(A) in accessing family planning services 
and counseling; 
(B) in using family planning methods, 
which method was preferred and whether de-
ployment conditions affected the decision on 
which family planning method or methods to be 
used; and 
(C) if pregnant, whether the pregnancy 
was intended. 
(2) COVERED
SURVEYS.—The surveys into 
which questions shall be integrated as described in 
paragraph (1) are the following: 
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(A) The Health Related Behavior Survey 
of Active Duty Military Personnel. 
(B) The Health Care Survey of Depart-
ment of Defense Beneficiaries. 
SEC. 6. EDUCATION ON FAMILY PLANNING FOR MEMBERS 
OF THE ARMED FORCES. 
(a) EDUCATION PROGRAM.— 
(1) IN
GENERAL.—Not later than one year 
after the date of the enactment of this Act, the Sec-
retary of Defense shall establish an education pro-
gram for all members of the Armed Forces, includ-
ing both men and women members, consisting of a 
uniform standard curriculum on family planning. 
(2) SENSE OF CONGRESS.—It is the sense of 
Congress that the standard curriculum should use 
the latest technology available to efficiently and ef-
fectively deliver information to members of the 
Armed Forces. 
(b) ELEMENTS.—The standard curriculum under 
subsection (a) shall include the following: 
(1) Information on the importance of providing 
comprehensive family planning for members of the 
Armed Forces, and their commanding officers, and 
on the positive impact family planning can have on 
the health and readiness of the Armed Forces. 
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(2) Current, medically accurate information. 
(3) Clear, user-friendly information on the full 
range of methods of contraception and where mem-
bers of the Armed Forces can access their chosen 
method of contraception. 
(4) Information on all applicable laws and poli-
cies so that members are informed of their rights 
and obligations. 
(5) Information on patients’ rights to confiden-
tiality. 
(6) Information on the unique circumstances 
encountered by members of the Armed Forces, and 
the effects of such circumstances on the use of con-
traception. 
SEC. 7. PREGNANCY PREVENTION ASSISTANCE AT MILI-
TARY TREATMENT FACILITIES FOR WOMEN 
WHO ARE SEXUAL ASSAULT SURVIVORS. 
(a) PURPOSE.—The purpose of this section is to pro-
vide in statute, and to enhance, existing regulations that 
require health care providers at military treatment facili-
ties to consult with survivors of sexual assault once clini-
cally stable regarding options for emergency contraception 
and any necessary follow-up care, including the provision 
of the emergency contraception. 
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(b) IN GENERAL.—The assistance specified in sub-
section (c) shall be provided at every military treatment 
facility to the following: 
(1) Any woman who presents at a military 
treatment facility and states to personnel of the fa-
cility that she is a victim of sexual assault or is ac-
companied by another individual who states that the 
woman is a victim of sexual assault. 
(2) Any woman who presents at a military 
treatment facility and is reasonably believed by per-
sonnel of such facility to be a survivor of sexual as-
sault. 
(c) ASSISTANCE.— 
(1) IN GENERAL.—The assistance specified in 
this subsection shall include the following: 
(A) The prompt provision by appropriate 
staff of the military treatment facility of com-
prehensive, medically and factually accurate, 
and unbiased written and oral information 
about all methods of emergency contraception 
approved by the Food and Drug Administra-
tion. 
(B) The prompt provision by such staff of 
emergency contraception to a woman upon her 
request. 
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(C) Notification to the woman of her right 
to confidentiality in the receipt of care and 
services pursuant to this section. 
(2) NATURE OF INFORMATION.—The informa-
tion provided pursuant to paragraph (1)(A) shall be 
provided in language that is clear and concise, is 
readily comprehensible, and meets such conditions 
(including conditions regarding the provision of in-
formation in languages other than English) as the 
Secretary may provide in the regulations under this 
section. 
Æ 
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