[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 9865 Introduced in House (IH)]
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118th CONGRESS
2d Session
H. R. 9865
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 HOUSE OF REPRESENTATIVES
September 27, 2024
Ms. Escobar (for herself, Ms. Strickland, Ms. Jacobs, Mr. Khanna, Ms.
McClellan, Ms. Slotkin, Mr. Ryan, Ms. Castor of Florida, Mr. Veasey,
Mr. McGovern, Mrs. Trahan, Mr. Himes, Ms. Tokuda, Ms. Kuster, Mrs.
Torres of California, Ms. Wilson of Florida, Mr. Landsman, Mr. Pocan,
Mr. Vargas, Mr. Johnson of Georgia, Ms. Wasserman Schultz, Mrs.
Cherfilus-McCormick, Ms. Wild, Ms. Stevens, Mr. Kim of New Jersey, Mr.
Peters, Mr. Carbajal, Mr. Lynch, Ms. Sherrill, Ms. Jayapal, Mr. Larson
of Connecticut, Mr. Panetta, Mr. Evans, Ms. Brownley, Mrs. Ramirez, Ms.
Crockett, Mr. Carter of Louisiana, Ms. Ross, and Ms. McCollum)
introduced the following bill; which was 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 2024''.
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, over 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) Reproductive freedom, including the decision to use
birth control, allows people to exercise autonomy and make
decisions about their health care. Yet making meaningful
decisions requires access to the full spectrum of reproductive
health care ranging from contraception to abortion to maternity
care. Everyone should have access to the full range of this
care, free from unnecessary barriers.
(5) 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 well-
being, equality, dignity, and ability to determine the course
of one's life. These protections have helped access to
contraception become a driving force in improving the health
and financial security of individuals and their families.
(6) The Supreme Court has repeatedly recognized the
constitutional right to contraception, including in Griswold v.
Connecticut (381 U.S. 479 (1965)), Eisenstadt v. Baird (405
U.S. 438 (1972)), and Carey v. Population Services
International (431 U.S. 678 (1977)).
(7) 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.
(8) Studies have shown that when cost barriers to the full
range of contraceptives are eliminated, patients are more
likely to use the contraceptive that meets their needs, and
therefore use contraception correctly and more consistently,
reducing the risk of unintended pregnancy. Moreover, cost
barriers to contraceptive care fall hardest on populations who
already face systemic barriers to achieving reproductive
access, such as military families of color, and families with
lower incomes.
(9) Following the Supreme Court's decision in Dobbs v.
Jackson Women's Health Organization, States have moved to enact
bans and restrictions on reproductive health care including
abortion and contraception. The basic right to access
reproductive health care, including contraception, must be
available to all people, regardless of where they live or
whether they serve.
(10) 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 Food and
Drug Administration (FDA)-approved, -granted, or -cleared
contraceptives and related services and education and
counseling. However, members not on active duty and dependents
of members do not have similar coverage of all FDA-approved, -
granted, or -cleared contraceptives without cost-sharing when
they obtain the contraceptive outside of a military medical
treatment facility.
(11) 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. These women's
preventive services include the full range of U.S. Food and
Drug Administration (FDA)-approved, -granted, or -cleared
contraceptives, 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).
(12) In July 2022, the Department of Defense eliminated
copayments for medical contraceptive services (i.e.,
intrauterine devices, birth control shot, birth control
implant, and diaphragm measurement and fitting), and effective
January 2023, certain TRICARE beneficiaries will no longer face
cost-sharing or copayments for tubal ligation (surgical
sterilization) services when obtaining care through a civilian
provider. However, congressional action is needed to completely
eliminate copayments for prescription contraceptives and ensure
that service members and their loved ones have equitable access
to all methods of contraception.
(13) 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.
(14) The military departments received more than 8,866
reports of sexual assaults during fiscal year 2021, an increase
of over one thousand reports compared to 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
may not be imposed or 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 under this
section, cost-sharing may not be imposed or 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 Food
and Drug Administration-approved, -granted, or cleared-
contraceptive, 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 may not be
imposed or collected with respect to any beneficiary under this section
for a service described in paragraph (2) that is provided under TRICARE
Prime.
``(2) A service described in this paragraph is any Food and Drug
Administration-approved, -granted, or -cleared contraceptive, 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) Notification of the right of the sexual assault
survivor to confidentiality with respect to the information and
care and services furnished under this section.
``(3) Upon request by the sexual assault survivor,
emergency contraception or, if applicable, a prescription for
emergency contraception.
``(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 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 Food and Drug Administration-approved, -
granted, or -cleared contraceptives; 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 patients' rights 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 contraception.
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