Affordability is Access Act

II 116TH CONGRESS 1ST SESSION S. 1847 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 JUNE 13, 2019 Mrs. MURRAY (for herself, Mrs. SHAHEEN, Mr. BOOKER, Ms. BALDWIN, Mr. BROWN, Mr. LEAHY, Mr. REED, Mrs. FEINSTEIN, Mr. BLUMENTHAL, Mr. KAINE, Mr. SANDERS, Ms. HIRONO, Ms. DUCKWORTH, Mr. MERKLEY, Ms. WARREN, Ms. CANTWELL, Ms. HASSAN, Mr. MENENDEZ, Mr. MARKEY, Mr. PETERS, Mr. WYDEN, Ms. KLOBUCHAR, Mr. BENNET, Ms. STABENOW, Ms. HARRIS, Mr. VAN HOLLEN, Mrs. GILLIBRAND, and Ms. SMITH) introduced the following bill; which was read twice and re- ferred 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 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 ‘‘Affordability is Access 4 Act’’. 5 VerDate Sep 11 2014 16:09 Jun 15, 2019 Jkt 034408 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1847.IS S1847 pbinns on DSK79D2C42PROD with BILLS 2 •S 1847 IS SEC. 2. PURPOSE. 1 The purpose of this Act is to ensure timely access 2 to affordable birth control by requiring coverage without 3 cost-sharing for oral birth control for routine, daily use 4 that is approved by, or otherwise legally marketed under 5 regulation by, the Food and Drug Administration for use 6 by women without a prescription. 7 SEC. 3. FINDINGS. 8 The Senate finds the following: 9 (1) Birth control is critical health care that al- 10 most all women will use at some point in their life- 11 times. 12 (2) Access to the full range of reproductive 13 health care, including birth control coverage as guar- 14 anteed under Federal law, provides women with the 15 opportunity to lead healthy lives and get the care 16 they need to reach their goals. 17 (3) Family planning has well-documented 18 health benefits for women, newborns, families, and 19 communities and can lower the risk of harm to ma- 20 ternal and infant health. 21 (4) An estimated 66,000,000 women of repro- 22 ductive age (ages 15 through 44) live in the United 23 States, of which nearly 70 percent are at risk of 24 having an unintended pregnancy. Sixty percent of 25 women of reproductive age are using a contraceptive 26 VerDate Sep 11 2014 16:09 Jun 15, 2019 Jkt 034408 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1847.IS S1847 pbinns on DSK79D2C42PROD with BILLS 3 •S 1847 IS method and 10 percent of women at risk for unin- 1 tended pregnancy are not using contraception. The 2 rates of non-use of contraception are highest among 3 those between 15 and 19 years old. 4 (5) The birth control benefit enacted under the 5 Patient Protection and Affordable Care Act (Public 6 Law 111–148) has been a crucial step forward in 7 advancing access to birth control and has helped en- 8 sure nearly 62,800,000 women have the power to de- 9 cide for themselves if and when to start a family. 10 (6) Despite legal requirements for birth control 11 coverage and access to services, gaps remain for mil- 12 lions of women. A national survey found that 1 in 13 3 women have struggled to afford birth control at 14 some point in their lives, and as a result, have used 15 birth control inconsistently. Access to birth control is 16 particularly difficult for women who live in contra- 17 ceptive deserts and lack reasonable access to a 18 health center that offers the full range of contracep- 19 tive methods. 20 (7) Health disparities persist among low-income 21 women, women of color, and women who lack access 22 to health coverage and health care providers. 23 (8) There are numerous social and economic 24 barriers that make it harder to access birth control, 25 VerDate Sep 11 2014 16:09 Jun 15, 2019 Jkt 034408 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1847.IS S1847 pbinns on DSK79D2C42PROD with BILLS 4 •S 1847 IS including rising income and wealth inequality, gaps 1 in insurance coverage and challenges accessing 2 health providers. 3 (9) Leading health experts support over-the- 4 counter birth control pills. 5 SEC. 4. SENSE OF THE SENATE. 6 It is the sense of the Senate that— 7 (1) in order to increase women’s access to oral 8 birth control, such birth control must be both easier 9 to obtain and affordable and, to make such birth 10 control either easier to obtain or more affordable, 11 but not both, is to leave unacceptable barriers in 12 place for women; 13 (2) it is imperative that the entities that re- 14 search and develop oral birth control and whose 15 medical and scientific experts have developed clinical 16 and other evidence that oral birth control for rou- 17 tine, daily use is safe and effective for women when 18 sold without a prescription, apply to the Food and 19 Drug Administration for review and approval for 20 sale of such birth control without a prescription; 21 (3) upon the receipt of such an application, the 22 Food and Drug Administration should determine 23 whether the oral birth control meets the rigorous 24 safety, efficacy, and quality standards for over-the- 25 VerDate Sep 11 2014 16:09 Jun 15, 2019 Jkt 034408 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1847.IS S1847 pbinns on DSK79D2C42PROD with BILLS 5 •S 1847 IS counter use under the Federal Food, Drug, and Cos- 1 metic Act (21 U.S.C. 301 et seq.), and if the prod- 2 uct meets those standards, the Food and Drug Ad- 3 ministration should approve the application without 4 delay; and 5 (4) if and when the Food and Drug Adminis- 6 tration approves an oral birth control that is avail- 7 able over-the-counter, such birth control should be 8 covered by health insurance, without a prescription 9 and without cost-sharing. 10 SEC. 5. CLARIFYING COVERAGE REQUIREMENTS. 11 The Secretaries of Health and Human Services, 12 Labor, and the Treasury shall clarify that coverage of con- 13 traceptives pursuant to section 2713(a)(4) of the Public 14 Health Service Act (42 U.S.C. 300gg–13(a)(4)) includes 15 coverage of over-the-counter contraceptive methods ap- 16 proved by the Food and Drug Administration, even if the 17 enrollee does not have a prescription for the contraceptive. 18 SEC. 6. RULES OF CONSTRUCTION. 19 (a) NON-INTERFERENCE WITH FDA REGULA- 20 TION.—Nothing in this Act shall be construed to modify 21 or interfere with Food and Drug Administration processes 22 to review or approve, or otherwise determine the safety 23 and efficacy of, and make available, non-prescription 24 drugs or devices, modify or interfere with the scientific 25 VerDate Sep 11 2014 16:09 Jun 15, 2019 Jkt 034408 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1847.IS S1847 pbinns on DSK79D2C42PROD with BILLS 6 •S 1847 IS and medical considerations of the Food and Drug Admin- 1 istration, or alter any other authority of the Food and 2 Drug Administration. 3 (b) NON-PREEMPTION.—Nothing in this Act pre- 4 empts any provision of Federal or State law to the extent 5 that such Federal or State law provides protections for 6 consumers that are greater than the protections provided 7 for in this Act. 8 SEC. 7. DUTIES OF RETAILERS TO ENSURE ACCESS TO 9 ORAL BIRTH CONTROL FOR USE WITHOUT A 10 PRESCRIPTION. 11 (a) IN GENERAL.—Any retailer that stocks oral birth 12 control for routine, daily use that is approved by, or other- 13 wise legally marketed under regulation by, the Food and 14 Drug Administration for use without a prescription may 15 not interfere with an individual’s access to or purchase 16 of such birth control or access to medically accurate, com- 17 prehensive information about such birth control. 18 (b) LIMITATION.—Nothing in this section shall pro- 19 hibit a retailer that stocks oral birth control for routine, 20 daily use from refusing to provide an individual with such 21 oral birth control that is approved by, or otherwise legally 22 marketed under regulation by, the Food and Drug Admin- 23 VerDate Sep 11 2014 16:09 Jun 15, 2019 Jkt 034408 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1847.IS S1847 pbinns on DSK79D2C42PROD with BILLS 7 •S 1847 IS istration if the individual is unable to pay for the birth 1 control, directly or through insurance coverage. 2 Æ VerDate Sep 11 2014 16:09 Jun 15, 2019 Jkt 034408 PO 00000 Frm 00007 Fmt 6652 Sfmt 6301 E:\BILLS\S1847.IS S1847 pbinns on DSK79D2C42PROD with BILLS