[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 1527 Introduced in Senate (IS)]
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118th CONGRESS
1st Session
S. 1527
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.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
May 10, 2023
Mrs. Shaheen (for herself, Ms. Collins, Ms. Hirono, Ms. Warren, Ms.
Stabenow, Mr. Menendez, Ms. Hassan, Mrs. Gillibrand, Mr. Bennet, Mr.
Tester, Mr. Blumenthal, Mr. Kelly, Ms. Baldwin, Mr. Kaine, Mrs. Murray,
Mr. Durbin, Mr. Brown, Mr. Sanders, Ms. Smith, and Mr. Wyden)
introduced the following bill; which was read twice and referred to the
Committee on Armed Services
_______________________________________________________________________
A BILL
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 2023''.
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, dignity, and ability to determine the
course of one's life. Those 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, cleared, or authorized under
section 505, 510(k), 513(f)(2), or 515 of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 355, 360(k), 360c(f)(2),
360e) and related services and education and counseling.
However, members not on active duty and dependents of members
do not have similar coverage of all contraceptive methods
approved, cleared, or authorized under section 505, 510(k),
513(f)(2), or 515 of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 355, 360(k), 360c(f)(2), 360e) 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. Those women's
preventive services include the full range of contraceptive
methods approved, cleared, or authorized under section 505,
510(k), 513(f)(2), or 515 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 355, 360(k), 360c(f)(2), 360e),
education on effective family planning practices, and
sterilization procedures. 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).
(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 8,866
reports of sexual assaults during fiscal year 2021, an increase
of more than 1,000 reports compared to 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
contraceptive method approved, cleared, or authorized under
section 505, 510(k), 513(f)(2), or 515 of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 355, 360(k), 360c(f)(2),
360e), 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 contraceptive, 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 contraceptive
method approved, cleared, or authorized under section 505, 510(k),
513(f)(2), or 515 of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 355, 360(k), 360c(f)(2), 360e), 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 contraceptive, 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 emergency
contraceptives approved by the Food and Drug Administration.
``(2) Upon request by the sexual assault survivor,
emergency contraceptives or, if applicable, a prescription for
emergency contraceptives.
``(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.
(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) all contraceptive methods approved, cleared, or
authorized under section 505, 510(k), 513(f)(2), or 515
of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
355, 360(k), 360c(f)(2), 360e); and
(B) where members of the Armed Forces can access
their chosen contraceptive.
(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 contraceptives.
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