I 113th CONGRESS 1st Session H. R. 2457 IN THE HOUSE OF REPRESENTATIVES June 20, 2013 Mr. Bera of California (for himself, Mrs. Napolitano , Ms. Lee of California , Ms. Norton , Mr. Rangel , Ms. Moore , Ms. Slaughter , Ms. Speier , Ms. Schakowsky , Mr. Connolly , Mr. Payne , Ms. Brownley of California , Ms. Titus , Mr. Swalwell of California , Mrs. Capps , Mr. Grijalva , Mr. Conyers , Mrs. Carolyn B. Maloney of New York , Ms. Roybal-Allard , Mr. Ellison , Mr. Levin , Mr. Cicilline , Ms. Pingree of Maine , Ms. Wilson of Florida , Mr. Lowenthal , Mr. Honda , Ms. Hahn , Ms. Linda T. Sánchez of California , Mr. Farr , Mr. Sherman , Mr. Costa , Mrs. Negrete McLeod , Mr. Perlmutter , Ms. Lofgren , Mr. Cárdenas , and Mr. McDermott ) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To provide for a national public outreach and education campaign to raise public awareness of women’s preventive health.

1. Short title This Act may be cited as the Women’s Preventive Health Awareness Campaign . 2. Findings Congress makes the following findings: (1) Well-woman visits are the foundation on which women’s preventive care is built. Such visits include not only specific screening tests, but also a medical history, physical examination, evaluation and counseling, and, as indicated, vaccinations. (2) Over the past 20 years, it has become clear that “one size does not fit all” when it comes to prevention. Although a 30-year-old woman without risk factors for cervical cancer may only need a Pap test with HPV co-testing every 5 years, the same woman would need more frequent screening if she were infected with HIV or had a history of cervical cancer precursors. (3) It is only after taking a medical history and evaluating and counseling a patient that a physician can make patient-specific recommendations for screening tests, vaccinations, preventive medications, and other preventive services. (4) Well-woman visits facilitate increased access to health care that is shown to identify chronic disease risk factors, promote well-being, and decrease the likelihood or delay the onset of a targeted disease or condition. (5) Heart disease, stroke, and other cardiovascular diseases are the number one cause of death in American women, claiming over 400,000 lives each year, or nearly one death each minute. (6) Women are less likely than men to receive aggressive diagnosis and treatment for cardiovascular diseases. (7) Women are more likely than men to have forgone needed health care due to cost. (8) Between 2002 and 2010, screening mammography rates among women in the United States who were 50 years of age to 64 years of age declined from about 79 percent to 73 percent. (9) In 2009, only 53 percent of 18- to 64-year-olds in the United States reported having ever received an HIV test. (10) The proportion of women in the United States 22 years of age to 30 years of age who reported never having had a Pap test increased from 6.6 percent in 2000 to 9.0 percent in 2010 despite current recommendations that they receive a Pap test every three years. (11) In 2007, 29.3 percent of women in the United States delivering a live birth did not receive any prenatal care in the first trimester, even though first trimester prenatal care is recommended. (12) Among sexually active females in the United States who are 16 years of age to 20 years of age, only 52.7 percent of such females receiving benefits under the Medicaid program and 40.1 percent of such females with health insurance coverage under commercial health insurance plans were screened for genital Chlamydia infections during the measurement year, as reported in 2008. A 2013 analysis published by the Centers for Disease Control and Prevention found that for Chlamydia cases diagnosed in 2008 alone, the associated lifetime direct medical costs amount to $516.7 million. (13) Almost half (49 percent) of the 6.7 million pregnancies in the United States each year (3.2 million) are unintended. Multiple studies have shown that improved access to birth control significantly improves the health of women and their families, as it is directly linked to improved maternal and infant health outcomes. Women that plan their pregnancies are more likely to access prenatal care, improving their own health and the health of their children. (14) Between 2006 and 2010, one-third of all pregnancies were conceived within 18 months of a previous birth, an interval that is potentially harmful to the health of the mother. (15) Improved access to family planning also saves money. For every $1.00 invested in family planning, taxpayers save nearly $4.00 in Medicaid-related expenses. (16) During the 2011–2012 flu season, 53 percent of pregnant women did not receive recommended vaccination against influenza. 3. Women’s Preventive Health Awareness Campaign Part P of title III of the Public Health Service Act (42 U.S.C. 280g et al.) is amended by adding at the end the following new section: 399V–6. Women’s Preventive Health Awareness Campaign (a) In general The Secretary shall provide for the planning and implementation of a national public outreach and education campaign to raise public awareness, including provider awareness, of women’s preventive health. Such campaign shall include the media campaign under subsection (b) and the website under subsection (c) and shall provide for the dissemination of information that— (1) describes the guidelines for women’s preventive services, including the cervical cancer recommendations updated in 2012, by the United States Preventive Services Task Force, by the American College of Obstetricians and Gynecologists (ACOG), and by the American Cancer Society, the American Society for Colposcopy and Cervical Pathology, and the American Society for Clinical Pathology; (2) promotes well-woman visits for health assessments which include screenings, evaluations, counseling, immunizations, and prenatal visits, as appropriate; (3) explains the women’s preventive services that are required under section 2713 to be covered without cost-sharing by a group health plan or a health insurance issuer offering group or individual health insurance coverage that is not a grandfathered plan (as defined in section 1251(e) of the Patient Protection and Affordable Care Act); and (4) addresses health disparities in the area of women’s prevention. (b) Media campaign (1) In general Not later than 1 year after the date of the enactment of this section, as part of the campaign under subsection (a), the Secretary shall establish and implement a national media campaign. (2) Requirement of campaign The campaign implemented under paragraph (1)— (A) shall disseminate information about the updated guidelines for women’s preventive services described in subsection (a)(1), promote well-woman visits described in subsection (a)(2), and provide information on the women’s preventive services described in subsection (a)(3); and (B) may include the use of television, radio, Internet, and other commercial marketing venues. (c) Website As part of the campaign under subsection (a), the Secretary shall, in consultation with private sector experts or through contract with a private entity including a medical association or non-profit organization, maintain and update an Internet website to provide information and resources about the updated guidelines for women’s preventive services described in subsection (a)(1), promote well-woman visits, and provide information on the women’s preventive services described in subsection (a)(3). (d) Funding The Secretary may use, out of any funds otherwise made available to the Department of Health and Human Services, such sums as may be necessary to carry out this section. .