II 118th CONGRESS 2d Session S. 4717 IN THE SENATE OF THE UNITED STATES July 11 (legislative day, July 10), 2024 Mr. Rubio (for himself and Mr. Risch ) introduced the following bill; which was read twice and referred to the Committee on Armed Services A BILL To include pregnancy and loss of pregnancy as qualifying life events under the TRICARE program and to require a study on maternal health in the military health system, and for other purposes.

1. Short title This Act may be cited as the Military Moms Act . 2. Definitions In this Act: (1) Covered beneficiary; dependent; TRICARE program The terms covered beneficiary , dependent , and TRICARE program have the meanings given those terms in section 1072 of title 10, United States Code. (2) Maternal health The term maternal health means care during labor, birthing, prenatal care, and postpartum care. (3) Maternity care desert The term maternity care desert means a county in the United States that does not have— (A) a hospital or birth center offering obstetric care; or (B) an obstetric provider. (4) Prenatal care The term prenatal care means medical care provided to maintain and improve fetal and maternal health during pregnancy. (5) Secretary The term Secretary means the Secretary of Defense. 3. Modification of qualifying life events (a) In general Not later than one year after the date of the enactment of this Act, the Secretary shall— (1) update the list of qualifying life events under the TRICARE program to include pregnancy and loss of pregnancy; and (2) issue guidance to covered beneficiaries describing the documentation required to make enrollment changes under the TRICARE program due to such qualifying life events, such as written confirmation from a medical provider confirming a pregnancy or loss of pregnancy. (b) Prohibition This section shall not apply to a covered beneficiary who seeks to claim an abortion as a qualifying life event. (c) Definitions In this section: (1) Abortion The term abortion means the use or prescription of any instrument, medicine, drug, or other substance or device to intentionally— (A) kill the unborn child of a woman known to be pregnant; or (B) prematurely terminate the pregnancy of a woman known to be pregnant, with an intention other than to— (i) increase the probability of a live birth or preserve the life or health of the child after a live birth; (ii) remove a dead unborn child; or (iii) treat an ectopic pregnancy. (2) Loss of pregnancy The term loss of pregnancy means miscarriage or stillbirth. 4. Report on access to maternal health care within the military health system (a) In general Not later than two years after the date of the enactment of this Act, the Secretary shall submit to the Committee on Armed Services and the Committee on Appropriations of the Senate and the Committee on Armed Services and the Committee on Appropriations of the House of Representatives a report on access to maternal health care within the military health system for covered beneficiaries during the preceding two-year period. (b) Contents The report required under subsection (a) shall include the following: (1) With respect to military medical treatment facilities, the following: (A) An analysis of the availability of maternal health care for covered beneficiaries who access the military health system through such facilities. (B) An identification of staffing shortages in positions relating to maternal health and childbirth, including obstetrician-gynecologists, certified nurse midwives, and labor and delivery nurses. (C) A description of specific challenges faced by covered beneficiaries in accessing maternal health care at such facilities. (D) An analysis of the timeliness of access to maternal health care, including wait times for and travel times to appointments. (E) A description of how such facilities track patient satisfaction with maternal health services. (F) A process to establish continuity of prenatal care and postpartum care for covered beneficiaries who experience a permanent change of station during a pregnancy. (G) An identification of barriers with regard to continuity of prenatal care and postpartum care during permanent changes of station. (H) A description of military-specific health challenges impacting covered beneficiaries who receive maternal health care at military medical treatment facilities, and a description of how the Department tracks such challenges. (I) For the 10-year period preceding the date of the submission of the report, the amount of funds annually expended— (i) by the Department of Defense on maternal health care; and (ii) by covered beneficiaries on out-of-pocket costs associated with maternal health care. (J) An identification of each medical facility of the Department of Defense located in a maternity care desert. (K) Recommendations and legislative proposals— (i) to address staffing shortages that impact the positions described in subparagraph (B); (ii) to improve the delivery and availability of maternal health services through military medical treatment facilities and improve patient experience; and (iii) to improve continuity of prenatal care and postpartum care for covered beneficiaries during a permanent change of station. (2) With respect to providers within the TRICARE program network that are not located at or affiliated with a military medical treatment facility, the following: (A) An analysis of the availability of maternal health care for covered beneficiaries who access the military health system through such providers. (B) An identification of staffing shortages for such providers in positions relating to maternal health and childbirth, including obstetrician-gynecologists, certified nurse midwives, and labor and delivery nurses. (C) A description of specific challenges faced by covered beneficiaries in accessing maternal health care from such providers. (D) An analysis of the timeliness of access to maternal health care, including wait times for and travel times to appointments. (E) A description of how such providers track patient satisfaction with maternal health services. (F) A process to establish continuity of prenatal care and postpartum care for covered beneficiaries who experience a permanent change of station during a pregnancy. (G) An identification of barriers with regard to continuity of prenatal care and postpartum care during permanent changes of station. (H) The number of dependents who choose to access maternal health care through such providers. (I) For the 10-year period preceding the date of the submission of the report, the amount of funds annually expended— (i) by the Department of Defense on maternal health care; and (ii) by covered beneficiaries on out-of-pocket costs associated with maternal health care. (J) Recommendations and legislative proposals— (i) to address staffing shortages that impact the positions described in subparagraph (B); (ii) to improve the delivery and availability of maternal health services through the TRICARE program and improve patient experience; (iii) to improve continuity of prenatal care and postpartum care for covered beneficiaries during a permanent change of station; and (iv) to improve the ability of contractors under the TRICARE program to build a larger network of providers for maternal health, including obstetrician-gynecologists, certified nurse midwives, and labor and delivery nurses. 5. Updates to Military OneSource program (a) In general Not later than one year after the date of the enactment of this Act, the Secretary shall publish on a publicly available website of the Military OneSource program of the Department of Defense a dedicated webpage that includes a comprehensive guide of resources available to covered beneficiaries, including— (1) a list of maternal health services that are available to covered beneficiaries under the TRICARE program and at military medical treatment facilities; (2) information on mental health counseling, pregnancy counseling, and other prepartum and postpartum services, including what services are reportable or non-reportable for members of the Armed Forces; (3) information on prenatal development, including anticipated prenatal appointments and available care for covered beneficiaries during prenatal development; (4) information on— (A) organizations that provide services and other resources to assist covered beneficiaries with maternal health needs and pregnancy support services located at, or in vicinity of, military installations; and (B) Federal, State, and local maternal health care resources that are either covered by the TRICARE program or could otherwise be made available to a covered beneficiary; (5) information on resources to assist covered beneficiaries who are pregnant with anticipated changes and health challenges that result from pregnancy, including information on anticipated postnatal appointments, available postnatal care for covered beneficiaries, and post-birth instructions specific to covered beneficiaries; (6) information on financial assistance available to covered beneficiaries to support pregnancy needs; (7) a best practice guide for smooth continuity of pregnancy care during a permanent change of station; and (8) information specific to pregnant members of the Armed Forces, including leave options and regulations, career field specific information and restrictions, physical fitness requirements, and uniform resources and requirements. (b) Limitations The guide required by subsection (a) may not include information, references, or resources on abortion. (c) Training The Secretary shall provide training to military and family life counselors available through the Military OneSource program on addressing the non-medical needs of covered beneficiaries who are pregnant. (d) Notification of pregnancy The Secretary shall notify the head of the Military OneSource program when a covered beneficiary makes the Secretary aware of a pregnancy. (e) Plan Not later than 540 days after the date of the enactment of this Act, the Secretary shall develop and submit to Congress a plan for the Secretary to disseminate to beneficiaries of the Military OneSource program the guide required by subsection (a).