[Congressional Record Volume 153, Number 21 (Monday, February 5, 2007)]
[Extensions of Remarks]
[Pages E259-E260]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                        THE PREVENTION FIRST ACT

                                 ______
                                 

                     HON. LOUISE McINTOSH SLAUGHTER

                              of new york

                    in the house of representatives

                        Monday, February 5, 2007

  Ms. SLAUGHTER. Madam Speaker, today, I am again proud to introduce 
the Prevention First Act. By emphasizing prevention first, my bill will 
help protect women's reproductive health, reduce unintended 
pregnancies, decrease the spread of STDs, and give women the tools they 
need to make the best decisions possible for themselves. The Prevention 
First Act will help to achieve these goals by providing comprehensive 
access to all forms of contraception and sex education.
  Throughout the years, conservative leaders have sought to limit 
women's rights and freedoms by imposing stricter penalties on doctors 
who help women faced with an unintended pregnancy. At the same time, 
these leaders have done very little to ensure that millions of 
unintended pregnancies and sexually transmitted diseases (STDs) are 
prevented in the first place. If they are opposed to abortion, if they 
support women's health, and if they believe that the right to choose 
when to start a family should apply to all women, no matter their 
economic or social situation, then they should be in favor of this 
bill.
  It has been more than 40 years since the Supreme Court said women had 
the right to access contraception. This decision was revolutionary, for 
the first time allowing women to choose when to become pregnant and how 
many children to have. Access to contraception greatly enhanced women's 
equality in American Society.
  It also helps to ameliorate economic disparities among women. The 
social and economic realities surrounding contraception could not be 
starker. Many poor and low-income women cannot afford to purchase 
contraceptive services and supplies on their own. About 1 in 5 women of 
reproductive age were uninsured in 2003, and that proportion has 
increased by 10% since 2001. Half of all women who are sexually active, 
but do not want to get pregnant, need publicly funded services to help 
them access public health programs like Medicaid and Title X, the 
national family planning program. These programs provide high-quality 
family planning services and other preventive health care, such as pap 
smears, to underinsured or uninsured individuals who may otherwise lack 
access to health care and alternative options for birth control. What's 
more, each year, publicly funded family planning services help women to 
prevent an estimated one million unplanned pregnancies and 630,000 
abortions. Despite the obvious benefits they bring, these programs are 
currently struggling to meet the growing demand for subsidized family 
planning services without corresponding increases in funding. The 
Prevention First Act authorizes funding for Title X clinics and 
strengthens states' coverage of Medicaid family planning services.

  Contraception is, of course, more than a means of fighting economic 
inequalities. It also provides a way to save scarce public health 
dollars. For every $1 spent on providing family planning services, an 
estimated $3.80 is saved in Medicaid expenditures for pregnancy-related 
and newborn care.
  And what's more, improved access to emergency contraception (EC) has 
been proven to significantly reduce the staggering rates of unintended 
pregnancy and, as a result, abortion. EC prevents pregnancy after 
unprotected sex or a contraceptive failure. The Alan Guttmacher 
Institute estimates that increased use of EC accounted for up to 43 
percent of the total decline in abortion rates between 1994 and 2000. 
In addition, EC is often the only contraceptive option for the 300,000 
women who are reported to be raped each year. Unfortunately, even with 
the recent FDA decision to allow EC to be sold over-the-counter to 
women 18 years of age and over, many women do not know about EC and 
many still face insurmountable barriers in accessing this important 
product. The Prevention First Act mandates that the Secretary of Health 
and Human Services implement an education campaign about EC and 
requires that hospitals receiving federal funds provide victims of 
sexual assault with information and access to EC.
  Despite the fact that contraceptives have a proven track record of 
enhancing the health of women and children, preventing unintended 
pregnancy, and reducing the need for abortion, far too many insurance 
policies do not cover them. While most employment-related insurance 
policies in the United States cover prescription drugs in general, many 
do not include equitable coverage for prescription contraceptive drugs 
and devices. Although 21 states now have laws in place requiring 
insurers to provide contraceptive coverage if they cover other 
prescription drugs, 29 states still have no corresponding law on the 
books. Out of pocket expenses for contraception can be costly. Women of 
reproductive age currently spend 68 percent more in out-of-pocket 
health care costs than men, much of which is due to reproductive 
health-related supplies and services.

[[Page E260]]

  The Prevention First Act requires that private health plans to cover 
FDA-approved prescription contraceptives and related medical services.
  Madam Speaker, it is critical in any discussion of reproductive 
rights to devote time to teenagers, who face the consequences of so 
many of these issues more acutely than other age groups. Teens face 
additional barriers regarding access to services and information. Sixty 
percent of teens have sex before graduating high school. Those who 
receive comprehensive sexuality 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. Efforts 
by conservatives to restrict access to family planning services and 
promote abstinence-only education programs--which are prohibited from 
discussing the benefits of contraception--actually jeopardize 
adolescent health and run counter to the views of many mainstream 
medical groups.
  Nearly 50 percent of new cases of STDs occur among people ages 15 to 
24, even though this age bracket makes up just a quarter of the 
sexually active population. Clearly, teens have the most to lose when 
faced with an unintended pregnancy or an STD infection.
  Moreover, 1 in 3 girls becomes pregnant before the age of 20, and 80 
percent of these pregnancies are unintended. Teen mothers are less 
likely to complete high school. Children of teenage mothers have lower 
birth weights, are more likely to perform poorly in school, and are at 
greater risk of abuse and neglect. Improving access to contraceptive 
services and information does not cause non-sexually active teens to 
start having sex. Instead, teens need information to help them both 
postpone sexual activity and to protect themselves if they do become 
sexually active. 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.
  The Prevention First Act provides funding to public and private 
entities to establish or expand their teenage pregnancy prevention 
programs. This bill also provides for comprehensive, medically accurate 
sex education programs that teach young people about abstinence, 
health, and contraceptives. Moreover, this bill requires federally 
funded programs that provide information on the use of contraceptives 
to ensure that the information is medically accurate and includes 
health benefits and failure rates.
  Madam Speaker, virtually everyone can agree that reducing unintended 
pregnancies, lowering STD infection rates, and promoting the health of 
all women and their children, regardless of their economic or social 
situation, are important public health goals. It should come as no 
surprise that the Centers for Disease Control and Prevention included 
family planning in their published list of the ``Ten Great Public 
Health Achievements in the 20th Century.'' My bill, the Prevention 
First Act, will improve access to family planning services for women in 
need throughout America, and will go a long way toward fulfilling the 
promise of this important public health achievement.
  Madam Speaker, I urge every Member to stand with the women of our 
country and to support this important bill.

                          ____________________