[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 1698 Introduced in Senate (IS)]
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118th CONGRESS
1st Session
S. 1698
To require group health plans and group or individual health insurance
coverage to provide coverage for over-the-counter contraceptives.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
May 18, 2023
Mrs. Murray (for herself, Ms. Hirono, Ms. Cortez Masto, Mr. Blumenthal,
Mrs. Shaheen, Mr. Reed, Mr. Schatz, Mr. Padilla, Mr. Merkley, Ms.
Warren, Mr. Carper, Ms. Baldwin, Mr. Murphy, Mr. Sanders, Ms. Cantwell,
Ms. Stabenow, Ms. Duckworth, Mr. Whitehouse, Mr. Welch, Ms. Smith, Mr.
Fetterman, Mr. Menendez, Mr. Bennet, Ms. Hassan, Mr. Booker, Mr. Kaine,
Mr. Heinrich, Mr. Van Hollen, and Ms. Klobuchar) introduced the
following bill; which was read twice and referred to the Committee on
Health, Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To require group health plans and group or individual health insurance
coverage to provide coverage for over-the-counter contraceptives.
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 ``Affordability is Access Act of
2023''.
SEC. 2. PURPOSE.
The purpose of this Act is to ensure timely access to affordable
birth control by requiring coverage without cost-sharing for
contraceptives that are approved, granted, or cleared by, or otherwise
legally marketed under regulation by, the Food and Drug Administration
for use without a prescription.
SEC. 3. FINDINGS.
The Senate finds the following:
(1) Birth control is critical health care that almost all
women, as well as many trans men and nonbinary people, will use
at some point in their lifetimes.
(2) Access to the full range of reproductive health care,
including birth control coverage as guaranteed under Federal
law, provides individuals with the opportunity to lead healthy
lives and get the care they need to reach their goals.
(3) Contraceptive access is associated with health benefits
for women, newborns, families, and communities and can lower
the risk of harm to maternal and infant health.
(4) An estimated 73 million women of reproductive age (ages
15 through 49) live in the United States. Among the 46 million
of such women who are sexually active and not seeking children,
89 percent use a form of birth control.
(5) The birth control benefit enacted under the Patient
Protection and Affordable Care Act (Public Law 111-148) has
been a crucial step forward in advancing access to birth
control and has helped ensure 58 million women have the power
to decide for themselves if and when to become pregnant.
(6) Despite legal requirements for birth control coverage
and access to services, gaps remain for millions of
individuals. Nearly 1 in 5 women are not using their preferred
method of contraception, and of those women, a quarter say it
is because of cost. As a result, many women have gone without
the birth control they want to use, also creating inconsistent
use. Access to birth control is particularly difficult for the
19 million women of reproductive age with lower incomes who
live in contraceptive deserts and lack reasonable access to a
health center that offers the full range of contraceptive
methods.
(7) Due to systemic discrimination, people paid low wages,
people of color, LGBTQ+ individuals, immigrants, and people
with disabilities are more likely to face barriers to, and lack
access to, health coverage and health care providers.
(8) There are numerous social and economic factors that
make it harder to access birth control, including rising income
and wealth inequality, gaps in insurance coverage, and barriers
to accessing health providers.
(9) Leading health experts support over-the-counter birth
control pills.
SEC. 4. SENSE OF THE SENATE.
It is the sense of the Senate that--
(1) in order to increase access to oral birth control, such
birth control must be both easier to obtain and affordable and,
to make such birth control either easier to obtain or more
affordable, but not both, is to leave unacceptable barriers in
place;
(2) it is imperative that the entities that research and
develop oral birth control and whose medical and scientific
experts have developed clinical and other evidence that oral
birth control for routine, daily use is safe and effective when
sold without a prescription, apply to the Food and Drug
Administration for review and approval for sale of such birth
control without a prescription;
(3) upon the receipt of such an application, the Food and
Drug Administration should determine whether the oral birth
control meets the rigorous safety, efficacy, and quality
standards for over-the-counter use under the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 301 et seq.), and if the
product meets those standards, the Food and Drug Administration
should approve the application without delay; and
(4) if and when the Food and Drug Administration approves
an oral birth control that is available over-the-counter, such
birth control should be covered by health insurance, without a
prescription and without cost-sharing.
SEC. 5. CLARIFYING COVERAGE REQUIREMENTS.
The Secretaries of Health and Human Services, Labor, and the
Treasury shall clarify that coverage of contraceptives pursuant to
section 2713(a)(4) of the Public Health Service Act (42 U.S.C. 300gg-
13(a)(4)) includes coverage of over-the-counter contraceptives
approved, granted, or cleared by the Food and Drug Administration, even
if the enrollee does not have a prescription for the contraceptive.
SEC. 6. RULES OF CONSTRUCTION.
(a) Non-Interference With FDA Regulation.--Nothing in this Act
shall be construed to modify or interfere with Food and Drug
Administration processes to review or approve, or otherwise determine
the safety and efficacy of, and make available, non-prescription drugs
or devices, modify or interfere with the scientific and medical
considerations of the Food and Drug Administration, or alter any other
authority of the Food and Drug Administration.
(b) Non-Preemption.--Nothing in this Act preempts any provision of
Federal or State law to the extent that such Federal or State law
provides protections for consumers that are greater than the
protections provided for in this Act.
SEC. 7. DUTIES OF RETAILERS TO ENSURE ACCESS TO CONTRACEPTION FOR USE
WITHOUT A PRESCRIPTION.
(a) In General.--Any retailer that stocks contraception that is
approved, granted, or cleared by, or otherwise legally marketed under
regulation by, the Food and Drug Administration for use without a
prescription may not interfere with an individual's access to or
purchase of such contraception or access to medically accurate,
comprehensive information about such contraception.
(b) Limitation.--Nothing in this section shall prohibit a retailer
that stocks over-the-counter contraceptive products from refusing to
provide an individual with such contraceptive product that is approved,
granted, or cleared by, or otherwise legally marketed under regulation
by, the Food and Drug Administration if the individual is unable to pay
for the contraceptive product, directly, through insurance coverage, or
through other payment mechanism.
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