[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1236 Introduced in House (IH)]

111th CONGRESS
  1st Session
                                H. R. 1236

   To provide for the provision by hospitals receiving Federal funds 
     through the Medicare Program or Medicaid Program of emergency 
      contraceptives to women who are survivors of sexual assault.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           February 26, 2009

 Mr. Rothman of New Jersey (for himself, Mr. Hinchey, Mrs. Capps, Mrs. 
  Maloney, Mrs. Davis of California, Mr. Moore of Kansas, Mr. George 
   Miller of California, Ms. DeLauro, Mr. McGovern, Mr. Hastings of 
 Florida, Ms. Hirono, Mr. Tierney, Mr. Sires, Mr. Nadler of New York, 
 Mr. Kind, Mr. Abercrombie, Mr. McDermott, Mrs. Napolitano, Mr. Honda, 
   Mr. Carson of Indiana, Ms. McCollum, Mr. Berman, Mr. Israel, Mrs. 
Tauscher, Mr. Serrano, Ms. Woolsey, Mr. Kennedy, Mr. Olver, Mr. Markey 
of Massachusetts, Mr. Wexler, Ms. Zoe Lofgren of California, Mr. Holt, 
Mr. Farr, Mr. Inslee, Mr. Brady of Pennsylvania, Mr. Patrick J. Murphy 
 of Pennsylvania, and Mr. Stark) introduced the following bill; which 
 was referred to the Committee on Energy and Commerce, and in addition 
  to the Committee on 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 jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
   To provide for the provision by hospitals receiving Federal funds 
     through the Medicare Program or Medicaid Program of emergency 
      contraceptives to women who are survivors of sexual assault.

    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 ``Compassionate Assistance for Rape 
Emergencies Act of 2009''.

SEC. 2. FINDINGS.

    The Congress finds as follows:
            (1) One out of every 6 American women will become a victim 
        of rape or sexual assault in their lifetime. It is estimated 
        that 12,700,000 American women today are survivors of these 
        violent crimes.
            (2) The Federal Bureau of Investigation reports that 90,427 
        women were raped in 2006. This statistic is derived from 
        records of crimes reported to law enforcement and does not 
        include reports of other actions falling under the broader term 
        of ``sexual assault''.
            (3) The 2006 violent crime report issued by the Bureau of 
        Justice Statistics indicates that only a minority, 41.4 
        percent, of rapes and sexual assaults perpetrated against women 
        and girls in the United States were reported to law 
        enforcement. For this reason, the total number of these violent 
        crimes committed in a given year is likely to be much higher.
            (4) According to a 2003 analysis of data collected by the 
        National Violence Against Women Survey, the risk of pregnancy 
        resulting from rape is estimated to be 7.98 percent for victims 
        who were not protected by some form of contraception at the 
        time of the attack.
            (5) It is estimated that approximately 7,216 rape-related 
        pregnancies occurred in 2006, based on such data.
            (6) Timely access to emergency contraception could help 
        many of these rape survivors avoid the additional trauma of 
        facing an unintended pregnancy.
            (7) In light of the safety and effectiveness of emergency 
        contraception pills, both the American Medical Association and 
        the American College of Obstetricians and Gynecologists have 
        endorsed more widespread availability of such pills to women of 
        all ages.
            (8) The American College of Emergency Physicians and the 
        American College of Obstetricians and Gynecologists agree that 
        offering emergency contraception to female patients after a 
        sexual assault should be considered the standard of care.
            (9) The Food and Drug Administration has declared emergency 
        contraception to be safe and effective in preventing unintended 
        pregnancy if taken in the first 72 hours of sex.
            (10) Approximately one-third of women of reproductive age 
        remain unaware of emergency contraception. Therefore, women who 
        have been sexually assaulted are unlikely to ask for emergency 
        contraception.
            (11) It is essential that all hospitals that provide 
        emergency medical care provide emergency contraception as a 
        treatment option to any woman who has been raped, so that she 
        may have the option of preventing an unintended pregnancy.
            (12) In 2004, the Bureau of Justice Statistics reported 
        that legal reforms and the growth in services available to rape 
        victims have been influential in increasing the likelihood that 
        women will report a rape to police, resulting in more 
        perpetrators being identified and brought to justice.
            (13) On December 19, 2008, the Department of Health and 
        Human Services promulgated a final rule that expanded the 
        ability of federally funded health care providers or employees 
        to refuse to provide services, including emergency 
        contraception. This rule has the potential to jeopardize 
        women's access to emergency contraception.
            (14) Polls show that nearly 80 percent of American women 
        want their hospitals, whether or not religiously affiliated, to 
        offer emergency contraception to rape survivors.

SEC. 3. SURVIVORS OF SEXUAL ASSAULT; PROVISION BY HOSPITALS OF 
              EMERGENCY CONTRACEPTIVES WITHOUT CHARGE.

    (a) In General.--Federal funds may not be provided to a hospital 
under title XVIII of the Social Security Act or to a State, with 
respect to services of a hospital, under title XIX of such Act, unless 
the hospital meets the conditions specified in subsection (b) in the 
case of--
            (1) any woman who presents at the hospital and states that 
        she is a victim of sexual assault, or is accompanied by someone 
        who states she is a victim of sexual assault; and
            (2) any woman who presents at the hospital whom hospital 
        personnel have reason to believe is a victim of sexual assault.
    (b) Assistance for Victims.--The conditions specified in this 
subsection regarding a hospital and a woman described in subsection (a) 
are as follows:
            (1) The hospital promptly provides the woman with medically 
        and factually accurate and unbiased written and oral 
        information about emergency contraception, including 
        information explaining that--
                    (A) emergency contraception has been approved by 
                the Food and Drug Administration as an over-the-counter 
                medication for women ages 18 and over and is a safe and 
                effective way to prevent pregnancy after unprotected 
                intercourse or contraceptive failure if taken in a 
                timely manner;
                    (B) emergency contraception is more effective the 
                sooner it is taken; and
                    (C) emergency contraception does not cause an 
                abortion and cannot interrupt an established pregnancy.
            (2) The hospital promptly offers emergency contraception to 
        the woman, and promptly provides such contraception to her at 
        the hospital on her request.
            (3) The information provided pursuant to paragraph (1) is 
        in clear and concise language, is readily comprehensible, and 
        meets such conditions regarding the provision of the 
        information in languages other than English as the Secretary 
        may establish.
            (4) The services described in paragraphs (1) through (3) 
        are not denied because of the inability of the woman or her 
        family to pay for the services.
    (c) Definitions.--For purposes of this section:
            (1) The term ``emergency contraception'' means a drug, drug 
        regimen, or device that--
                    (A) is approved by the Food and Drug Administration 
                to prevent pregnancy; and
                    (B) is used postcoitally.
            (2) The term ``hospital'' has the meaning given such term 
        in section 1861(e) of the Social Security Act (42 U.S.C. 
        1395x(e)), and includes a critical access hospital, as defined 
        in section 1861(mm)(1) of such Act (42 U.S.C. 1395x(mm)(1)).
            (3) The term ``Secretary'' means the Secretary of Health 
        and Human Services.
            (4) The term ``sexual assault'' means coitus in which the 
        woman involved does not consent or lacks the legal capacity to 
        consent.
    (d) Effective Date; Agency Criteria.--This section takes effect 
upon the expiration of the 180-day period beginning on the date of the 
enactment of this Act. Not later than 30 days prior to the expiration 
of such period, the Secretary shall publish in the Federal Register 
criteria for carrying out this section.
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