I 118th CONGRESS 1st Session H. R. 3646 IN THE HOUSE OF REPRESENTATIVES May 24, 2023 Ms. Meng (for herself, Ms. Barragán , Mrs. Beatty , Mr. Bowman , Ms. Brownley , Ms. Budzinski , Ms. Bush , Mr. Carson , Mr. Casten , Ms. Chu , Ms. Clarke of New York , Mr. Connolly , Ms. DelBene , Mr. Doggett , Ms. Escobar , Mr. Espaillat , Mr. Evans , Ms. Lois Frankel of Florida , Ms. Garcia of Texas , Mr. García of Illinois , Mr. Gomez , Mr. Green of Texas , Mr. Grijalva , Ms. Jacobs , Ms. Jayapal , Mr. Johnson of Georgia , Ms. Kamlager-Dove , Ms. Kelly of Illinois , Mr. Kilmer , Mr. Kim of New Jersey , Ms. Kuster , Ms. Lee of Pennsylvania , Ms. Lee of California , Ms. Matsui , Mr. Meeks , Mr. Menendez , Ms. Moore of Wisconsin , Mr. Morelle , Mr. Mullin , Mrs. Napolitano , Ms. Norton , Mr. Payne , Ms. Pettersen , Ms. Pingree , Mr. Quigley , Ms. Scanlon , Ms. Schakowsky , Ms. Schrier , Ms. Sewell , Mr. Sherman , Ms. Strickland , Mr. Takano , Ms. Tlaib , Ms. Tokuda , Mr. Tonko , Mr. Torres of New York , Mr. Trone , Ms. Velázquez , Ms. Wasserman Schultz , Mrs. Watson Coleman , Ms. Williams of Georgia , Ms. Wilson of Florida , Ms. Balint , and Ms. Ocasio-Cortez ) introduced the following bill; which was referred to the Committee on Education and the Workforce , and in addition to the Committees on the Judiciary , Financial Services , Energy and Commerce , Transportation and Infrastructure , Ways and Means , and the Budget , for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To increase the availability and affordability of menstrual products for individuals with limited access, and for other purposes.

1. Short title; table of contents (a) Short title This Act may be cited as the Menstrual Equity For All Act of 2023 . (b) Table of contents The table of contents of this Act is as follows: Sec. 1. Short title; table of contents. Sec. 2. Findings. Sec. 3. Menstrual products for students at elementary and secondary schools. Sec. 4. Menstrual products for students at institutions of higher education. Sec. 5. Menstrual products for incarcerated individuals and detainees. Sec. 6. Menstrual products availability for homeless individuals under Emergency Food and Shelter Grant Program. Sec. 7. Menstrual products covered by Medicaid. Sec. 8. Menstrual products for employees. Sec. 9. Menstrual products in Federal buildings. Sec. 10. Menstrual products in the Social Services Block Grant Program. Sec. 11. Menstrual products and taxation. Sec. 12. Menstrual products in TANF. 2. Findings Congress finds the following: (1) Menstrual products are a necessity each month for millions of individuals across the United States. (2) More than half of the United States population will likely menstruate every month for decades of their lives. (3) A lack of menstrual products, often called period poverty , can adversely affect an individual’s health and well-being. (4) Period poverty exacerbates the vicious cycle of poverty by further marginalizing individuals who menstruate, causing them to withdraw from daily life, forego pay, or miss educational opportunities. (5) Addressing period poverty is essential to ensuring educational equity for diverse populations. (6) Studies have shown that 1 in 4 women and girls report struggling to afford menstrual products. (7) Studies have shown that 1 in 10 college students in the United States are affected by period poverty. (8) Period poverty disproportionately affects Black, Latina, immigrant, and first-generation students at higher rates than other cohorts. (9) Individuals living in period poverty are more likely to experience depression than individuals with access to period products. (10) Period poverty can increase the risk of infections due to— (A) the use of substitutes for menstrual products (such as paper towels or toilet paper); and (B) the inability to change menstrual products as frequently as recommended. 3. Menstrual products for students at elementary and secondary schools (a) In general Section 4108(5)(C) of the Elementary and Secondary Education Act of 1965 ( 20 U.S.C. 7118(5)(C) ) is amended— (1) in clause (vi), by striking or after the semicolon; (2) in clause (vii), by inserting or after the semicolon; and (3) by adding at the end the following: (viii) provide free menstrual products to students who use menstrual products; . (b) Definitions Section 4102 of the Elementary and Secondary Education Act of 1965 ( 20 U.S.C. 7112 ) is amended— (1) by redesignating paragraphs (6) through (8) as paragraphs (7) through (9), respectively; and (2) by inserting after paragraph (5) the following: (6) Menstrual products The term menstrual products means sanitary napkins and tampons that conform to applicable industry standards. . (c) Rulemaking Not later than 1 year after the date of enactment of this Act, the Secretary of Education, in consultation with the Secretary of Health and Human Services, shall promulgate rules with respect to the definition of menstrual products in paragraph (6) of section 4102 of the Elementary and Secondary Education Act of 1965 ( 20 U.S.C. 7112 ), as amended by section 3(b). 4. Menstrual products for students at institutions of higher education (a) Purpose The purpose of this section is to alleviate— (1) the barriers to academic success faced by many college and graduate students due to the inability of such students to afford to purchase menstrual products; and (2) the unique set of burdens that college and graduate students experiencing period poverty face that can be compounded by lack of access to basic needs such as housing, food, transportation, and access to physical and mental health services. (b) In general The Secretary of Education shall establish a program to award grants, on a competitive basis, to at least 4 institutions of higher education (as such term is defined in section 101 of the Higher Education Act of 1965 ( 20 U.S.C. 1001 )), to— (1) support programs that provide free menstrual products to students; and (2) report on best practices of such programs. (c) Application To apply for a grant under this section, an institution of higher education shall submit to the Secretary an application in such form, at such time, and containing such information as the Secretary determines appropriate, including an assurance that such grant will be used to carry out the activities described in subsection (e). (d) Community colleges At least 50 percent of the grants awarded under this section shall be awarded to community colleges. (e) Grant uses A grant awarded under this section may only be used to— (1) carry out or expand activities that fund programs that support direct provision of free menstrual products to students in appropriate campus locations, including— (A) campus restroom facilities; (B) wellness centers; and (C) on-campus residential buildings; (2) report on best practices of such programs; (3) conduct outreach to students to encourage participation in menstrual equity programs and services; (4) help eligible students apply for and enroll in local, State, and Federal public assistance programs; and (5) coordinate and collaborate with government or community-based organizations to carry out the activities described in paragraphs (1) through (4). (f) Priority In awarding grants under this section, the Secretary shall prioritize— (1) institutions with Federal Pell Grant enrollment that is at least 25 percent of the total enrollment of such institution; and (2) historically Black colleges and universities, Hispanic-serving institutions, Asian American and Native American Pacific Islander-serving institutions, and other minority serving institutions. (g) Menstrual product defined In this section, the term menstrual product means a sanitary napkin or tampon that conforms to industry standards. (h) Authorization of appropriations There are authorized to be appropriated $5,000,000 out of funds appropriated for a fiscal year to the Fund for the Improvement of Postsecondary Education under section 741 of the Higher Education Act of 1965 ( 20 U.S.C. 1138 ) to carry out the grant program under this section. 5. Menstrual products for incarcerated individuals and detainees (a) Requirement for States Beginning on the date that is 180 days after the date of the enactment of this Act, and annually thereafter, the chief executive officer of each State that receives a grant under subpart 1 of part E of title I of the Omnibus Crime Control and Safe Streets Act of 1968 ( 42 U.S.C. 3750 et seq. ) (commonly referred to as the Edward Byrne Memorial Justice Assistance Grant Program ) shall submit to the Attorney General a certification, in such form and containing such information as the Attorney General may require, that all incarcerated individuals and detainees in that State have access to menstrual products on demand and at no cost to the incarcerated individuals and detainees, and that no visitor is prohibited from visiting an incarcerated individual due to the visitor’s use of menstrual products. (b) Reduction in Grant Funding In the case of a State whose chief executive officer fails to submit a certification required under subsection (a) in a fiscal year, the Attorney General shall reduce the amount that the State would have otherwise received under section 505 of title I of the Omnibus Crime Control and Safe Streets Act of 1968 ( 42 U.S.C. 3755 ) by 20 percent for the following fiscal year. (c) Reallocation Amounts not allocated to a State under section 505 of title I of the Omnibus Crime Control and Safe Streets Act of 1968 ( 42 U.S.C. 3755 ) for a fiscal year pursuant to subsection (b) shall be reallocated under such section to States that submit such certifications. (d) Menstrual products For the purposes of subsection (a), the term menstrual products means sanitary napkins and tampons that conform to applicable industry standards. (e) Availability for Federal prisoners The Attorney General shall make rules requiring, and the Director of the Bureau of Prisons shall take such actions as may be necessary to ensure, the distribution and accessibility without charge of menstrual products to prisoners in the custody of the Bureau of Prisons, including any prisoner in a Federal penal or correctional institution, any Federal prisoner in a State penal or correctional institution, and any Federal prisoner in a facility administered by a private detention entity, to ensure that each prisoner who requires these products may receive them in sufficient quantity. (f) Availability for detainees The Secretary of Homeland Security shall take such actions as may be necessary to ensure that menstrual products are distributed and made accessible to each alien detained by the Secretary of Homeland Security, including any alien in a facility administered by a private detention entity, at no expense to the alien. 6. Menstrual products availability for homeless individuals under Emergency Food and Shelter Grant Program Subsection (a) of section 316 of the McKinney-Vento Homeless Assistance Act ( 42 U.S.C. 11346(a) ) is amended— (1) in paragraph (5), by striking and at the end; (2) in paragraph (6), by striking the period at the end and inserting ; and ; and (3) by adding at the end the following new paragraph: (7) guidelines that ensure that amounts provided under the program to private nonprofit organizations and local governments may be used to provide sanitary napkins and tampons that conform to applicable industry standards. . 7. Menstrual products covered by Medicaid (a) In general Section 1905 of the Social Security Act ( 42 U.S.C. 1396d ) is amended— (1) in subsection (a)— (A) by redesignating paragraphs (30) and (31) as paragraphs (31) and (32), respectively; and (B) by inserting after paragraph (29) the following new paragraph: (30) menstrual products (as defined in subsection (jj)); ; and (2) by adding at the end the following new subsection: (jj) Menstrual products For purposes of subsection (a)(30), the term menstrual products means menstrual cups, menstrual discs, menstrual underwear, and sanitary napkins and tampons, that conform to applicable industry standards. . (b) Effective date (1) In general Subject to paragraph (2), the amendments made by this section shall apply with respect to medical assistance furnished during or after the first calendar quarter beginning on or after the date that is 1 year after the date of the enactment of this Act. (2) Exception for State legislation In the case of a State plan under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) that the Secretary of Health and Human Services determines requires State legislation in order for the respective plan to meet any requirement imposed by amendments made by this section, the respective plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet such an additional requirement before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of the enactment of this Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session shall be considered to be a separate regular session of the State legislature. 8. Menstrual products for employees Section 6 of the Occupational Safety and Health Act of 1970 ( 29 U.S.C. 655 ) is amended by adding at the end the following: (h) The Secretary shall by rule promulgate a requirement that each employer with not less than 100 employees provide menstrual products free of charge for employees of the employer. For purposes of the preceding sentence, menstrual products means sanitary napkins and tampons that conform to applicable industry standards. . 9. Menstrual products in Federal buildings (a) Requirement Each appropriate authority shall ensure that menstrual products are stocked in, and available free of charge in, each covered restroom in each covered public building under the jurisdiction of such authority. (b) Definitions In this section: (1) Appropriate authority The term appropriate authority means the head of a Federal agency, the Architect of the Capitol, or other official authority responsible for the operation of a covered public building. (2) Covered public building The term covered public building means a public building, as defined in section 3301 of title 40, United States Code, that is open to the public and contains a public restroom, and includes a building listed in section 6301 or 5101 of such title. (3) Covered restroom The term covered restroom means a restroom in a covered public building. (4) Menstrual products The term menstrual products means sanitary napkins and tampons that conform to applicable industry standards. 10. Menstrual products in the Social Services Block Grant Program (a) Increase in funding for Social Services Block Grant Program (1) In general The amount specified in subsection (c) of section 2003 of the Social Security Act ( 42 U.S.C. 1397b ) for purposes of subsections (a) and (b) of such section is deemed to be $1,900,000,000 for each of fiscal years 2024 through 2027, of which, the amount equal to $200,000,000, reduced by the amounts reserved under paragraph (2)(B) for each such fiscal year, shall be obligated by States in accordance with subsection (b). (2) Appropriation (A) In general Out of any money in the Treasury of the United States not otherwise appropriated, there is appropriated $200,000,000 for each of fiscal years 2024 through 2027, to carry out this section. (B) Reservations (i) Purposes The Secretary shall reserve, from the amount appropriated under subparagraph (A) to carry out this section— (I) for each of fiscal years 2024 through 2027, not more than 2 percent of the amount appropriated for the fiscal year for purposes of entering into an agreement with an eligible entity described in subparagraph (C) to assist in providing technical assistance and training, to support effective policy, practice, research, and cross-system collaboration among grantees and subgrantees, and to assist in the administration of the program described in this section; and (II) for fiscal year 2024, an amount, not to exceed $2,000,000, for purposes of conducting an evaluation under subsection (d). (ii) No State entitlement to reserved funds The State entitlement under section 2002(a) of the Social Security Act ( 42 U.S.C. 1397a(a) ) shall not apply to the amounts reserved under clause (i). (C) Eligible entity described An eligible entity described in this subparagraph is a nonprofit organization described in section 501(c)(3) of the Internal Revenue Code of 1986 and exempt from taxation under section 501(a) of such Code, that— (i) has experience in more than 1 State in the area of community distributions of basic need services, including experience collecting, warehousing, and distributing basic necessities such as menstrual products; (ii) demonstrates competency to implement a project, provide fiscal accountability, collect data, and prepare reports and other necessary documentation; and (iii) demonstrates a willingness to share information with researchers, practitioners, and other interested parties. (b) Rules governing use of additional funds (1) In general Funds are used in accordance with this subsection if— (A) the State, in consultation with relevant stakeholders, including agencies, professional associations, and nonprofit organizations, distributes the funds to eligible entities to— (i) decrease the unmet need for menstrual products by low-income menstruating individuals through— (I) the distribution of free menstrual products; (II) community outreach to assist in participation in existing menstrual product distribution programs; or (III) improving access to menstrual products among low-income individuals; and (ii) increase the ability of communities and low-income families in such communities to provide for the need for menstrual products of low-income adults; and (B) the funds are used subject to the limitations in section 2005 of the Social Security Act ( 42 U.S.C. 1397d ). (2) Allowable uses by eligible entities (A) In general An eligible entity receiving funds made available under subsection (a) shall use the funds for any of the following: (i) To pay for the purchase and distribution of menstrual products among low-income individuals. (ii) To integrate activities carried out under subparagraph (A) with other basic needs assistance programs serving low-income families, including the following: (I) Programs funded by the temporary assistance for needy families program under part A of title IV of the Social Security Act ( 42 U.S.C. 601 et seq. ), including the State maintenance of effort provisions of such program. (II) Programs designed to support the health of eligible children, such as the Children’s Health Insurance Program under title XXI of the Social Security Act, the Medicaid program under title XIX of such Act, or State funded health care programs. (III) Programs funded through the special supplemental nutrition program for women, infants, and children under section 17 of the Child Nutrition Act of 1966. (IV) Programs that offer early home visiting services, including the maternal, infant, and early childhood home visiting program (including the Tribal home visiting program) under section 511 of the Social Security Act ( 42 U.S.C. 711 ). (iii) To provide training or technical assistance in carrying out activities under this section. (iv) To cover administrative costs. (B) Limitation on use of funds for administrative costs An eligible entity receiving funds made available under this section shall not use more than 9 percent of the funds for administrative costs incurred pursuant to this section. (3) Availability of funds (A) Funds distributed to eligible entities Funds made available under subsection (a) that are distributed to an eligible entity by a State for a fiscal year may be expended by the eligible entity only in such fiscal year or the succeeding fiscal year. (B) Evaluation Funds reserved under subsection (a)(2)(B)(i)(II) to carry out the evaluation under subsection (d) shall be available for expenditure through September 30, 2028. (4) No effect on other programs Any assistance or benefits received by a family through funds made available under subsection (a) shall be disregarded for purposes of determining the family’s eligibility for, or amount of, benefits under any other Federal needs-based programs. (c) Annual reports Section 2004 of the Social Security Act shall apply with respect to payments made to a State under this section in the same way it applies with respect to payments made to a State under section 2002 of such Act. (d) Evaluation The Secretary, in consultation with States, the eligible entities described in subsection (a)(2)(C) receiving funds made available under this section, shall— (1) not later than December 30, 2030, complete an evaluation of the effectiveness of the assistance program carried out pursuant to this section, such as the effect of activities carried out under this Act on mitigating the health risks of unmet menstrual products need among individuals in low-income families; (2) not later than March 31, 2031, submit to the Committees on Energy and Commerce and on Ways and Means of the House of Representatives and the Committee on Finance of the Senate a report on the results of the evaluation; and (3) not later than April 30, 2031, publish the results of the evaluation on the internet website of the Department of Health and Human Services. (e) Guidance Not later than 180 days after the date of the enactment of this Act, the Secretary shall issue guidance regarding how the provisions of this section should be carried out, including information regarding eligible entities, allowable use of funds, and reporting requirements. (f) Best practices The Secretary of Health and Human Services, in cooperation with the Secretary of Education, shall develop best practices for school officials to use in discussing menstruation with students, and shall publish this information on the internet website of the Department of Health and Human Services. (g) Definitions In this section: (1) Menstrual products The term menstrual products means menstrual cups, menstrual discs, menstrual underwear, and sanitary napkins and tampons, that conform to applicable industry standards. (2) Eligible entities The term eligible entity means a State or local governmental entity, an Indian tribe or tribal organization (as defined in section 4 of the Indian Self-Determination and Education Assistance Act), or a nonprofit organization described in section 501(c)(3) of the Internal Revenue Code of 1986 and exempt from taxation under section 501(a) of such Code that— (A) has experience in the area of community distributions of basic need services, including experience collecting, warehousing, and distributing basic necessities such as diapers, food, or menstrual products; (B) demonstrates competency to implement a project, provide fiscal accountability, collect data, and prepare reports and other necessary documentation; and (C) demonstrates a willingness to share information with researchers, practitioners, and other interested parties. (3) State The term State has the meaning given in section 1101(a)(1) of the Social Security Act for purposes of title XX of such Act. (h) Limitation on authorization of appropriations For the administration of this section, there are authorized to be appropriated to the Secretary of Health and Human Services not more than $6,000,000 for fiscal years 2024 through 2027. (i) Exemption from sequestration Funds made available to carry out this section shall be exempt from reduction under any order issued under the Balanced Budget and Emergency Deficit Control Act of 1985. 11. Menstrual products and taxation (a) In general It shall be unlawful for a State, or unit of local government of a State, to impose a tax on the retail sale of a menstrual product. (b) Definitions For purposes of this Act: (1) Menstrual product The term menstrual products means menstrual cups, menstrual discs, menstrual underwear, and sanitary napkins and tampons, that conform to applicable industry standards. (2) State The term State means any of the several States or the District of Columbia. (c) Effective Date This Act shall take effect 120 days after the date of the enactment of this Act. 12. Menstrual products in TANF (a) In general Section 403(a) of the Social Security Act ( 42 U.S.C. 603(a) ) is amended by adding at the end the following: (6) Grants for menstrual products (A) In general The Secretary may make grants, on a competitive basis, for each fiscal year to eligible applicants for the grants, in such amounts as the Secretary deems appropriate to enable the eligible applicants to provide, to covered families that include an individual who is capable of menstruating, such benefits as are needed to ensure that the individual can purchase menstrual products for personal use. (B) Definitions In subparagraph (A): (i) Covered families The term covered families means families eligible for assistance under a State program funded under this part. (ii) Eligible applicant The term eligible applicant means— (I) a State to which a grant is made under paragraph (1) for a fiscal year; and (II) a political subdivision of a State that administers the State program funded under this part in the political subdivision. (iii) Menstrual products The term menstrual products means menstrual cups, menstrual discs, menstrual underwear, and sanitary napkins and tampons, that conform to applicable industry standards. (C) Consideration of applications The Secretary shall award grants under this paragraph on the basis of how effectively the programs proposed by the eligible applicants will help low-income individuals suffering from material deprivation meet their need for menstrual products. (D) Administration A State or political subdivision to which a grant is made under this paragraph may use the grant to provide benefits under this paragraph in such form and in such manner as the State or political subdivision deems appropriate. (E) Treatment of assistance Benefits provided using funds made available under this paragraph shall not be considered assistance under any State program funded under this part. (F) Appropriation Out of any money in the Treasury of the United States not otherwise appropriated, there are appropriated for fiscal year 2024 and each succeeding fiscal year $10,000,000 for grants under this paragraph. . (b) Evaluations Section 413 of such Act ( 42 U.S.C. 613 ) is amended by redesignating subsection (h) as subsection (i) and inserting after subsection (g) the following: (h) Evaluations of grants for menstrual products (1) In general The Secretary shall submit to the Congress reports, in writing, that evaluate the effectiveness of the benefit program provided for in section 403(a)(6). Each such report shall, for the period covered by the report— (A) describe— (i) the extent of material deprivation in the population, including lacking sufficient funds to regularly purchase necessities such as menstrual products; and (ii) the extent to which the program alleviated such material deprivation; (B) specify the number and identity of the entities to which a grant has been made under such section, and the amount of the grant made to each such entity; (C) describe how the grantees used the grants to provide benefits under the program; (D) specify the number of individuals who received the benefits; (E) describe how efficacious the program has been in helping low-income individuals meet their need for menstrual products; (F) describe the extent to which the program has improved the economic security of the benefit recipients; and (G) include such other relevant information as the Secretary deems appropriate. (2) Timing The Secretary shall submit a report that meets the requirements of paragraph (1) within 2 years after the date of the enactment of this paragraph and every 2 years thereafter. .