Access to Contraception for Servicemembers and Dependents Act of 2021
Bill: S.1238 | Sponsor: Sen. Shaheen, Jeanne (D-NH)
Policy area: Armed Forces and National Security

Summary:
Access to Contraception for Servicemembers and Dependents Act of 2021
This bill addresses Department of Defense (DOD) contraceptive care and family planning services.
Specifically, the bill prohibits cost-sharing requirements with respect to TRICARE beneficiaries for specified prescription contraceptives.
Additionally, the bill prohibits cost-sharing requirements for TRICARE Select and TRICARE Prime beneficiaries in relation to any in-network method of contraception or contraceptive care (including with respect to insertion, removal, and follow-up), any sterilization procedure, or any related patient education or counseling service.
The bill requires DOD to provide information on all methods of emergency contraception and care to sexual assault survivors at its medical treatment facilities. Upon request by a sexual assault survivor, DOD must provide such emergency contraception or a prescription for emergency contraception.
Finally, DOD must establish a uniform standard curriculum for education programs on family planning for all members of the Armed Forces. Such education programs must be provided to service members during their first year of service and at other appropriate times, as determined by each military department.

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.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Access to Contraception for 
Servicemembers and Dependents Act of 2021''.

SEC. 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 18 percent of members 
        of the Armed Forces, and as of fiscal year 2019, more than 
        390,000 women serve on active duty in the Armed Forces or in 
        the reserve components. An estimated several thousand 
        transgender men also serve on active duty in the Armed Forces 
        and in the reserve components, in addition to non-binary 
        members and those who identify with a different gender.
            (2) Ninety-five percent of women serving in the Armed 
        Forces are of reproductive age and as of 2019, more than 
        700,000 female spouses and dependents of members of the Armed 
        Forces on active duty are of reproductive age.
            (3) The TRICARE program covered more than 1,570,000 women 
        of reproductive age in 2019, including spouses and dependents 
        of members of the Armed Forces on active duty. Additionally, 
        thousands of transgender dependents of members of the Armed 
        Forces are covered by the TRICARE program.
            (4) The right to access contraception is grounded in the 
        principle that contraception and the ability to determine if 
        and when to have children are inextricably tied to one's 
        wellbeing, equality, and ability to determine the course of 
        one's life. These protections have helped access to 
        contraception become a driving force in improving the health 
        and financial security of individuals and their families.
            (5) Access to contraception is critical to the health of 
        every individual capable of becoming pregnant. This Act is 
        intended to apply to all individuals with the capacity for 
        pregnancy, including cisgender women, transgender men, non-
        binary individuals, those who identify with a different gender, 
        and others.
            (6) Studies have shown that when cost barriers to the full 
        range of methods of contraception are eliminated, patients are 
        more likely to use the contraceptive method that meets their 
        needs, and therefore use contraception correctly and more 
        consistently, reducing the risk of unintended pregnancy.
            (7) Under the TRICARE program, members of the Armed Forces 
        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), which requires coverage of all 
        contraceptive methods approved by the Food and Drug 
        Administration for women and related services and education and 
        counseling. However, members not on active duty and dependents 
        of members do not have similar coverage of all methods of 
        contraception approved by the Food and Drug Administration 
        without cost-sharing when they obtain the contraceptive outside 
        of a military medical treatment facility.
            (8) 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) 
        requires all non-grandfathered individual and group health 
        plans to cover without cost-sharing preventive services, 
        including a set of evidence-based preventive services for women 
        supported by the Health Resources and Services Administration 
        of the Department of Health and Human Services. These women's 
        preventive services include the full range of female-controlled 
        contraceptive methods, effective family planning practices, and 
        sterilization procedures, approved by the Food and Drug 
        Administration. The Health Resources and Services 
        Administration has affirmed that contraceptive care includes 
        contraceptive counseling, initiation of contraceptive use, and 
        follow-up care (such as management, evaluation, and changes to 
        and removal or discontinuation of the contraceptive method).
            (9) 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 Armed Forces 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 Armed Forces.
            (10) The military departments received more than 7,800 
        reports of sexual assaults involving members of the Armed 
        Forces as victims or subjects during fiscal year 2019. Through 
        regulations, the Department of Defense already supports a 
        policy of ensuring that members of the Armed Forces who are 
        sexually assaulted have access to emergency contraception, and 
        the initiation of contraception if desired and medically 
        appropriate.

SEC. 3. CONTRACEPTION COVERAGE PARITY UNDER THE TRICARE PROGRAM.

    (a) Pharmacy Benefits Program.--Section 1074g(a)(6) of title 10, 
United States Code, is amended by adding at the end the following new 
subparagraph:
    ``(D) Notwithstanding subparagraphs (A), (B), and (C), cost-sharing 
requirements may not be imposed and cost-sharing amounts may not be 
collected with respect to any eligible covered beneficiary for any 
prescription contraceptive on the uniform formulary provided through a 
retail pharmacy described in paragraph (2)(E)(ii) or through the 
national mail-order pharmacy program.''.
    (b) TRICARE Select.--Section 1075 of such title is amended--
            (1) in subsection (c), by adding at the end the following 
        new paragraph:
            ``(4)(A) Notwithstanding any other provision of this 
        section, cost-sharing requirements may not be imposed and cost-
        sharing amounts may not be collected with respect to any 
        beneficiary under this section for a service described in 
        subparagraph (B) that is provided by a network provider.
            ``(B) A service described in this subparagraph is any 
        method of contraception approved by the Food and Drug 
        Administration, any contraceptive care (including with respect 
        to insertion, removal, and follow up), any sterilization 
        procedure, or any patient education or counseling service 
        provided in connection with any such method, care, or 
        procedure.''; and
            (2) in subsection (f), by striking ``calculated as'' and 
        inserting ``calculated (except as provided in subsection 
        (c)(4)) as''.
    (c) TRICARE Prime.--Section 1075a of such title is amended by 
adding at the end the following new subsection:
    ``(d) Prohibition on Cost-Sharing for Certain Services.--(1) 
Notwithstanding subsections (a), (b), and (c), cost-sharing 
requirements may not be imposed and cost-sharing amounts may not be 
collected with respect to any beneficiary enrolled in TRICARE Prime for 
a service described in paragraph (2) that is provided under TRICARE 
Prime.
    ``(2) A service described in this paragraph is any method of 
contraception approved by the Food and Drug Administration, any 
contraceptive care (including with respect to insertion, removal, and 
follow up), any sterilization procedure, or any patient education or 
counseling service provided in connection with any such method, care, 
or procedure.''.

SEC. 4. PREGNANCY PREVENTION ASSISTANCE AT MILITARY MEDICAL TREATMENT 
              FACILITIES FOR SEXUAL ASSAULT SURVIVORS.

    (a) In General.--Chapter 55 of title 10, United States Code, is 
amended by inserting after section 1074o the following new section:
``Sec. 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) Upon request by the sexual assault survivor, 
        emergency contraception or, if applicable, a prescription for 
        emergency contraception.
            ``(3) Notification of the right of the sexual assault 
        survivor to confidentiality with respect to the information and 
        care and services furnished under this section.
    ``(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' means any 
        individual who presents at a military medical treatment 
        facility and--
                    ``(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' means the conduct described 
        in section 1565b(c) of this title that may result in 
        pregnancy.''.
    (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.''.

SEC. 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.
            (2) Timing.--Education programs under paragraph (1) shall 
        be provided to members of the Armed Forces as follows:
                    (A) During the first year of service of the member.
                    (B) At such other times as each Secretary of a 
                military department determines appropriate with respect 
                to members of the Armed Forces under the jurisdiction 
                of such Secretary.
            (3) 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 for education 
programs 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 of the Armed Forces, 
                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 of the Armed Forces can access 
                their chosen method of contraception.
            (6) Information on all applicable laws and policies so that 
        members of the Armed Forces are informed of their rights and 
        obligations.
            (7) Information on the rights of patients to 
        confidentiality.
            (8) Information on the unique circumstances encountered by 
        members of the Armed Forces and the effects of such 
        circumstances on the use of contraception.
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