[Congressional Record Volume 170, Number 115 (Thursday, July 11, 2024)]
[Senate]
[Pages S4807-S4808]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  SA 2485. Mr. RUBIO (for himself and Mr. Braun) submitted an amendment 
intended to be proposed by him to the bill S. 4638, to authorize 
appropriations for fiscal year 2025 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 subtitle C of title VII, add the following:

     SEC. 727. IMPROVING ACCESS TO MATERNAL HEALTH FOR MILITARY 
                   AND DEPENDENT MOMS ACT OF 2024.

       (a) Short Title.--This section may be cited as the 
     ``Improving Access to Maternal Health for Military and 
     Dependent Moms Act of 2024''.
       (b) Definitions.--In this section:
       (1) Covered individual.--The term ``covered individual'' 
     means--
       (A) a covered beneficiary; or
       (B) a dependent.
       (2) Covered beneficiary; dependent; tricare program.--The 
     terms ``covered beneficiary'', ``dependent'', and ``TRICARE 
     program'' have the meanings given those terms in section 1072 
     of title 10, United States Code.
       (3) Maternal health.--The term ``maternal health'' means 
     care during labor, birthing, prenatal care, and postpartum 
     care.
       (4) Maternity care desert.-- The term ``maternity care 
     desert'' means a county in the United States that does not 
     have--
       (A) a hospital or birth center offering obstetric care; or
       (B) an obstetric provider.
       (5) Prenatal care.--The term ``prenatal care'' means 
     medical care provided to maintain and improve fetal and 
     maternal health during pregnancy.
       (6) Secretary.--The term ``Secretary'' means the Secretary 
     of Defense.
       (c) Report on Access to Maternal Health Care Within the 
     Military Health System.--
       (1) In general.--Not later than 2 years after the date of 
     the enactment of this Act, the Secretary shall submit to the 
     Committee on Armed Services and the Committee on 
     Appropriations of the Senate and the Committee on Armed 
     Services and the Committee on Appropriations of the House of 
     Representatives a report on access to maternal health care 
     within the military health system for covered individuals, 
     during the preceding 2 year period.
       (2) Contents.--The report required under paragraph (1) 
     shall include the following:
       (A) With respect to military medical treatment facilities:
       (i) An analysis of the availability of maternal health care 
     for covered individuals who access the military health system 
     through such facilities.
       (ii) An identification of staffing shortages in positions 
     relating to maternal health and childbirth, including 
     obstetrician-gynecologists, certified nurse midwives, and 
     labor and delivery nurses.
       (iii) A description of specific challenges faced by covered 
     individuals in accessing maternal health care at such 
     facilities.
       (iv) An analysis of the timeliness of access to maternal 
     health care, including wait times for and travel times to 
     appointments.
       (v) A description of how such facilities track patient 
     satisfaction with maternal health services.
       (vi) A process to establish continuity of prenatal care and 
     postpartum care for covered individuals who experience a 
     permanent change of station during a pregnancy.
       (vii) An identification of barriers with regard to 
     continuity of prenatal care and postpartum care during 
     permanent changes of station.
       (viii) A description of military-specific health challenges 
     impacting covered individuals who receive maternal healthcare 
     at military medical treatment facilities, and a description 
     of how the Department tracks such challenges.
       (ix) For the 10-year period preceding the date of the 
     submission of the report, the amount of funds annually 
     expended--

       (I) by the Department of Defense on maternal health care; 
     and
       (II) by covered individuals on out-of-pocket costs 
     associated with maternal health care.

       (x) An identification of each medical facility of the 
     Department of Defense located in a maternity care desert.
       (xi) Recommendations and legislative proposals--

       (I) to address staffing shortages that impact the positions 
     described in clause (ii);
       (II) to improve the delivery and availability of maternal 
     health services through military medical treatment facilities 
     and improve patient experience; and
       (III) to improve continuity of prenatal care and postpartum 
     care for covered individuals during a permanent change of 
     station.

       (B) With respect to providers within the TRICARE program 
     network that are not located at or affiliated with a military 
     medical treatment facility:
       (i) An analysis of the availability of maternal health care 
     for covered individuals who access the military health system 
     through such providers.
       (ii) An identification of staffing shortages for such 
     providers in positions relating to

[[Page S4808]]

     maternal health and childbirth, including obstetrician-
     gynecologists, certified nurse midwives, and labor and 
     delivery nurses.
       (iii) A description of specific challenges faced by covered 
     individuals in accessing maternal health care from such 
     providers.
       (iv) An analysis of the timeliness of access to maternal 
     health care, including wait times for and travel times to 
     appointments.
       (v) A description of how such providers track patient 
     satisfaction with maternal health services.
       (vi) A process to establish continuity of prenatal care and 
     postpartum care for covered individuals who experience a 
     permanent change of station during a pregnancy.
       (vii) An identification of barriers with regard to 
     continuity of prenatal care and postpartum care during 
     permanent changes of station.
       (viii) The number of dependents who choose to access 
     maternal health care through such providers.
       (ix) For the 10-year period preceding the date of the 
     submission of the report, the amount of funds annually 
     expended--

       (I) by the Department of Defense on maternal health care; 
     and
       (II) by covered individuals on out-of-pocket costs 
     associated with maternal health care.

       (x) Recommendations and legislative proposals--

       (I) to address staffing shortages that impact the positions 
     described in clause (ii);
       (II) to improve the delivery and availability of maternal 
     health services through the TRICARE program and improve 
     patient experience;
       (III) to improve continuity of prenatal care and postpartum 
     care for covered individuals during a permanent change of 
     station; and
       (IV) to improve the ability of contractors under the 
     TRICARE program to build a larger network of providers for 
     maternal health, including obstetrician-gynecologists, 
     certified nurse midwives, and labor and delivery nurses.

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