[Congressional Record Volume 155, Number 8 (Wednesday, January 14, 2009)]
[Extensions of Remarks]
[Pages E86-E87]
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

                      Wednesday, January 14, 2009

  Ms. SLAUGHTER. Madam Speaker, today, I am again proud to introduce 
the Prevention First Act. I first introduced this legislation in the 
108th Congress as an innovative approach to reducing unintended 
pregnancies. The Prevention First Act achieves this goal by providing 
comprehensive access to all forms of contraception and sex education.
  If we want to reduce the number of abortions in this country, the 
methodology is clear--empower women to prevent unintended pregnancies 
through education and access to contraception. And, that is precisely 
what the Prevention First Act does.
  Throughout the years, our conservative leaders have sought to limit 
women's rights and freedoms by imposing stricter penalties and enacting 
laws to criminalize doctors and women, when one is faced with an 
unintended pregnancy. Yet, these leaders have done very little to 
ensure that millions of unintended pregnancies and sexually transmitted 
diseases, STD, are prevented in the first place. If they are opposed to 
abortion, they should be for preventing unintended pregnancies and they 
should be for this bill.
  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.
  It has been more than 40 years since the Supreme Court said women 
could access contraception. This decision was revolutionary in that it 
allowed women to control when to get pregnant and how many children to 
have. Access to contraception single-handedly improved women's equality 
in American society.

[[Page E87]]

  That is why for most women, including women who want to have 
children, contraception is not an option; it is a basic health care 
necessity. Contraceptive use saves 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.
  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 percent 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. Each year, publicly funded family planning services help women 
to prevent an estimated 1 million unplanned pregnancies and 630,000 
abortions. Yet these programs are 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.
  Improved access to emergency contraception, EC, can further reduce 
the staggering rates of unintended pregnancy and abortion in this 
country. 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.
  Contraceptives have a proven track record of enhancing the health of 
women and children, preventing unintended pregnancy, and reducing the 
need for abortion. However far too many insurance policies exclude this 
vital coverage. While most employment-related insurance policies in the 
United States cover prescription drugs in general, the 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 do not have any laws. 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. The 
Prevention First Act requires that private health plans cover FDA-
approved prescription contraceptives and related medical services.
  Teens face additional barriers regarding access to services and 
information. Sixty percent of teens have sex before graduating high 
school. Teens 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. Furthermore, 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 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, my 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.
  Reducing unintended pregnancy and infection with STDs are important 
public health goals. 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 all women in need and will go a long way in fulfilling the promise 
of this important public health achievement.
  Madam Speaker, I urge every Member to join me in this comprehensive, 
nationwide effort to reduce unintended pregnancies.

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