Access to Contraception for Servicemembers and Dependents Act of 2021

I 117TH CONGRESS 1ST SESSION H. R. 2709 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 APRIL 20, 2021 Ms. SPEIER (for herself, Ms. STRICKLAND, Ms. ESCOBAR, Mr. AGUILAR, Mr. AUCHINCLOSS, Mr. BERA, Mr. BISHOP of Georgia, Mr. BLUMENAUER, Ms. BLUNT ROCHESTER, Ms. BONAMICI, Mr. BROWN, Ms. BROWNLEY, Ms. BUSH, Mr. CA´RDENAS, Mr. CARSON, Ms. CASTOR of Florida, Ms. CHU, Mr. CICILLINE, Ms. CLARKE of New York, Mr. COHEN, Mr. CON- NOLLY, Mr. COOPER, Mr. DANNY K. DAVIS of Illinois, Ms. DEAN, Mr. DEFAZIO, Ms. DEGETTE, Ms. DELAURO, Ms. DELBENE, Mr. DEUTCH, Mr. FOSTER, Ms. LOIS FRANKEL of Florida, Mr. GALLEGO, Mr. GRI- JALVA, Mrs. HAYES, Mr. HIMES, Mr. HORSFORD, Ms. HOULAHAN, Mr. HUFFMAN, Ms. JACKSON LEE, Ms. JACOBS of California, Ms. JAYAPAL, Mr. JOHNSON of Georgia, Mr. JONES, Mr. KEATING, Mr. KHANNA, Mr. KILMER, Mrs. KIRKPATRICK, Ms. KUSTER, Mr. LARSEN of Washington, Mrs. LAWRENCE, Mr. LAWSON of Florida, Ms. LEE of California, Mr. LEVIN of California, Mr. LIEU, Mr. LOWENTHAL, Mr. MALINOWSKI, Mr. SEAN PATRICK MALONEY of New York, Mrs. CAROLYN B. MALONEY of New York, Mrs. MCBATH, Ms. MCCOLLUM, Mr. MCGOVERN, Ms. MENG, Ms. MOORE of Wisconsin, Mr. MORELLE, Mr. MOULTON, Mr. NADLER, Mrs. NAPOLITANO, Mr. NEGUSE, Ms. NEWMAN, Ms. NORTON, Ms. OMAR, Mr. PANETTA, Mr. PAPPAS, Mr. PAYNE, Mr. PETERS, Ms. PINGREE, Ms. PORTER, Ms. PRESSLEY, Mr. PRICE of North Carolina, Mr. QUIGLEY, Mr. RASKIN, Miss RICE of New York, Ms. ROSS, Mr. RYAN, Mr. SABLAN, Ms. SA´NCHEZ, Mr. SARBANES, Ms. SCANLON, Ms. SCHAKOWSKY, Mr. SCHIFF, Ms. SCHRIER, Mr. SHERMAN, Mr. SIRES, Mr. SWALWELL, Mr. TAKANO, Ms. TITUS, Mr. VEASEY, Ms. VELA´ZQUEZ, Ms. WASSERMAN SCHULTZ, Mr. WELCH, Ms. WILLIAMS of Georgia, Mr. YARMUTH, Mr. KAHELE, Mr. O’HALLERAN, and Ms. WILSON of Florida) introduced the following bill; which was referred to the Committee on Armed Services VerDate Sep 11 2014 23:45 Jun 02, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6652 E:\BILLS\H2709.IH H2709 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 2709 IH A BILL To amend title 10, United States Code, to ensure that mem- bers 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 Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Access to Contracep- 4 tion for Servicemembers and Dependents Act of 2021’’. 5 SEC. 2. FINDINGS. 6 Congress finds the following: 7 (1) Women are serving in the Armed Forces at 8 increasing rates, playing a critical role in the na- 9 tional security of the United States. Women com- 10 prise more than 18 percent of members of the 11 Armed Forces, and as of fiscal year 2019, over 12 390,000 women serve on active duty in the Armed 13 Forces or in the reserve components. An estimated 14 several thousand transgender men also serve on ac- 15 tive duty in the Armed Forces and in the reserve 16 components, in addition to non-binary members and 17 those who identify with a different gender. 18 (2) Ninety-five percent of women serving in the 19 Armed Forces are of reproductive age and as of 20 VerDate Sep 11 2014 23:45 Jun 02, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2709.IH H2709 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 2709 IH 2019, more than 700,000 female spouses and de- 1 pendents of members of the Armed Forces on active 2 duty are of reproductive age. 3 (3) The TRICARE program covered more than 4 1,570,000 women of reproductive age in 2019, in- 5 cluding spouses and dependents of members of the 6 Armed Forces on active duty. Additionally, thou- 7 sands of transgender dependents of members of the 8 Armed Forces are covered by TRICARE. 9 (4) The right to access contraception is ground- 10 ed in the principle that contraception and the ability 11 to determine if and when to have children are inex- 12 tricably tied to one’s wellbeing, equality, and ability 13 to determine the course of one’s life. These protec- 14 tions have helped access to contraception become a 15 driving force in improving the health and financial 16 security of individuals and their families. 17 (5) Access to contraception is critical to the 18 health of every individual capable of becoming preg- 19 nant. This Act is intended to apply to all individuals 20 with the capacity for pregnancy, including cisgender 21 women, transgender men, non-binary individuals, 22 those who identify with a different gender, and oth- 23 ers. 24 VerDate Sep 11 2014 23:45 Jun 02, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2709.IH H2709 kjohnson on DSK79L0C42PROD with BILLS 4 •HR 2709 IH (6) Studies have shown that when cost barriers 1 to the full range of methods of contraception are 2 eliminated, patients are more likely to use the con- 3 traceptive method that meets their needs, and there- 4 fore use contraception correctly and more consist- 5 ently, reducing the risk of unintended pregnancy. 6 (7) Under the TRICARE program, members of 7 the Armed Forces on active duty have full coverage 8 of all prescription drugs, including contraception, 9 without cost-sharing requirements, in line with the 10 Patient Protection and Affordable Care Act (Public 11 Law 111–148), which requires coverage of all con- 12 traceptive methods approved by the Food and Drug 13 Administration for women and related services and 14 education and counseling. However, members not on 15 active duty and dependents of members do not have 16 similar coverage of all methods of contraception ap- 17 proved by the Food and Drug Administration with- 18 out cost-sharing when they obtain the contraceptive 19 outside of a military medical treatment facility. 20 (8) In order to fill gaps in coverage and access 21 to preventive care critical for women’s health, the 22 Patient Protection and Affordable Care Act (Public 23 Law 111–148) requires all non-grandfathered indi- 24 vidual and group health plans to cover without cost- 25 VerDate Sep 11 2014 23:45 Jun 02, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2709.IH H2709 kjohnson on DSK79L0C42PROD with BILLS 5 •HR 2709 IH sharing preventive services, including a set of evi- 1 dence-based preventive services for women supported 2 by the Health Resources and Services Administra- 3 tion of the Department of Health and Human Serv- 4 ices. These women’s preventive services include the 5 full range of female-controlled contraceptive meth- 6 ods, effective family planning practices, and steriliza- 7 tion procedures, approved by the Food and Drug 8 Administration. The Health Resources and Services 9 Administration has affirmed that contraceptive care 10 includes contraceptive counseling, initiation of con- 11 traceptive use, and follow-up care (such as manage- 12 ment, evaluation, and changes to and removal or dis- 13 continuation of the contraceptive method). 14 (9) The Defense Advisory Committee on 15 Women in the Services has recommended that all 16 the Armed Forces, to the extent that they have not 17 already, implement initiatives that inform members 18 of the Armed Forces of the importance of family 19 planning, educate them on methods of contraception, 20 and make various methods of contraception avail- 21 able, based on the finding that family planning can 22 increase the overall readiness and quality of life of 23 all members of the Armed Forces. 24 VerDate Sep 11 2014 23:45 Jun 02, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H2709.IH H2709 kjohnson on DSK79L0C42PROD with BILLS 6 •HR 2709 IH (10) The military departments received more 1 than 7,800 reports of sexual assaults involving mem- 2 bers of the Armed Forces as victims or subjects dur- 3 ing fiscal year 2019. Through regulations, the De- 4 partment of Defense already supports a policy of en- 5 suring that members of the Armed Forces who are 6 sexually assaulted have access to emergency contra- 7 ception, and the initiation of contraception if desired 8 and medically appropriate. 9 SEC. 3. CONTRACEPTION COVERAGE PARITY UNDER THE 10 TRICARE PROGRAM. 11 (a) PHARMACY BENEFITS PROGRAM.—Section 12 1074g(a)(6) of title 10, United States Code, is amended 13 by adding at the end the following new subparagraph: 14 ‘‘(D) Notwithstanding subparagraphs (A), (B), 15 and (C), cost-sharing may not be imposed or col- 16 lected with respect to any eligible covered beneficiary 17 for any prescription contraceptive on the uniform 18 formulary provided through a retail pharmacy de- 19 scribed in paragraph (2)(E)(ii) or through the na- 20 tional mail-order pharmacy program.’’. 21 (b) TRICARE SELECT.—Section 1075 of such title 22 is amended— 23 (1) in subsection (c), by adding at the end the 24 following new paragraph: 25 VerDate Sep 11 2014 23:45 Jun 02, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2709.IH H2709 kjohnson on DSK79L0C42PROD with BILLS 7 •HR 2709 IH ‘‘(4)(A) Notwithstanding any other provision 1 under this section, cost-sharing may not be imposed 2 or collected with respect to any beneficiary under 3 this section for a service described in subparagraph 4 (B) that is provided by a network provider. 5 ‘‘(B) A service described in this subparagraph 6 is any method of contraception approved by the 7 Food and Drug Administration, any contraceptive 8 care (including with respect to insertion, removal, 9 and follow up), any sterilization procedure, or any 10 patient education or counseling service provided in 11 connection with any such method, care, or proce- 12 dure.’’; and 13 (2) in subsection (f), by striking ‘‘calculated as’’ 14 and inserting ‘‘calculated (except as provided in sub- 15 section (c)(4)) as’’. 16 (c) TRICARE PRIME.—Section 1075a of such title 17 is amended by adding at the end the following new sub- 18 section: 19 ‘‘(d) PROHIBITION ON COST-SHARING FOR CERTAIN 20 SERVICES.—(1) Notwithstanding subsections (a), (b), and 21 (c), cost-sharing may not be imposed or collected with re- 22 spect to any beneficiary under this section for a service 23 described in paragraph (2) that is provided under 24 TRICARE Prime. 25 VerDate Sep 11 2014 23:45 Jun 02, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H2709.IH H2709 kjohnson on DSK79L0C42PROD with BILLS 8 •HR 2709 IH ‘‘(2) A service described in this paragraph is any 1 method of contraception approved by the Food and Drug 2 Administration, any contraceptive care (including with re- 3 spect to insertion, removal, and follow up), any steriliza- 4 tion procedure, or any patient education or counseling 5 service provided in connection with any such method, care, 6 or procedure.’’. 7 SEC. 4. PREGNANCY PREVENTION ASSISTANCE AT MILI- 8 TARY MEDICAL TREATMENT FACILITIES FOR 9 SEXUAL ASSAULT SURVIVORS. 10 (a) IN GENERAL.—Chapter 55 of title 10, United 11 States Code, is amended by inserting after section 1074o 12 the following new section: 13 ‘‘§ 1074p. Provision of pregnancy prevention assist- 14 ance at military medical treatment facili- 15 ties 16 ‘‘(a) INFORMATION AND ASSISTANCE.—The Sec- 17 retary of Defense shall promptly furnish to sexual assault 18 survivors at each military medical treatment facility the 19 following: 20 ‘‘(1) Comprehensive, medically and factually ac- 21 curate, and unbiased written and oral information 22 about all methods of emergency contraception ap- 23 proved by the Food and Drug Administration. 24 VerDate Sep 11 2014 23:45 Jun 02, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H2709.IH H2709 kjohnson on DSK79L0C42PROD with BILLS 9 •HR 2709 IH ‘‘(2) Notification of the right of the sexual as- 1 sault survivor to confidentiality with respect to the 2 information and care and services furnished under 3 this section. 4 ‘‘(3) Upon request by the sexual assault sur- 5 vivor, emergency contraception or, if applicable, a 6 prescription for emergency contraception. 7 ‘‘(b) INFORMATION.—The Secretary shall ensure that 8 information provided pursuant to subsection (a) is pro- 9 vided in language that— 10 ‘‘(1) is clear and concise; 11 ‘‘(2) is readily comprehensible; and 12 ‘‘(3) meets such conditions (including condi- 13 tions regarding the provision of information in lan- 14 guages other than English) as the Secretary may 15 prescribe in regulations to carry out this section. 16 ‘‘(c) DEFINITIONS.—In this section: 17 ‘‘(1) The term ‘sexual assault survivor’ means 18 any individual who presents at a military medical 19 treatment facility and— 20 ‘‘(A) states to personnel of the facility that 21 the individual experienced a sexual assault; 22 ‘‘(B) is accompanied by another person 23 who states that the individual experienced a 24 sexual assault; or 25 VerDate Sep 11 2014 23:45 Jun 02, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H2709.IH H2709 kjohnson on DSK79L0C42PROD with BILLS 10 •HR 2709 IH ‘‘(C) whom the personnel of the facility 1 reasonably believes to be a survivor of sexual 2 assault. 3 ‘‘(2) The term ‘sexual assault’ means the con- 4 duct described in section 1565b(c) of this title that 5 may result in pregnancy.’’. 6 (b) CLERICAL AMENDMENT.—The table of sections 7 at the beginning of such chapter is amended by inserting 8 after the item relating to section 1074o the following new 9 item: 10 ‘‘1074p. Provision of pregnancy prevention assistance at military medical treat- ment facilities.’’. SEC. 5. EDUCATION ON FAMILY PLANNING FOR MEMBERS 11 OF THE ARMED FORCES. 12 (a) EDUCATION PROGRAMS.— 13 (1) IN GENERAL.—Not later than one year 14 after the date of the enactment of this Act, the Sec- 15 retary of Defense shall establish a uniform standard 16 curriculum to be used in education programs on 17 family planning for all members of the Armed 18 Forces, including both men and women members. 19 Such education programs shall be provided to mem- 20 bers as follows: 21 (A) During the first year of service of the 22 member. 23 VerDate Sep 11 2014 23:45 Jun 02, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H2709.IH H2709 kjohnson on DSK79L0C42PROD with BILLS 11 •HR 2709 IH (B) At such other times as each Secretary 1 of a military department determines appro- 2 priate with respect to members of the Armed 3 Forces under the jurisdiction of the respective 4 military department. 5 (2) SENSE OF CONGRESS.—It is the sense of 6 Congress that the education programs under para- 7 graph (1) should be evidence-informed and use the 8 latest technology available to efficie [Text truncated for display. 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