[Congressional Record Volume 167, Number 201 (Thursday, November 18, 2021)]
[Senate]
[Pages S8459-S8460]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  SA 4787. Mrs. SHAHEEN (for herself and Ms. Collins) submitted an 
amendment intended to be proposed to amendment SA 3867 submitted by Mr. 
Reed and intended to be proposed to the bill H.R. 4350, to authorize 
appropriations for fiscal year 2022 for military activities of the 
Department of Defense, for military construction, and for defense 
activities of the Department of Energy, to prescribe military personnel 
strengths for such fiscal year, and for other purposes; which was 
ordered to lie on the table; as follows:

        At the end of title VII, add the following:

                  Subtitle D--Access to Contraception

     SEC. 761. SHORT TITLE.

       This subtitle may be cited as the ``Access to Contraception 
     for Servicemembers and Dependents Act of 2021''.

     SEC. 762. FINDINGS.

       Congress finds the following:
       (1) Women are serving in the Armed Forces at increasing 
     rates, playing a critical role in the national security of 
     the United States. Women comprise more than 18 percent of 
     members of the Armed Forces, and as of fiscal year 2019, more 
     than 390,000 women serve on active duty in the Armed Forces 
     or in the reserve components. An estimated several thousand 
     transgender men also serve on active duty in the Armed Forces 
     and in the reserve components, in addition to non-binary 
     members and those who identify with a different gender.
       (2) Ninety-five percent of women serving in the Armed 
     Forces are of reproductive age and as of 2019, more than 
     700,000 female spouses and dependents of members of the Armed 
     Forces on active duty are of reproductive age.
       (3) The TRICARE program covered more than 1,570,000 women 
     of reproductive age in 2019, including spouses and dependents 
     of members of the Armed Forces on active duty. Additionally, 
     thousands of transgender dependents of members of the Armed 
     Forces are covered by the TRICARE program.
       (4) The right to access contraception is grounded in the 
     principle that contraception and the ability to determine if 
     and when to have children are inextricably tied to one's 
     wellbeing, equality, and ability to determine the course of 
     one's life. These protections have helped access to 
     contraception become a driving force in improving the health 
     and financial security of individuals and their families.
       (5) Access to contraception is critical to the health of 
     every individual capable of becoming pregnant. This subtitle 
     is intended to apply to all individuals with the capacity for 
     pregnancy, including cisgender women, transgender men, non-
     binary individuals, those who identify with a different 
     gender, and others.
       (6) Studies have shown that when cost barriers to the full 
     range of methods of contraception are eliminated, patients 
     are more likely to use the contraceptive method that meets 
     their needs, and therefore use contraception correctly and 
     more consistently, reducing the risk of unintended pregnancy.
       (7) Under the TRICARE program, members of the Armed Forces 
     on active duty have full coverage of all prescription drugs, 
     including contraception, without cost-sharing requirements, 
     in line with the Patient Protection and Affordable Care Act 
     (Public Law 111-148), which requires coverage of all 
     contraceptive methods approved by the Food and Drug 
     Administration for women and related services and education 
     and counseling. However, members not on active duty and 
     dependents of members do not have similar coverage of all 
     methods of contraception approved by the Food and Drug 
     Administration without cost-sharing when they obtain the 
     contraceptive outside of a military medical treatment 
     facility.
       (8) In order to fill gaps in coverage and access to 
     preventive care critical for women's

[[Page S8460]]

     health, the Patient Protection and Affordable Care Act 
     (Public Law 111-148) requires all non-grandfathered 
     individual and group health plans to cover without cost-
     sharing preventive services, including a set of evidence-
     based preventive services for women supported by the Health 
     Resources and Services Administration of the Department of 
     Health and Human Services. These women's preventive services 
     include the full range of female-controlled contraceptive 
     methods, effective family planning practices, and 
     sterilization procedures, approved by the Food and Drug 
     Administration. The Health Resources and Services 
     Administration has affirmed that contraceptive care includes 
     contraceptive counseling, initiation of contraceptive use, 
     and follow-up care (such as management, evaluation, and 
     changes to and removal or discontinuation of the 
     contraceptive method).
       (9) The Defense Advisory Committee on Women in the Services 
     has recommended that all the Armed Forces, to the extent that 
     they have not already, implement initiatives that inform 
     members of the Armed Forces of the importance of family 
     planning, educate them on methods of contraception, and make 
     various methods of contraception available, based on the 
     finding that family planning can increase the overall 
     readiness and quality of life of all members of the Armed 
     Forces.
       (10) The military departments received more than 7,800 
     reports of sexual assaults involving members of the Armed 
     Forces as victims or subjects during fiscal year 2019. 
     Through regulations, the Department of Defense already 
     supports a policy of ensuring that members of the Armed 
     Forces who are sexually assaulted have access to emergency 
     contraception, and the initiation of contraception if desired 
     and medically appropriate.

     SEC. 763. CONTRACEPTION COVERAGE PARITY UNDER THE TRICARE 
                   PROGRAM.

       (a) Pharmacy Benefits Program.--Section 1074g(a)(6) of 
     title 10, United States Code, is amended by adding at the end 
     the following new subparagraph:
       ``(D) Notwithstanding subparagraphs (A), (B), and (C), 
     cost-sharing requirements may not be imposed and cost-sharing 
     amounts may not be collected with respect to any eligible 
     covered beneficiary for any prescription contraceptive on the 
     uniform formulary provided through a retail pharmacy 
     described in paragraph (2)(E)(ii) or through the national 
     mail-order pharmacy program.''.
       (b) TRICARE Select.--Section 1075 of such title is 
     amended--
       (1) in subsection (c), by adding at the end the following 
     new paragraph:
       ``(4)(A) Notwithstanding any other provision of this 
     section, cost-sharing requirements may not be imposed and 
     cost-sharing amounts may not be collected with respect to any 
     beneficiary under this section for a service described in 
     subparagraph (B) that is provided by a network provider.
       ``(B) A service described in this subparagraph is any 
     method of contraception approved by the Food and Drug 
     Administration, any contraceptive care (including with 
     respect to insertion, removal, and follow up), any 
     sterilization procedure, or any patient education or 
     counseling service provided in connection with any such 
     method, care, or procedure.''; and
       (2) in subsection (f), by striking ``calculated as'' and 
     inserting ``calculated (except as provided in subsection 
     (c)(4)) as''.
       (c) TRICARE Prime.--Section 1075a of such title is amended 
     by adding at the end the following new subsection:
       ``(d) Prohibition on Cost-Sharing for Certain Services.--
     (1) Notwithstanding subsections (a), (b), and (c), cost-
     sharing requirements may not be imposed and cost-sharing 
     amounts may not be collected with respect to any beneficiary 
     enrolled in TRICARE Prime for a service described in 
     paragraph (2) that is provided under TRICARE Prime.
       ``(2) A service described in this paragraph is any method 
     of contraception approved by the Food and Drug 
     Administration, any contraceptive care (including with 
     respect to insertion, removal, and follow up), any 
     sterilization procedure, or any patient education or 
     counseling service provided in connection with any such 
     method, care, or procedure.''.

     SEC. 764. PREGNANCY PREVENTION ASSISTANCE AT MILITARY MEDICAL 
                   TREATMENT FACILITIES FOR SEXUAL ASSAULT 
                   SURVIVORS.

       (a) In General.--Chapter 55 of title 10, United States 
     Code, is amended by inserting after section 1074o the 
     following new section:

     ``Sec. 1074p. Provision of pregnancy prevention assistance at 
       military medical treatment facilities

       ``(a) Information and Assistance.--The Secretary of Defense 
     shall promptly furnish to sexual assault survivors at each 
     military medical treatment facility the following:
       ``(1) Comprehensive, medically and factually accurate, and 
     unbiased written and oral information about all methods of 
     emergency contraception approved by the Food and Drug 
     Administration.
       ``(2) Upon request by the sexual assault survivor, 
     emergency contraception or, if applicable, a prescription for 
     emergency contraception.
       ``(3) Notification of the right of the sexual assault 
     survivor to confidentiality with respect to the information 
     and care and services furnished under this section.
       ``(b) Information.--The Secretary shall ensure that 
     information provided pursuant to subsection (a) is provided 
     in language that--
       ``(1) is clear and concise;
       ``(2) is readily comprehensible; and
       ``(3) meets such conditions (including conditions regarding 
     the provision of information in languages other than English) 
     as the Secretary may prescribe in regulations to carry out 
     this section.
       ``(c) Definitions.--In this section:
       ``(1) The term `sexual assault survivor' means any 
     individual who presents at a military medical treatment 
     facility and--
       ``(A) states to personnel of the facility that the 
     individual experienced a sexual assault;
       ``(B) is accompanied by another person who states that the 
     individual experienced a sexual assault; or
       ``(C) whom the personnel of the facility reasonably 
     believes to be a survivor of sexual assault.
       ``(2) The term `sexual assault' means the conduct described 
     in section 1565b(c) of this title that may result in 
     pregnancy.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of such chapter is amended by inserting after the 
     item relating to section 1074o the following new item:

``1074p. Provision of pregnancy prevention assistance at military 
              medical treatment facilities.''.

     SEC. 765. EDUCATION ON FAMILY PLANNING FOR MEMBERS OF THE 
                   ARMED FORCES.

       (a) Education Programs.--
       (1) In general.--Not later than one year after the date of 
     the enactment of this Act, the Secretary of Defense shall 
     establish a uniform standard curriculum to be used in 
     education programs on family planning for all members of the 
     Armed Forces, including both men and women members.
       (2) Timing.--Education programs under paragraph (1) shall 
     be provided to members of the Armed Forces as follows:
       (A) During the first year of service of the member.
       (B) At such other times as each Secretary of a military 
     department determines appropriate with respect to members of 
     the Armed Forces under the jurisdiction of such Secretary.
       (3) Sense of congress.--It is the sense of Congress that 
     the education programs under paragraph (1) should be 
     evidence-informed and use the latest technology available to 
     efficiently and effectively deliver information to members of 
     the Armed Forces.
       (b) Elements.--The uniform standard curriculum for 
     education programs under subsection (a) shall include the 
     following:
       (1) Information for members of the Armed Forces on active 
     duty to make informed decisions regarding family planning.
       (2) Information about the prevention of unintended 
     pregnancy and sexually transmitted infections, including 
     human immunodeficiency virus (commonly known as ``HIV'').
       (3) Information on--
       (A) the importance of providing comprehensive family 
     planning for members of the Armed Forces, including 
     commanding officers; and
       (B) the positive impact family planning can have on the 
     health and readiness of the Armed Forces.
       (4) Current, medically accurate information.
       (5) Clear, user-friendly information on--
       (A) the full range of methods of contraception approved by 
     the Food and Drug Administration; and
       (B) where members of the Armed Forces can access their 
     chosen method of contraception.
       (6) Information on all applicable laws and policies so that 
     members of the Armed Forces are informed of their rights and 
     obligations.
       (7) Information on the rights of patients to 
     confidentiality.
       (8) Information on the unique circumstances encountered by 
     members of the Armed Forces and the effects of such 
     circumstances on the use of contraception.
                                 ______