[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 21 Introduced in Senate (IS)]







111th CONGRESS
  1st Session
                                 S. 21

To reduce unintended pregnancy, reduce abortions, and improve access to 
                          women's health care.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            January 6, 2009

    Mr. Reid (for himself, Mrs. Clinton, Mr. Akaka, Mr. Inouye, Mr. 
 Whitehouse, Mr. Lautenberg, Mrs. Murray, Mr. Menendez, Mr. Levin, Mr. 
  Baucus, Mr. Kerry, Mrs. Boxer, Mr. Carper, Mrs. Feinstein, and Ms. 
   Stabenow) introduced the following bill; which was read twice and 
  referred to the Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
To reduce unintended pregnancy, reduce abortions, and improve access to 
                          women's health care.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Prevention First 
Act''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Findings.
             TITLE I--TITLE X OF PUBLIC HEALTH SERVICE ACT

Sec. 101. Short title.
Sec. 102. Authorization of appropriations.
 TITLE II--EQUITY IN PRESCRIPTION INSURANCE AND CONTRACEPTIVE COVERAGE

Sec. 201. Short title.
Sec. 202. Amendments to Employee Retirement Income Security Act of 
                            1974.
Sec. 203. Amendments to Public Health Service Act relating to the group 
                            market.
Sec. 204. Amendment to Public Health Service Act relating to the 
                            individual market.
      TITLE III--EMERGENCY CONTRACEPTION EDUCATION AND INFORMATION

Sec. 301. Short title.
Sec. 302. Emergency contraception education and information programs.
        TITLE IV--COMPASSIONATE ASSISTANCE FOR RAPE EMERGENCIES

Sec. 401. Short title.
Sec. 402. Survivors of sexual assault; provision by hospitals of 
                            emergency contraceptives without charge.
       TITLE V--AT-RISK COMMUNITIES TEEN PREGNANCY PREVENTION ACT

Sec. 501. Short title.
Sec. 502. Teen pregnancy prevention.
Sec. 503. Research.
Sec. 504. General requirements.
            TITLE VI--ACCURACY OF CONTRACEPTIVE INFORMATION

Sec. 601. Short title.
Sec. 602. Accuracy of contraceptive information.
             TITLE VII--UNINTENDED PREGNANCY REDUCTION ACT

Sec. 701. Short title.
Sec. 702. Medicaid; clarification of coverage of family planning 
                            services and supplies.
Sec. 703. Expansion of family planning services.
Sec. 704. Effective date.
            TITLE VIII--RESPONSIBLE EDUCATION ABOUT LIFE ACT

Sec. 801. Short title.
Sec. 802. Assistance to reduce teen pregnancy, HIV/AIDS, and other 
                            sexually transmitted diseases and to 
                            support healthy adolescent development.
Sec. 803. Sense of Congress.
Sec. 804. Evaluation of programs.
Sec. 805. Definitions.
Sec. 806. Appropriations.
             TITLE IX--PREVENTION THROUGH AFFORDABLE ACCESS

Sec. 901. Short title.
Sec. 902. Restoring and protecting access to discount drug prices for 
                            university-based and safety-net clinics.

SEC. 2. FINDINGS.

    The Congress finds as follows:
            (1) Healthy People 2010 sets forth a reduction of 
        unintended pregnancies as an important health objective for the 
        Nation to achieve over the first decade of the new century, a 
        goal first articulated in the 1979 Surgeon General's Report, 
        Healthy People, and reiterated in Healthy People 2000: National 
        Health Promotion and Disease Prevention Objectives.
            (2) Although the Centers for Disease Control and Prevention 
        (referred to in this section as the ``CDC'') included family 
        planning in its published list of the Ten Great Public Health 
        Achievements in the 20th Century, the United States still has 
        one of the highest rates of unintended pregnancies among 
        industrialized nations.
            (3) Each year, nearly half of all pregnancies in the United 
        States are unintended, and nearly half of unintended 
        pregnancies end in abortion.
            (4) In 2006, 36,200,000 women, more than half of all women 
        of reproductive age, were in need of contraceptive services and 
        supplies to help prevent unintended pregnancy, and nearly half 
        of those were in need of public support for such care.
            (5) The United States has some of the highest rates of 
        sexually transmitted infections (STIs) among industrialized 
        nations. In 2006, there were approximately 19,000,000 new cases 
        of STIs, almost half of them occurring in young people ages 15 
        to 24. According to the Centers for Disease Control and 
        Prevention, in addition to the burden on public health, STIs 
        impose a tremendous economic burden with direct medical costs 
        as high as $14,700,000,000 each year in 2006 dollars.
            (6) Contraceptive use can improve overall health by 
        enabling women to plan and space their pregnancies and has 
        contributed to dramatic declines in maternal and infant 
        mortality. Widespread use of contraceptives has been the 
        driving force in reducing unintended pregnancies and sexually 
        transmitted infections (STIs), and reducing the need for 
        abortion in this Nation. Contraceptive use also saves public 
        health dollars. For every dollar spent to provide services in 
        publicly funded family planning clinics, $4.02 in Medicaid 
        expenses are saved because unintended births are averted.
            (7) Reducing unintended pregnancy improves maternal health 
        and is an important strategy in efforts to reduce maternal 
        mortality. Women experiencing unintended pregnancy are at 
        greater risk for physical abuse.
            (8) A child born from an unintended pregnancy is at greater 
        risk than a child born from an intended pregnancy of low birth 
        weight, dying in the first year of life, being abused, and not 
        receiving sufficient resources for healthy development.
            (9) The ability to control fertility allows couples to 
        achieve economic stability by facilitating greater educational 
        achievement and participation in the workforce.
            (10) Contraceptives are effective in preventing unintended 
        pregnancy when used consistently and correctly. Without 
        contraception, a sexually active woman has an 85 percent chance 
        of becoming pregnant within a year.
            (11) Approximately 50 percent of unintended pregnancies 
        occur among women who do not use contraception.
            (12) Many poor and low-income women cannot afford to 
        purchase contraceptive services and supplies on their own. The 
        number of women needing subsidized services has increased by 
        more than 1,000,000 (7 percent) since 2000. A poor woman in the 
        United States is now nearly 4 times as likely as a more 
        affluent woman to have an unplanned pregnancy. Between 1994 and 
        2001, unintended pregnancy among low-income women increased by 
        29 percent, while unintended pregnancy decreased by 20 percent 
        among women with higher incomes.
            (13) Public health programs, such as the Medicaid program 
        and family planning programs under title X of the Public Health 
        Service Act, provide high-quality family planning services and 
        other preventive health care to underinsured or uninsured 
        individuals who may otherwise lack access to health care.
            (14) Medicaid has become an essential source of support for 
        the provision of subsidized family planning services and 
        supplies. It is the single largest source of public funds 
        supporting these services. In 2001, the program provided 6 in 
        10 of all public dollars spent on family planning services. In 
        2006, 12 percent of women of reproductive age (7,300,000 women 
        ages 15 to 44) looked to Medicaid for their care and 37 percent 
        of poor women of reproductive age rely upon Medicaid.
            (15) Approximately 1,400,000 unintended pregnancies and 
        600,000 abortions are averted each year because of services 
        provided in publicly funded clinics. In 2006, Title X (of the 
        Public Health Service Act) service providers performed more 
        than 2,400,000 Pap tests, 2,400,000 breast exams, and 5,800,000 
        tests for sexually transmitted diseases, including 652,426 HIV 
        tests and 2,300,000 Chlamydia tests. One in 4 women who obtain 
        reproductive health services from a medical provider do so at a 
        publicly funded clinic.
            (16) The stagnant funding for public family planning 
        programs in combination with the increasing demand for 
        subsidized services, the rising costs of contraceptive services 
        and supplies, and the high cost of improved screening and 
        treatment for cervical cancer and sexually transmitted 
        infections has diminished the ability of clinics receiving 
        funds under title X of the Public Health Services Act to 
        adequately serve all those in need. At present, clinics are 
        able to reach just 41 percent of the women needing subsidized 
        services. Had Title X funding kept up with inflation since 
        fiscal year 1980, it would now be funded at $759,000,000, 
        instead of its fiscal year 2007 funding level of $283,000,000. 
        Taking inflation into account, funding for Title X in constant 
        dollars is 63 percent lower today than it was in fiscal year 
        1980.
            (17) While the Medicaid program remains the largest source 
        of subsidized family planning services, States are facing 
        significant budgetary pressures to cut their Medicaid programs, 
        putting many women at risk of losing coverage for family 
        planning services.
            (18) In addition, eligibility under the Medicaid program in 
        many States is severely restricted, which leaves family 
        planning services financially out of reach for many poor women. 
        Many States have demonstrated tremendous success with Medicaid 
        family planning waivers that allow States to expand access to 
        Medicaid family planning services. However, the administrative 
        burden of applying for a waiver poses a significant barrier to 
        States that would like to expand their coverage of family 
        planning programs through Medicaid.
            (19) As of December of 2008, 27 States offered expanded 
        family planning benefits as a result of Medicaid family 
        planning waivers. The cost-effectiveness of these waivers was 
        affirmed by a recent evaluation funded by the Centers for 
        Medicare & Medicaid Services. This evaluation of six waivers 
        found that all family planning programs under such waivers 
        resulted in significant savings to both the Federal and State 
        governments. Moreover, the researchers found measurable 
        reductions in unintended pregnancy.
            (20) Although employer-sponsored health plans have improved 
        coverage of contraceptive services and supplies, largely in 
        response to State contraceptive coverage laws, there is still 
        significant room for improvement. The ongoing lack of coverage 
        in health insurance plans, particularly in self-insured and 
        individual plans, continues to place effective forms of 
        contraception beyond the financial reach of many women.
            (21) Including contraceptive coverage in private health 
        care plans saves employers money. Not covering contraceptives 
        in employee health plans costs employers 15 to 17 percent more 
        than providing such coverage.
            (22) Approved for use by the Food and Drug Administration, 
        emergency contraception is a safe and effective way to prevent 
        unintended pregnancy after unprotected sex. Research confirms 
        that easier access to emergency contraceptives does not 
        increase sexual risk-taking or sexually transmitted diseases.
            (23) The available evidence shows that many women do not 
        know about emergency contraception, do not know where to get 
        it, or are unable to access it. Overcoming these obstacles 
        could help ensure that more women use emergency contraception 
        consistently and correctly.
            (24) A November 2006 study of declining pregnancy rates 
        among teens concluded that the reduction in teen pregnancy 
        between 1995 and 2002 is primarily the result of increased use 
        of contraceptives. As such, it is critically important that 
        teens receive accurate, unbiased information about 
        contraception.
            (25) The American Medical Association, the American Nurses 
        Association, the American Academy of Pediatrics, the American 
        College of Obstetricians and Gynecologists, the American Public 
        Health Association, and the Society for Adolescent Medicine, 
        support responsible sex education that includes information 
        about both abstinence and contraception.
            (26) Teens who receive comprehensive sex education that 
        includes discussion of contraception as well as abstinence are 
        more likely than those who receive abstinence-only messages to 
        delay sex, to have fewer partners, and to use contraceptives 
        when they do become sexually active.
            (27) Government-funded abstinence-only-until-marriage 
        programs are precluded from discussing contraception except to 
        talk about failure rates. An October 2006 report by the 
        Government Accountability Office found that the Department of 
        Health and Human Services does not review the materials of 
        recipients of grants administered by such department for 
        scientific accuracy and requires grantees to review their own 
        materials for scientific accuracy. The GAO also reported on the 
        Department's total lack of appropriate and customary 
        measurements to determine if funded programs are effective. In 
        addition, a separate letter from the Government Accountability 
        Office found that the Department of Health and Human Services 
        is in violation of Federal law by failing to enforce a 
        requirement under the Public Health Service Act that Federally 
        funded grantees working to address the prevention of sexually 
        transmitted diseases, including abstinence-only-until-marriage 
        programs, must provide medically accurate information about the 
        effectiveness of condoms.
            (28) Recent scientific reports by the Institute of 
        Medicine, the American Medical Association, and the Office on 
        National AIDS Policy stress the need for sex education that 
        includes messages about abstinence and provides young people 
        with information about contraception for the prevention of teen 
        pregnancy, HIV/AIDS, and other sexually transmitted diseases.
            (29) A 2006 statement from the American Public Health 
        Association (``APHA'') ``recognizes the importance of 
        abstinence education, but only as part of a comprehensive 
        sexuality education program . . . APHA calls for repealing 
        current Federal funding for abstinence-only programs and 
        replacing it with funding for a new Federal program to promote 
        comprehensive sexuality education, combining information about 
        abstinence with age-appropriate sexuality education.''
            (30) Comprehensive sex education programs respect the 
        diversity of values and beliefs represented in the community 
        and will complement and augment the sex education children 
        receive from their families.
            (31) Over 60 percent of the 56,300 annual new cases of HIV 
        infections in the United States occur in youth ages 13 through 
        24. African-American and Latino youth have been 
        disproportionately affected by the HIV/AIDS epidemic. In 2005, 
        Blacks and Latinos accounted for 84 percent of all new HIV 
        infections among 13 to 19 year olds and 76 percent of HIV 
        infections among 20 to 24 year olds in the United States even 
        though, together, they represent only about 32 percent of 
        people in these ages. Teens in the United States contract an 
        estimated 9,000,000 sexually transmitted infections each year. 
        By age 24, at least 1 in 4 sexually active people between the 
        ages of 15 and 24 will have contracted a sexually transmitted 
        infection.
            (32) Approximately 50 young people a day, an average of two 
        young people every hour of every day, are infected with HIV in 
        the United States.
            (33) In 1990, Congress passed the Medicaid Anti-
        Discriminatory Drug Price and Patient Benefit Restoration Act 
        to ensure that Medicaid receives the lowest drug prices in the 
        marketplace. Congress intentionally protected the practice of 
        pharmaceutical companies offering charitable organizations and 
        clinics nominally priced drugs. As an unintended consequence of 
        the Deficit Reduction Act of 2005, birth control prices have 
        skyrocketed for millions of women who depend on safety net 
        providers for their birth control. Birth control that 
        previously cost only $5 to $10 per month is now prohibitively 
        expensive, running as much as $40 or $50 a month. Many family 
        planning health centers have absorbed much of this price 
        increase, further straining already limited resources. As the 
        economic crisis worsens, women and their families are 
        increasingly turning to health care safety net providers, such 
        as family planning health centers, for a reliable source of 
        care.

             TITLE I--TITLE X OF PUBLIC HEALTH SERVICE ACT

SEC. 101. SHORT TITLE.

    This title may be cited as the ``Title X Family Planning Services 
Act of 2009''.

SEC. 102. AUTHORIZATION OF APPROPRIATIONS.

    For the purpose of making grants and contracts under section 1001 
of the Public Health Service Act, there are authorized to be 
appropriated $700,000,000 for fiscal year 2010 and such sums as may be 
necessary for each subsequent fiscal year.

 TITLE II--EQUITY IN PRESCRIPTION INSURANCE AND CONTRACEPTIVE COVERAGE

SEC. 201. SHORT TITLE.

    This title may be cited as the ``Equity in Prescription Insurance 
and Contraceptive Coverage Act of 2007''.

SEC. 202. AMENDMENTS TO EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 
              1974.

    (a) In General.--Subpart B of part 7 of subtitle B of title I of 
the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185 et 
seq.) is amended by adding at the end the following:

``SEC. 715. STANDARDS RELATING TO BENEFITS FOR CONTRACEPTIVES.

    ``(a) Requirements for Coverage.--A group health plan, and a health 
insurance issuer providing health insurance coverage in connection with 
a group health plan, may not--
            ``(1) exclude or restrict benefits for prescription 
        contraceptive drugs or devices approved by the Food and Drug 
        Administration, or generic equivalents approved as 
        substitutable by the Food and Drug Administration, if such plan 
        or coverage provides benefits for other outpatient prescription 
        drugs or devices; or
            ``(2) exclude or restrict benefits for outpatient 
        contraceptive services if such plan or coverage provides 
        benefits for other outpatient services provided by a health 
        care professional (referred to in this section as `outpatient 
        health care services').
    ``(b) Prohibitions.--A group health plan, and a health insurance 
issuer providing health insurance coverage in connection with a group 
health plan, may not--
            ``(1) deny to an individual eligibility, or continued 
        eligibility, to enroll or to renew coverage under the terms of 
        the plan because of the individual's or enrollee's use or 
        potential use of items or services that are covered in 
        accordance with the requirements of this section;
            ``(2) provide monetary payments or rebates to a covered 
        individual to encourage such individual to accept less than the 
        minimum protections available under this section;
            ``(3) penalize or otherwise reduce or limit the 
        reimbursement of a health care professional because such 
        professional prescribed contraceptive drugs or devices, or 
        provided contraceptive services, described in subsection (a), 
        in accordance with this section; or
            ``(4) provide incentives (monetary or otherwise) to a 
        health care professional to induce such professional to 
        withhold from a covered individual contraceptive drugs or 
        devices, or contraceptive services, described in subsection 
        (a).
    ``(c) Rules of Construction.--
            ``(1) In general.--Nothing in this section shall be 
        construed--
                    ``(A) as preventing a group health plan and a 
                health insurance issuer providing health insurance 
                coverage in connection with a group health plan from 
                imposing deductibles, coinsurance, or other cost-
                sharing or limitations in relation to--
                            ``(i) benefits for contraceptive drugs 
                        under the plan or coverage, except that such a 
                        deductible, coinsurance, or other cost-sharing 
                        or limitation for any such drug shall be 
                        consistent with those imposed for other 
                        outpatient prescription drugs otherwise covered 
                        under the plan or coverage;
                            ``(ii) benefits for contraceptive devices 
                        under the plan or coverage, except that such a 
                        deductible, coinsurance, or other cost-sharing 
                        or limitation for any such device shall be 
                        consistent with those imposed for other 
                        outpatient prescription devices otherwise 
                        covered under the plan or coverage; and
                            ``(iii) benefits for outpatient 
                        contraceptive services under the plan or 
                        coverage, except that such a deductible, 
                        coinsurance, or other cost-sharing or 
                        limitation for any such service shall be 
                        consistent with those imposed for other 
                        outpatient health care services otherwise 
                        covered under the plan or coverage;
                    ``(B) as requiring a group health plan and a health 
                insurance issuer providing health insurance coverage in 
                connection with a group health plan to cover 
                experimental or investigational contraceptive drugs or 
                devices, or experimental or investigational 
                contraceptive services, described in subsection (a), 
                except to the extent that the plan or issuer provides 
                coverage for other experimental or investigational 
                outpatient prescription drugs or devices, or 
                experimental or investigational outpatient health care 
                services; or
                    ``(C) as modifying, diminishing, or limiting the 
                rights or protections of an individual under any other 
                Federal law.
            ``(2) Limitations.--As used in paragraph (1), the term 
        `limitation' includes--
                    ``(A) in the case of a contraceptive drug or 
                device, restricting the type of health care 
                professionals that may prescribe such drugs or devices, 
                utilization review provisions, and limits on the volume 
                of prescription drugs or devices that may be obtained 
                on the basis of a single consultation with a 
                professional; or
                    ``(B) in the case of an outpatient contraceptive 
                service, restricting the type of health care 
                professionals that may provide such services, 
                utilization review provisions, requirements relating to 
                second opinions prior to the coverage of such services, 
                and requirements relating to preauthorizations prior to 
                the coverage of such services.
    ``(d) Notice Under Group Health Plan.--The imposition of the 
requirements of this section shall be treated as a material 
modification in the terms of the plan described in section 102(a)(1), 
for purposes of assuring notice of such requirements under the plan, 
except that the summary description required to be provided under the 
last sentence of section 104(b)(1) with respect to such modification 
shall be provided by not later than 60 days after the first day of the 
first plan year in which such requirements apply.
    ``(e) Preemption.--Nothing in this section shall be construed to 
preempt any provision of State law to the extent that such State law 
establishes, implements, or continues in effect any standard or 
requirement that provides coverage or protections for participants or 
beneficiaries that are greater than the coverage or protections 
provided under this section.
    ``(f) Definition.--In this section, the term `outpatient 
contraceptive services' means consultations, examinations, procedures, 
and medical services, provided on an outpatient basis and related to 
the use of contraceptive methods (including natural family planning) to 
prevent an unintended pregnancy.''.
    (b) Clerical Amendment.--The table of contents in section 1 of the 
Employee Retirement Income Security Act of 1974 (29 U.S.C. 1001) is 
amended by inserting after the item relating to section 713 the 
following:

``Sec. 715. Standards relating to benefits for contraceptives.''.
    (c) Effective Date.--The amendments made by this section shall 
apply with respect to plan years beginning on or after January 1, 2010.

SEC. 203. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT RELATING TO THE GROUP 
              MARKET.

    (a) In General.--Subpart 2 of part A of title XXVII of the Public 
Health Service Act (42 U.S.C. 300gg-4 et seq.) is amended by adding at 
the end the following:

``SEC. 2708. STANDARDS RELATING TO BENEFITS FOR CONTRACEPTIVES.

    ``(a) Requirements for Coverage.--A group health plan, and a health 
insurance issuer providing health insurance coverage in connection with 
a group health plan, may not--
            ``(1) exclude or restrict benefits for prescription 
        contraceptive drugs or devices approved by the Food and Drug 
        Administration, or generic equivalents approved as 
        substitutable by the Food and Drug Administration, if such plan 
        or coverage provides benefits for other outpatient prescription 
        drugs or devices; or
            ``(2) exclude or restrict benefits for outpatient 
        contraceptive services if such plan or coverage provides 
        benefits for other outpatient services provided by a health 
        care professional (referred to in this section as `outpatient 
        health care services').
    ``(b) Prohibitions.--A group health plan, and a health insurance 
issuer providing health insurance coverage in connection with a group 
health plan, may not--
            ``(1) deny to an individual eligibility, or continued 
        eligibility, to enroll or to renew coverage under the terms of 
        the plan because of the individual's or enrollee's use or 
        potential use of items or services that are covered in 
        accordance with the requirements of this section;
            ``(2) provide monetary payments or rebates to a covered 
        individual to encourage such individual to accept less than the 
        minimum protections available under this section;
            ``(3) penalize or otherwise reduce or limit the 
        reimbursement of a health care professional because such 
        professional prescribed contraceptive drugs or devices, or 
        provided contraceptive services, described in subsection (a), 
        in accordance with this section; or
            ``(4) provide incentives (monetary or otherwise) to a 
        health care professional to induce such professional to 
        withhold from covered individual contraceptive drugs or 
        devices, or contraceptive services, described in subsection 
        (a).
    ``(c) Rules of Construction.--
            ``(1) In general.--Nothing in this section shall be 
        construed--
                    ``(A) as preventing a group health plan and a 
                health insurance issuer providing health insurance 
                coverage in connection with a group health plan from 
                imposing deductibles, coinsurance, or other cost-
                sharing or limitations in relation to--
                            ``(i) benefits for contraceptive drugs 
                        under the plan or coverage, except that such a 
                        deductible, coinsurance, or other cost-sharing 
                        or limitation for any such drug shall be 
                        consistent with those imposed for other 
                        outpatient prescription drugs otherwise covered 
                        under the plan or coverage;
                            ``(ii) benefits for contraceptive devices 
                        under the plan or coverage, except that such a 
                        deductible, coinsurance, or other cost-sharing 
                        or limitation for any such device shall be 
                        consistent with those imposed for other 
                        outpatient prescription devices otherwise 
                        covered under the plan or coverage; and
                            ``(iii) benefits for outpatient 
                        contraceptive services under the plan or 
                        coverage, except that such a deductible, 
                        coinsurance, or other cost-sharing or 
                        limitation for any such service shall be 
                        consistent with those imposed for other 
                        outpatient health care services otherwise 
                        covered under the plan or coverage;
                    ``(B) as requiring a group health plan and a health 
                insurance issuer providing health insurance coverage in 
                connection with a group health plan to cover 
                experimental or investigational contraceptive drugs or 
                devices, or experimental or investigational 
                contraceptive services, described in subsection (a), 
                except to the extent that the plan or issuer provides 
                coverage for other experimental or investigational 
                outpatient prescription drugs or devices, or 
                experimental or investigational outpatient health care 
                services; or
                    ``(C) as modifying, diminishing, or limiting the 
                rights or protections of an individual under any other 
                Federal law.
            ``(2) Limitations.--As used in paragraph (1), the term 
        `limitation' includes--
                    ``(A) in the case of a contraceptive drug or 
                device, restricting the type of health care 
                professionals that may prescribe such drugs or devices, 
                utilization review provisions, and limits on the volume 
                of prescription drugs or devices that may be obtained 
                on the basis of a single consultation with a 
                professional; or
                    ``(B) in the case of an outpatient contraceptive 
                service, restricting the type of health care 
                professionals that may provide such services, 
                utilization review provisions, requirements relating to 
                second opinions prior to the coverage of such services, 
                and requirements relating to preauthorizations prior to 
                the coverage of such services.
    ``(d) Notice.--A group health plan under this part shall comply 
with the notice requirement under section 715(d) of the Employee 
Retirement Income Security Act of 1974 with respect to the requirements 
of this section as if such section applied to such plan.
    ``(e) Preemption.--Nothing in this section shall be construed to 
preempt any provision of State law to the extent that such State law 
establishes, implements, or continues in effect any standard or 
requirement that provides coverage or protections for enrollees that 
are greater than the coverage or protections provided under this 
section.
    ``(f) Definition.--In this section, the term `outpatient 
contraceptive services' means consultations, examinations, procedures, 
and medical services, provided on an outpatient basis and related to 
the use of contraceptive methods (including natural family planning) to 
prevent an unintended pregnancy.''.
    (b) Effective Date.--The amendments made by this section shall 
apply with respect to group health plans for plan years beginning on or 
after January 1, 2010.

SEC. 204. AMENDMENT TO PUBLIC HEALTH SERVICE ACT RELATING TO THE 
              INDIVIDUAL MARKET.

    (a) In General.--Part B of title XXVII of the Public Health Service 
Act (42 U.S.C. 300gg-41 et seq.) is amended--
            (1) by redesignating the first subpart 3 (relating to other 
        requirements) as subpart 2; and
            (2) by adding at the end of subpart 2 the following:

``SEC. 2754. STANDARDS RELATING TO BENEFITS FOR CONTRACEPTIVES.

    ``The provisions of section 2708 shall apply to health insurance 
coverage offered by a health insurance issuer in the individual market 
in the same manner as they apply to health insurance coverage offered 
by a health insurance issuer in connection with a group health plan in 
the small or large group market.''.
    (b) Effective Date.--The amendment made by this section shall apply 
with respect to health insurance coverage offered, sold, issued, 
renewed, in effect, or operated in the individual market on or after 
January 1, 2008.

      TITLE III--EMERGENCY CONTRACEPTION EDUCATION AND INFORMATION

SEC. 301. SHORT TITLE.

    This title may be cited as the ``Emergency Contraception Education 
Act of 2009''.

SEC. 302. EMERGENCY CONTRACEPTION EDUCATION AND INFORMATION PROGRAMS.

    (a) Definitions.--For purposes of this section:
            (1) Emergency contraception.--The term ``emergency 
        contraception'' means a drug or device (as the terms are 
        defined in section 201 of the Federal Food, Drug, and Cosmetic 
        Act (21 U.S.C. 321)) or a drug regimen that is--
                    (A) used after sexual relations;
                    (B) prevents pregnancy, by preventing ovulation, 
                fertilization of an egg, or implantation of an egg in a 
                uterus; and
                    (C) approved by the Food and Drug Administration.
            (2) Health care provider.--The term ``health care 
        provider'' means an individual who is licensed or certified 
        under State law to provide health care services and who is 
        operating within the scope of such license.
            (3) Institution of higher education.--The term 
        ``institution of higher education'' has the same meaning given 
        such term in section 101(a) of the Higher Education Act of 1965 
        (20 U.S.C. 1001(a)).
            (4) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
    (b) Emergency Contraception Public Education Program.--
            (1) In general.--The Secretary, acting through the Director 
        of the Centers for Disease Control and Prevention, shall 
        develop and disseminate to the public information on emergency 
        contraception.
            (2) Dissemination.--The Secretary may disseminate 
        information under paragraph (1) directly or through 
        arrangements with nonprofit organizations, consumer groups, 
        institutions of higher education, Federal, State, or local 
        agencies, clinics, and the media.
            (3) Information.--The information disseminated under 
        paragraph (1) shall include, at a minimum, a description of 
        emergency contraception and an explanation of the use, safety, 
        efficacy, and availability of such contraception.
    (c) Emergency Contraception Information Program for Health Care 
Providers.--
            (1) In general.--The Secretary, acting through the 
        Administrator of the Health Resources and Services 
        Administration and in consultation with major medical and 
        public health organizations, shall develop and disseminate to 
        health care providers information on emergency contraception.
            (2) Information.--The information disseminated under 
        paragraph (1) shall include, at a minimum--
                    (A) information describing the use, safety, 
                efficacy, and availability of emergency contraception;
                    (B) a recommendation regarding the use of such 
                contraception in appropriate cases; and
                    (C) information explaining how to obtain copies of 
                the information developed under subsection (b) for 
                distribution to the patients of the providers.
    (d) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of the fiscal years 2010 through 2014.

        TITLE IV--COMPASSIONATE ASSISTANCE FOR RAPE EMERGENCIES

SEC. 401. SHORT TITLE.

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

SEC. 402. 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 any health-related program, 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 does not cause an 
                abortion; and
                    (B) emergency contraception is effective in most 
                cases in preventing pregnancy after unprotected sex.
            (2) The hospital promptly offers emergency contraception to 
        the woman, and promptly provides such contraception to her 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 used postcoitally;
                    (B) prevents pregnancy by delaying ovulation, 
                preventing fertilization of an egg, or preventing 
                implantation of an egg in a uterus; and
                    (C) is approved by the Food and Drug 
                Administration.
            (2) The term ``hospital'' has the meanings given such term 
        in title XVIII of the Social Security Act, including the 
        meaning applicable in such title for purposes of making 
        payments for emergency services to hospitals that do not have 
        agreements in effect under such title.
            (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.

       TITLE V--AT-RISK COMMUNITIES TEEN PREGNANCY PREVENTION ACT

SEC. 501. SHORT TITLE.

    This title may be cited as the ``At-Risk Communities Teen Pregnancy 
Prevention Act of 2009''.

SEC. 502. TEENAGE PREGNANCY PREVENTION.

    Part P of title III of the Public Health Service Act (42 U.S.C. 
280g et seq.) is amended by inserting after section 399N the following 
section:

``SEC. 399N-1. TEENAGE PREGNANCY PREVENTION GRANTS.

    ``(a) Authority.--The Secretary may award on a competitive basis 
grants to public and private entities to establish or expand teenage 
pregnancy prevention programs.
    ``(b) Grant Recipients.--Grant recipients under this section may 
include State and local not-for-profit coalitions working to prevent 
teenage pregnancy, State, local, and tribal agencies, schools, entities 
that provide after-school programs, and community and faith-based 
groups.
    ``(c) Priority.--In selecting grant recipients under this section, 
the Secretary shall give--
            ``(1) highest priority to applicants seeking assistance for 
        programs targeting communities or populations in which--
                    ``(A) teenage pregnancy or birth rates are higher 
                than the corresponding State average; or
                    ``(B) teenage pregnancy or birth rates are 
                increasing; and
            ``(2) priority to applicants seeking assistance for 
        programs that--
                    ``(A) will benefit underserved or at-risk 
                populations such as young males or immigrant youths; or
                    ``(B) will take advantage of other available 
                resources and be coordinated with other programs that 
                serve youth, such as workforce development and after 
                school programs.
    ``(d) Use of Funds.--Funds received by an entity as a grant under 
this section shall be used for programs that--
            ``(1) replicate or substantially incorporate the elements 
        of one or more teenage pregnancy prevention programs that have 
        been proven (on the basis of rigorous scientific research) to 
        delay sexual intercourse or sexual activity, increase condom or 
        contraceptive use without increasing sexual activity, or reduce 
        teenage pregnancy; and
            ``(2) incorporate one or more of the following strategies 
        for preventing teenage pregnancy: encouraging teenagers to 
        delay sexual activity; sex and HIV education; interventions for 
        sexually active teenagers; preventive health services; youth 
        development programs; service learning programs; and outreach 
        or media programs.
    ``(e) Complete Information.--Programs receiving funds under this 
section that choose to provide information on HIV/AIDS or contraception 
or both must provide information that is complete and medically 
accurate.
    ``(f) Relation to Abstinence-Only Programs.--Funds under this 
section are not intended for use by abstinence-only education programs. 
Abstinence-only education programs that receive Federal funds through 
the Maternal and Child Health Block Grant, the Administration for 
Children and Families, the Adolescent Family Life Program, and any 
other program that uses the definition of `abstinence education' found 
in section 510(b) of the Social Security Act are ineligible for 
funding.
    ``(g) Applications.--Each entity seeking a grant under this section 
shall submit an application to the Secretary at such time and in such 
manner as the Secretary may require.
    ``(h) Matching Funds.--
            ``(1) In general.--The Secretary may not award a grant to 
        an applicant for a program under this section unless the 
        applicant demonstrates that it will pay, from funds derived 
        from non-Federal sources, at least 25 percent of the cost of 
        the program.
            ``(2) Applicant's share.--The applicant's share of the cost 
        of a program shall be provided in cash or in kind.
    ``(i) Supplementation of Funds.--An entity that receives funds as a 
grant under this section shall use the funds to supplement and not 
supplant funds that would otherwise be available to the entity for 
teenage pregnancy prevention.
    ``(j) Evaluations.--
            ``(1) In general.--The Secretary shall--
                    ``(A) conduct or provide for a rigorous evaluation 
                of 10 percent of programs for which a grant is awarded 
                under this section;
                    ``(B) collect basic data on each program for which 
                a grant is awarded under this section; and
                    ``(C) upon completion of the evaluations referred 
                to in subparagraph (A), submit to the Congress a report 
                that includes a detailed statement on the effectiveness 
                of grants under this section.
            ``(2) Cooperation by grantees.--Each grant recipient under 
        this section shall provide such information and cooperation as 
        may be required for an evaluation under paragraph (1).
    ``(k) Definition.--For purposes of this section, the term `rigorous 
scientific research' means based on a program evaluation that:
            ``(1) Measured impact on sexual or contraceptive behavior, 
        pregnancy or childbearing.
            ``(2) Employed an experimental or quasi-experimental design 
        with well-constructed and appropriate comparison groups.
            ``(3) Had a sample size large enough (at least 100 in the 
        combined treatment and control group) and a follow-up interval 
        long enough (at least six months) to draw valid conclusions 
        about impact.
    ``(l) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section such sums as may be necessary 
for fiscal year 2010 and each subsequent fiscal year.''.

SEC. 503. RESEARCH.

    (a) In General.--The Secretary of Health and Human Services, acting 
through the Director of the Centers for Disease Control and Prevention, 
shall make grants to public or nonprofit private entities to conduct, 
support, and coordinate research on the prevention of teen pregnancy in 
eligible communities, including research on the factors contributing to 
the disproportionate rates of teen pregnancy in such communities.
    (b) Research.--In carrying out subsection (a), the Secretary of 
Health and Human Services shall support research that--
            (1) investigates and determines the incidence and 
        prevalence of teen pregnancy in communities described in such 
        subsection;
            (2) examines--
                    (A) the extent of the impact of teen pregnancy on--
                            (i) the health and well-being of teenagers 
                        in the communities; and
                            (ii) the scholastic achievement of such 
                        teenagers;
                    (B) the variance in the rates of teen pregnancy 
                by--
                            (i) location (such as inner cities, inner 
                        suburbs, and outer suburbs);
                            (ii) population subgroup (such as Hispanic, 
                        Asian-Pacific Islander, African-American, 
                        Native American); and
                            (iii) level of acculturation;
                    (C) the importance of the physical and social 
                environment as a factor in placing communities at risk 
                of increased rates of teen pregnancy; and
                    (D) the importance of aspirations as a factor 
                affecting young women's risk of teen pregnancy; and
            (3) is used to develop--
                    (A) measures to address race, ethnicity, 
                socioeconomic status, environment, and educational 
                attainment and the relationship to the incidence and 
                prevalence of teen pregnancy; and
                    (B) efforts to link the measures to relevant 
                databases, including health databases.
    (c) Priority.--In making grants under subsection (a), the Secretary 
of Health and Human Services shall give priority to research that 
incorporates--
            (1) interdisciplinary approaches; or
            (2) a strong emphasis on community-based participatory 
        research.
    (d) Authorization of Appropriations.--For the purpose of carrying 
out this section, there is authorized to be appropriated such sums as 
may be necessary for each of the fiscal years 2010 through 2014.

SEC. 504. GENERAL REQUIREMENTS.

    (a) Medically Accurate Information.--A grant may be made under this 
title only if the applicant involved agrees that all information 
provided pursuant to the grant will be age-appropriate, factually and 
medically accurate and complete, and scientifically based.
    (b) Cultural Context of Services.--A grant may be made under this 
title only if the applicant involved agrees that information, 
activities, and services under the grant that are directed toward a 
particular population group will be provided in the language and 
cultural context that is most appropriate for individuals in such 
group.
    (c) Application for Grant.--A grant may be made under this title 
only if an application for the grant is submitted to the Secretary of 
Health and Human Services and the application is in such form, is made 
in such manner, and contains such agreements, assurances, and 
information as the Secretary of Health and Human Services determines to 
be necessary to carry out the program involved.

            TITLE VI--ACCURACY OF CONTRACEPTIVE INFORMATION

SEC. 601. SHORT TITLE.

    This title may be cited as the ``Truth in Contraception Act of 
2009''.

SEC. 602. ACCURACY OF CONTRACEPTIVE INFORMATION.

    Notwithstanding any other provision of law, any information 
concerning the use of a contraceptive provided through any federally 
funded sex education, family life education, abstinence education, 
comprehensive health education, or character education program shall be 
medically accurate and shall include health benefits and failure rates 
relating to the use of such contraceptive.

             TITLE VII--UNINTENDED PREGNANCY REDUCTION ACT

SEC. 701. SHORT TITLE.

    This title may be cited as the ``Unintended Pregnancy Reduction Act 
of 2009''.

SEC. 702. MEDICAID; CLARIFICATION OF COVERAGE OF FAMILY PLANNING 
              SERVICES AND SUPPLIES.

    Section 1937(b) of the Social Security Act (42 U.S.C. 1396u-7(b)) 
is amended by adding at the end the following:
            ``(5) Coverage of family planning services and supplies.--
        Notwithstanding the previous provisions of this section, a 
        State may not provide for medical assistance through enrollment 
        of an individual with benchmark coverage or benchmark-
        equivalent coverage under this section unless such coverage 
        includes for any individual described in section 1905(a)(4)(C), 
        medical assistance for family planning services and supplies in 
        accordance with such section.''.

SEC. 703. EXPANSION OF FAMILY PLANNING SERVICES.

    (a) Coverage as Mandatory Categorically Needy Group.--
            (1) In general.--Section 1902(a)(10)(A)(i) of the Social 
        Security Act (42 U.S.C. 1396a(a)(10)(A)(i)) is amended--
                    (A) in subclause (VI), by striking ``or'' at the 
                end;
                    (B) in subclause (VII), by adding ``or'' at the 
                end; and
                    (C) by adding at the end the following new 
                subclause:
                                    ``(VIII) who are described in 
                                subsection (dd) (relating to 
                                individuals who meet the income 
                                standards for pregnant women);''.
            (2) Group described.--Section 1902 of the Social Security 
        Act (42 U.S.C. 1396a) is amended by adding at the end the 
        following new subsection:
    ``(dd)(1) Individuals described in this subsection are 
individuals--
            ``(A) meet at least the income eligibility standards 
        established under the State plan as of January 1, 2009, for 
        pregnant women or such higher income eligibility standard for 
        such women as the State may establish; and
            ``(B) are not pregnant.
    ``(2) At the option of a State, individuals described in this 
subsection may include individuals who are determined to meet the 
income eligibility standards referred to in paragraph (1)(A) under the 
terms and conditions applicable to making eligibility determinations 
for medical assistance under this title under a waiver to provide the 
benefits described in clause (XV) of the matter following subparagraph 
(G) of section 1902(a)(10) granted to the State under section 1115 as 
of January 1, 2007.''.
            (3) Limitation on benefits.--Section 1902(a)(10) of the 
        Social Security Act (42 U.S.C. 1396a(a)(10)) is amended in the 
        matter following subparagraph (G)--
                    (A) by striking ``and (XIV)'' and inserting 
                ``(XIV)''; and
                    (B) by inserting ``, and (XV) the medical 
                assistance made available to an individual described in 
                subsection (dd) shall be limited to family planning 
                services and supplies described in 1905(a)(4)(C) 
                including medical diagnosis and treatment services that 
                are provided pursuant to a family planning service in a 
                family planning setting;'' after ``cervical cancer''.
            (4) Conforming amendments.--Section 1905(a) of the Social 
        Security Act (42 U.S.C. 1396d(a)) is amended in the matter 
        preceding paragraph (1)--
                    (A) in clause (xii), by striking ``or'' at the end;
                    (B) in clause (xii), by adding ``or'' at the end; 
                and
                    (C) by inserting after clause (xiii) the following:
                            ``(xiv) individuals described in section 
                        1902(dd),''.
    (b) Presumptive Eligibility.--
            (1) In general.--Title XIX of the Social Security Act (42 
        U.S.C. 1396 et seq.) is amended by inserting after section 
        1920B the following:

         ``presumptive eligibility for family planning services

    ``Sec. 1920C.  (a) State Option.--A State plan approved under 
section 1902 may provide for making medical assistance available to an 
individual described in section 1902(dd) (relating to individuals who 
meet certain income eligibility standards) during a presumptive 
eligibility period. In the case of an individual described in section 
1902(dd), such medical assistance shall be limited to family planning 
services and supplies described in 1905(a)(4)(C) including medical 
diagnosis and treatment services that are provided pursuant to a family 
planning service in a family planning setting.
    ``(b) Definitions.--For purposes of this section:
            ``(1) Presumptive eligibility period.--The term 
        `presumptive eligibility period' means, with respect to an 
        individual described in subsection (a), the period that--
                    ``(A) begins with the date on which a qualified 
                entity determines, on the basis of preliminary 
                information, that the individual is described in 
                section 1902(dd); and
                    ``(B) ends with (and includes) the earlier of--
                            ``(i) the day on which a determination is 
                        made with respect to the eligibility of such 
                        individual for services under the State plan; 
                        or
                            ``(ii) in the case of such an individual 
                        who does not file an application by the last 
                        day of the month following the month during 
                        which the entity makes the determination 
                        referred to in subparagraph (A), such last day.
            ``(2) Qualified entity.--
                    ``(A) In general.--Subject to subparagraph (B), the 
                term `qualified entity' means any entity that--
                            ``(i) is eligible for payments under a 
                        State plan approved under this title; and
                            ``(ii) is determined by the State agency to 
                        be capable of making determinations of the type 
                        described in paragraph (1)(A).
                    ``(B) Rule of construction.--Nothing in this 
                paragraph shall be construed as preventing a State from 
                limiting the classes of entities that may become 
                qualified entities.
    ``(c) Administration.--
            ``(1) In general.--The State agency shall provide qualified 
        entities with--
                    ``(A) such forms as are necessary for an 
                application to be made by an individual described in 
                subsection (a) for medical assistance under the State 
                plan; and
                    ``(B) information on how to assist such individuals 
                in completing and filing such forms.
            ``(2) Notification requirements.--A qualified entity that 
        determines under subsection (b)(1)(A) that an individual 
        described in subsection (a) is presumptively eligible for 
        medical assistance under a State plan shall--
                    ``(A) notify the State agency of the determination 
                within 5 working days after the date on which 
                determination is made; and
                    ``(B) inform such individual at the time the 
                determination is made that an application for medical 
                assistance is required to be made by not later than the 
                last day of the month following the month during which 
                the determination is made.
            ``(3) Application for medical assistance.--In the case of 
        an individual described in subsection (a) who is determined by 
        a qualified entity to be presumptively eligible for medical 
        assistance under a State plan, the individual shall apply for 
        medical assistance by not later than the last day of the month 
        following the month during which the determination is made.
    ``(d) Payment.--Notwithstanding any other provision of this title, 
medical assistance that--
            ``(1) is furnished to an individual described in subsection 
        (a)--
                    ``(A) during a presumptive eligibility period;
                    ``(B) by a entity that is eligible for payments 
                under the State plan; and
            ``(2) is included in the care and services covered by the 
        State plan, shall be treated as medical assistance provided by 
        such plan for purposes of clause (4) of the first sentence of 
        section 1905(b).''.
            (2) Conforming amendments.--
                    (A) Section 1902(a)(47) of the Social Security Act 
                (42 U.S.C. 1396a(a)(47)) is amended by inserting before 
                the semicolon at the end the following: ``and provide 
                for making medical assistance available to individuals 
                described in subsection (a) of section 1920C during a 
                presumptive eligibility period in accordance with such 
                section.''.
                    (B) Section 1903(u)(1)(D)(v) of such Act (42 U.S.C. 
                1396b(u)(1)(D)(v)) is amended--
                            (i) by striking ``or for'' and inserting 
                        ``, for''; and
                            (ii) by inserting before the period the 
                        following: ``, or for medical assistance 
                        provided to an individual described in 
                        subsection (a) of section 1920C during a 
                        presumptive eligibility period under such 
                        section''.

SEC. 704. EFFECTIVE DATE.

    (a) In General.--Except as provided in paragraph (2), the 
amendments made by this title take effect on October 1, 2009.
    (b) Extension of Effective Date for State Law Amendment.--In the 
case of a State plan under title XIX of the Social Security Act (42 
U.S.C. 1396 et seq.) which the Secretary of Health and Human Services 
determines requires State legislation in order for the plan to meet the 
additional requirements imposed by the amendments made by this title, 
the State plan shall not be regarded as failing to comply with the 
requirements of such title solely on the basis of its failure to meet 
these additional requirements before the first day of the first 
calendar quarter beginning after the close of the first regular session 
of the State legislature that begins after the date of the enactment of 
this Act. For purposes of the previous sentence, in the case of a State 
that has a 2-year legislative session, each year of the session is 
considered to be a separate regular session of the State legislature.

            TITLE VIII--RESPONSIBLE EDUCATION ABOUT LIFE ACT

SEC. 801. SHORT TITLE.

    This title may be cited as the ``Responsible Education About Life 
Act of 2009''.

SEC. 802. ASSISTANCE TO REDUCE TEEN PREGNANCY, HIV/AIDS, AND OTHER 
              SEXUALLY TRANSMITTED DISEASES AND TO SUPPORT HEALTHY 
              ADOLESCENT DEVELOPMENT.

    (a) In General.--Each eligible State shall be eligible to receive 
from the Secretary of Health and Human Services, for each of the fiscal 
years 2010 through 2014, a grant to conduct programs of family life 
education, including education on both abstinence and contraception for 
the prevention of teenage pregnancy and sexually transmitted diseases, 
including HIV/AIDS.
    (b) Requirements for Family Life Programs.--For purposes of this 
title, a program of family life education is a program that--
            (1) is age-appropriate and medically accurate;
            (2) does not teach or promote religion;
            (3) teaches that abstinence is the only sure way to avoid 
        pregnancy or sexually transmitted diseases;
            (4) stresses the value of abstinence while not ignoring 
        those young people who have had or are having sexual 
        intercourse;
            (5) provides information about the health benefits and side 
        effects of all contraceptives and barrier methods as a means to 
        prevent pregnancy and reduce the risk of contracting sexually 
        transmitted diseases, including HIV/AIDS;
            (6) encourages family communication between parent and 
        child about sexuality;
            (7) teaches young people the skills to make responsible 
        decisions about sexuality, including how to avoid unwanted 
        verbal, physical, and sexual advances; and
            (8) teaches young people how alcohol and drug use can 
        effect responsible decision making.
    (c) Additional Activities.--In carrying out a program of family 
life education, a State may expend a grant under subsection (a) to 
carry out educational and motivational activities that help young 
people--
            (1) gain knowledge about the physical, emotional, 
        biological, and hormonal changes of adolescence and subsequent 
        stages of human maturation;
            (2) develop the knowledge and skills necessary to ensure 
        and protect their sexual and reproductive health from 
        unintended pregnancy and sexually transmitted disease, 
        including HIV/AIDS throughout their lifespan;
            (3) gain knowledge about the specific involvement and 
        responsibility of males in sexual decision making;
            (4) develop healthy attitudes and values about adolescent 
        growth and development, body image, racial and ethnic 
        diversity, and other related subjects;
            (5) develop and practice healthy life skills, including 
        goal-setting, decisionmaking, negotiation, communication, and 
        stress management;
            (6) develop healthy relationships, including the prevention 
        of dating and relationship violence;
            (7) promote self-esteem and positive interpersonal skills 
        focusing on relationship dynamics, including friendships, 
        dating, romantic involvement, marriage and family interactions; 
        and
            (8) prepare for the adult world by focusing on educational 
        and career success, including developing skills for employment 
        preparation, job seeking, independent living, financial self-
        sufficiency, and workplace productivity.

SEC. 803. SENSE OF CONGRESS.

    It is the sense of Congress that while States are not required 
under this title to provide matching funds, with respect to grants 
authorized under section 802(a), they are encouraged to do so.

SEC. 804. EVALUATION OF PROGRAMS.

    (a) In General.--For the purpose of evaluating the effectiveness of 
programs of family life education carried out with a grant under 
section 802, evaluations of such program shall be carried out in 
accordance with subsections (b) and (c).
    (b) National Evaluation.--
            (1) In general.--The Secretary shall provide for a national 
        evaluation of a representative sample of programs of family 
        life education carried out with grants under section 802. A 
        condition for the receipt of such a grant is that the State 
        involved agree to cooperate with the evaluation. The purposes 
        of the national evaluation shall be the determination of--
                    (A) the effectiveness of such programs in helping 
                to delay the initiation of sexual intercourse and other 
                high-risk behaviors;
                    (B) the effectiveness of such programs in 
                preventing adolescent pregnancy;
                    (C) the effectiveness of such programs in 
                preventing sexually transmitted disease, including HIV/
                AIDS;
                    (D) the effectiveness of such programs in 
                increasing contraceptive knowledge and contraceptive 
                behaviors when sexual intercourse occurs; and
                    (E) a list of best practices based upon essential 
                programmatic components of evaluated programs that have 
                led to success in subparagraphs (A) through (D).
            (2) Report.--A final report providing the results of the 
        national evaluation under paragraph (1) shall be submitted to 
        Congress not later than March 31, 2015, with an interim report 
        provided on an annual basis at the end of each fiscal year 
        under section 802(a).
    (c) Individual State Evaluations.--
            (1) In general.--A condition for the receipt of a grant 
        under section 802 is that the State involved agree to provide 
        for the evaluation of the programs of family education carried 
        out with the grant in accordance with the following:
                    (A) The evaluation will be conducted by an 
                external, independent entity.
                    (B) The purposes of the evaluation will be the 
                determination of--
                            (i) the effectiveness of such programs in 
                        helping to delay the initiation of sexual 
                        intercourse and other high-risk behaviors;
                            (ii) the effectiveness of such programs in 
                        preventing adolescent pregnancy;
                            (iii) the effectiveness of such programs in 
                        preventing sexually transmitted disease, 
                        including HIV/AIDS; and
                            (iv) the effectiveness of such programs in 
                        increasing contraceptive knowledge and 
                        contraceptive behaviors when sexual intercourse 
                        occurs.
            (2) Use of grant.--A condition for the receipt of a grant 
        under section 802 is that the State involved agree that not 
        more than 10 percent of the grant will be expended for the 
        evaluation under paragraph (1).

SEC. 805. DEFINITIONS.

    For purposes of this title:
            (1) The term ``eligible State'' means a State that submits 
        to the Secretary an application for a grant under section 802 
        that is in such form, is made in such manner, and contains such 
        agreements, assurances, and information as the Secretary 
        determines to be necessary to carry out this title.
            (2) The term ``HIV/AIDS'' means the human immunodeficiency 
        virus, and includes acquired immune deficiency syndrome.
            (3) The term ``medically accurate'', with respect to 
        information, means information that is supported by research, 
        recognized as accurate and objective by leading medical, 
        psychological, psychiatric, and public health organizations and 
        agencies, and where relevant, published in peer review 
        journals.
            (4) The term ``Secretary'' means the Secretary of Health 
        and Human Services.

SEC. 806. APPROPRIATIONS.

    (a) In General.--For the purpose of carrying out this title, there 
are authorized to be appropriated such sums as may be necessary for 
each of the fiscal years 2010 through 2014.
    (b) Allocations.--Of the amounts appropriated under subsection (a) 
for a fiscal year--
            (1) not more than 7 percent may be used for the 
        administrative expenses of the Secretary in carrying out this 
        title for that fiscal year; and
            (2) not more than 10 percent may be used for the national 
        evaluation under section 804(b).

             TITLE IX--PREVENTION THROUGH AFFORDABLE ACCESS

SEC. 901. SHORT TITLE.

    This title may be cited as the ``Prevention Through Affordable 
Access Act''.

SEC. 902. RESTORING AND PROTECTING ACCESS TO DISCOUNT DRUG PRICES FOR 
              UNIVERSITY-BASED AND SAFETY-NET CLINICS.

    (a) Restoring Nominal Pricing.--Section 1927(c)(1)(D)(i) of the 
Social Security Act (42 U.S.C. 1396r-8(c)(1)(D)(i)) is amended--
            (1) by redesignating subclause (IV) as subclause (VI); and
            (2) by inserting after subclause (III) the following new 
        subclauses:
                                    ``(IV) An entity that is operated 
                                by a health center of an institution of 
                                higher education, the primary purpose 
                                of which is to provide health services 
                                to students of that institution.
                                    ``(V) An entity that is a public or 
                                private nonprofit entity that provides 
                                a service or services described under 
                                section 1001(a) of the Public Health 
                                Service Act.''.
    (b) Effective Date.--The amendments made by this section shall be 
effective as of the date of the enactment of this Act.
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