Affordability is Access Act of 2023

I 118TH CONGRESS 1ST SESSION H. R. 3589 To require group health plans and group or individual health insurance coverage to provide coverage for over-the-counter contraceptives. IN THE HOUSE OF REPRESENTATIVES MAY 22, 2023 Ms. PRESSLEY (for herself, Ms. OCASIO-CORTEZ, Mr. BERA, Ms. CROCKETT, Mr. DOGGETT, Mr. ESPAILLAT, Ms. NORTON, Mr. VARGAS, Ms. BROWNLEY, Ms. CASTOR of Florida, Mr. JOHNSON of Georgia, Mr. KIL- MER, Mrs. NAPOLITANO, Ms. WILSON of Florida, Ms. CHU, Mr. BOW- MAN, Mrs. WATSON COLEMAN, Mr. POCAN, Mr. BLUMENAUER, Ms. BROWN, Ms. MCCOLLUM, Mr. CASTEN, Ms. WILLIAMS of Georgia, Ms. CLARKE of New York, Ms. UNDERWOOD, Mr. TRONE, Ms. GARCIA of Texas, Mr. KHANNA, Mr. GOMEZ, Mr. EVANS, Ms. SCANLON, Ms. LEE of California, Mr. TAKANO, Mrs. MCBATH, Ms. JAYAPAL, Ms. TLAIB, Mr. CARTER of Louisiana, Ms. LOIS FRANKEL of Florida, Ms. DELAURO, Ms. LEE of Pennsylvania, Mr. CONNOLLY, Mr. PETERS, Mr. CARTWRIGHT, Mr. MULLIN, and Mr. MENENDEZ) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and the Workforce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdic- tion of the committee concerned 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 VerDate Sep 11 2014 21:14 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H3589.IH H3589 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 3589 IH SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘Affordability is Access 2 Act of 2023’’. 3 SEC. 2. PURPOSE. 4 The purpose of this Act is to ensure timely access 5 to affordable birth control by requiring coverage without 6 cost-sharing for contraceptives that are approved, granted, 7 or cleared by, or otherwise legally marketed under regula- 8 tion by, the Food and Drug Administration for use with- 9 out a prescription. 10 SEC. 3. FINDINGS. 11 Congress finds the following: 12 (1) Birth control is critical health care that al- 13 most all women, as well as many trans men and 14 nonbinary people, will use at some point in their life- 15 times. 16 (2) Access to the full range of reproductive 17 health care, including birth control coverage as guar- 18 anteed under Federal law, provides individuals with 19 the opportunity to lead healthy lives and get the care 20 they need to reach their goals. 21 (3) Contraceptive access is associated with 22 health benefits for women, newborns, families, and 23 communities and can lower the risk of harm to ma- 24 ternal and infant health. 25 VerDate Sep 11 2014 21:14 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3589.IH H3589 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 3589 IH (4) An estimated 73 million women of reproduc- 1 tive age (ages 15 through 49) live in the United 2 States. Among the 46 million of such women who 3 are sexually active and not seeking children, 89 per- 4 cent use a form of birth control. 5 (5) The birth control benefit enacted under the 6 Patient Protection and Affordable Care Act (Public 7 Law 111–148) has been a crucial step forward in 8 advancing access to birth control and has helped en- 9 sure 58 million women have the power to decide for 10 themselves if and when to become pregnant. 11 (6) Despite legal requirements for birth control 12 coverage and access to services, gaps remain for mil- 13 lions of individuals. Nearly 1 in 5 women are not 14 using their preferred method of contraception, and 15 of those women, a quarter say it is because of cost. 16 As a result, many women have gone without the 17 birth control they want to use, also creating incon- 18 sistent use. Access to birth control is particularly 19 difficult for the 19 million women of reproductive 20 age with lower incomes who live in contraceptive 21 deserts and lack reasonable access to a health center 22 that offers the full range of contraceptive methods. 23 (7) Due to systemic discrimination, people paid 24 low wages, people of color, LGBTQ+ individuals, 25 VerDate Sep 11 2014 21:14 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H3589.IH H3589 kjohnson on DSK79L0C42PROD with BILLS 4 •HR 3589 IH immigrants, and people with disabilities are more 1 likely to face barriers to, and lack access to, health 2 coverage and health care providers. 3 (8) There are numerous social and economic 4 factors that make it harder to access birth control, 5 including rising income and wealth inequality, gaps 6 in insurance coverage, and barriers to accessing 7 health providers. 8 (9) Leading health experts support over-the- 9 counter birth control pills. 10 SEC. 4. SENSE OF CONGRESS. 11 It is the sense of Congress that— 12 (1) in order to increase access to oral birth con- 13 trol, such birth control must be both easier to obtain 14 and affordable and, to make such birth control ei- 15 ther easier to obtain or more affordable, but not 16 both, is to leave unacceptable barriers in place; 17 (2) it is imperative that the entities that re- 18 search and develop oral birth control and whose 19 medical and scientific experts have developed clinical 20 and other evidence that oral birth control for rou- 21 tine, daily use is safe and effective when sold with- 22 out a prescription, apply to the Food and Drug Ad- 23 ministration for review and approval for sale of such 24 birth control without a prescription; 25 VerDate Sep 11 2014 21:14 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H3589.IH H3589 kjohnson on DSK79L0C42PROD with BILLS 5 •HR 3589 IH (3) upon the receipt of such an application, the 1 Food and Drug Administration should determine 2 whether the oral birth control meets the rigorous 3 safety, efficacy, and quality standards for over-the- 4 counter use under the Federal Food, Drug, and Cos- 5 metic Act (21 U.S.C. 301 et seq.), and if the prod- 6 uct meets those standards, the Food and Drug Ad- 7 ministration should approve the application without 8 delay; and 9 (4) if and when the Food and Drug Adminis- 10 tration approves an oral birth control that is avail- 11 able over-the-counter, such birth control should be 12 covered by health insurance, without a prescription 13 and without cost-sharing. 14 SEC. 5. CLARIFYING COVERAGE REQUIREMENTS. 15 The Secretaries of Health and Human Services, 16 Labor, and the Treasury shall clarify that coverage of con- 17 traceptives pursuant to section 2713(a)(4) of the Public 18 Health Service Act (42 U.S.C. 300gg–13(a)(4)) includes 19 coverage of over-the-counter contraceptives approved, 20 granted authorization for emergency use, or cleared by the 21 Food and Drug Administration, even if the enrollee does 22 not have a prescription for the contraceptive. 23 VerDate Sep 11 2014 21:14 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H3589.IH H3589 kjohnson on DSK79L0C42PROD with BILLS 6 •HR 3589 IH SEC. 6. RULES OF CONSTRUCTION. 1 (a) NON-INTERFERENCE WITH FDA REGULA- 2 TION.—Nothing in this Act shall be construed to modify 3 or interfere with Food and Drug Administration processes 4 to review, approve, clear, or authorize for emergency use, 5 or otherwise determine the safety and efficacy of, and 6 make available, non-prescription drugs or devices, modify 7 or interfere with the scientific and medical considerations 8 of the Food and Drug Administration, or alter any other 9 authority of the Food and Drug Administration. 10 (b) NON-PREEMPTION.—Nothing in this Act pre- 11 empts any provision of Federal or State law to the extent 12 that such Federal or State law provides protections for 13 consumers that are greater than the protections provided 14 for in this Act. 15 SEC. 7. DUTIES OF RETAILERS TO ENSURE ACCESS TO CON- 16 TRACEPTION FOR USE WITHOUT A PRESCRIP- 17 TION. 18 (a) IN GENERAL.—Any retailer that stocks contra- 19 ception that is approved, granted authorization for emer- 20 gency use, or cleared by, or otherwise legally marketed 21 under regulation by, the Food and Drug Administration 22 for use without a prescription may not interfere with an 23 individual’s access to or purchase of such contraception 24 or access to medically accurate, comprehensive informa- 25 tion about such contraception. 26 VerDate Sep 11 2014 21:14 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H3589.IH H3589 kjohnson on DSK79L0C42PROD with BILLS 7 •HR 3589 IH (b) LIMITATION.—Nothing in this section shall pro- 1 hibit a retailer that stocks over-the-counter contraceptive 2 products from refusing to provide an individual with such 3 contraceptive product that is approved, granted, or cleared 4 by, or otherwise legally marketed under regulation by, the 5 Food and Drug Administration if the individual is unable 6 to pay for the contraceptive product, directly, through in- 7 surance coverage, or through other payment mechanism. 8 Æ VerDate Sep 11 2014 21:14 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6301 E:\BILLS\H3589.IH H3589 kjohnson on DSK79L0C42PROD with BILLS