[Congressional Record Volume 149, Number 117 (Friday, August 1, 2003)]
[Senate]
[Pages S10914-S10915]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. CORZINE (for himself, Mr. Kerry, Mrs. Murray, Mr. Durbin, 
        Mr. Lautenberg, and Ms. Cantwell):
  S. 1564. A bill to provide for the provision by hospitals of 
emergency contraceptives to women who are survivors of sexual assault; 
to the Committee on Health, Education, Labor, and Pensions.
  Mr. CORZINE. Mr. President, every two minutes a woman is sexually 
assaulted in the United States, and an estimated 25,000 annually will 
become pregnant as a result of rape. Though there is widespread 
consensus in the medical community that emergency contraception is a 
safe and effective means of preventing pregnancy after unprotected 
intercourse, studies indicate that many hospitals still do not provide 
emergency contraception to rape survivors. That is why today, along 
with my colleagues Senators Kerry, Murray, Durbin, Lautenberg, and 
Cantwell, I am introducing the Compassionate Assistance in Rape 
Emergencies Act, or CARE Act, which will ensure that women who are 
survivors of sexual assault have access to and information about 
emergency contraception regardless of where they receive medical care.
  Emergency Contraceptive Pills (ECPs) are the most commonly used 
method of emergency contraception. ECPs are birth control pills taken 
in larger doses that can reduce a woman's risk of becoming pregnant by 
up to 95 percent when taken within 72 hours of unprotected intercourse. 
I want to be clear that emergency contraception does not cause 
abortion. Instead, emergency contraception works by inhibiting 
ovulation or fertilization, or by preventing the implantation of a 
fertilized egg before a pregnancy can occur.
  Despite the documented benefits of emergency contraception, many 
hospitals neglect their responsibility to offer emergency contraception 
to sexual assault survivors. For example, a survey of emergency rooms 
in New York State found that 54 percent did not consistently provide 
emergency contraception to women who had been raped. In Pennsylvania, 
only 28 percent of hospitals routinely offer and provide emergency 
contraception to sexual assault survivors.
  In short, survivors of sexual assault are not consistently getting 
access to all the treatment options available to them to prevent an 
unwanted pregnancy. I believe it is unacceptable that a rape victim's 
access to standard care depends on the hospital to which she is taken. 
All healthcare institutions that counsel or treat women who have been 
raped should consistently inform, provide or meaningfully refer women 
for emergency contraception. Indeed, the emergency care standards of 
the American Medical Association recommend that rape survivors seeking 
medical care be counseled about their risk of pregnancy and offered 
emergency contraception.
  The legislation, which is identical to legislation recently 
introduced in the House of Representatives by Representatives James 
Greenwood and Steven Rothman, would require hospitals that receive 
federal funds to offer information about and access to emergency 
contraception for victims of rape. This commonsense legislation will 
help ensure that women who have survived a heinous sexual attack will 
have access to comprehensive and compassionate emergency medical care.
  We must not sit idly by while so many sexual assault victims are not 
given the opportunity to safely and effectively prevent a pregnancy 
caused by their assault. I ask my colleagues to join me in support of 
this effort to help sexual assault victims across the country receive 
the medical care they need and deserve.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1564

       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''.

     SEC. 2. FINDINGS.

       Congress makes the following findings:
       (1) It is estimated that 25,000 to 32,000 women become 
     pregnant each year as a result of rape or incest. An 
     estimated 22,000 of these pregnancies could be prevented if 
     rape survivors had timely access to emergency contraception.
       (2) A 1996 study of rape-related pregnancies (published in 
     the American Journal of Obstetrics and Gynecology) found that 
     50 percent of the pregnancies described in paragraph (1) 
     ended in abortion.
       (3) Surveys have shown that many hospitals do not routinely 
     provide emergency contraception to women seeking treatment 
     after being sexually assaulted.
       (4) The risk of pregnancy after sexual assault has been 
     estimated to be 4.7 percent in survivors who were not 
     protected by some form of contraception at the time of the 
     attack.
       (5) The Food and Drug Administration has declared emergency 
     contraception to be safe and effective in preventing 
     unintended pregnancy, reducing the risk by as much as 89 
     percent.
       (6) Medical research strongly indicates that the sooner 
     emergency contraception is administered, the greater the 
     likelihood of preventing unintended pregnancy.
       (7) In light of the safety and effectiveness of emergency 
     contraceptive pills, both the American Medical Association 
     and the American College of Obstetricians and Gynecologists 
     have endorsed more widespread availability of such pills.

[[Page S10915]]

       (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) Nine out of ten women of reproductive age remain 
     unaware of emergency contraception. Therefore, women who have 
     been sexually assaulted are unlikely to ask for emergency 
     contraception.
       (10) New data from a survey of women having abortions 
     estimates that 51,000 abortions were prevented by use of 
     emergency contraception in 2000 and that increased use of 
     emergency contraception accounted for 43 percent of the 
     decrease in total abortions between 1994 and 2000.
       (11) It is essential that all hospitals that provide 
     emergency medical treatment provide emergency contraception 
     as a treatment option to any woman who has been sexually 
     assaulted, so that she may prevent an unintended pregnancy.

     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 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 is--
       (A) 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 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.
                                 ______