[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.
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