I 111th CONGRESS 1st Session H. R. 1236 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.

1.

Short title

This Act may be cited as the Compassionate Assistance for Rape Emergencies Act of 2009.

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.

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.