HR 463 IHCommentsClose CommentsPermalink

To expand access to preventive health care services that help reduce unintended pregnancy, reduce abortions, and improve access to women’s health care.CommentsClose CommentsPermalink

January 13, 2009CommentsClose CommentsPermalink

Ms. SLAUGHTER (for herself, Ms. DEGETTE, Ms. DELAURO, Ms. HARMAN, Ms. LEE of California, Mrs. LOWEY, Mr. ROTHMAN of New Jersey, Mr. WAXMAN, Mr. ABERCROMBIE, Mr. ACKERMAN, Mr. ADLER of New Jersey, Mr. ARCURI, Ms. BALDWIN, Ms. BERKLEY, Mr. BERMAN, Mrs. BIGGERT, Mr. BISHOP of New York, Mr. BISHOP of Georgia, Mr. BLUMENAUER, Mr. BOUCHER, Mr. BRADY of Pennsylvania, Mr. BRALEY of Iowa, Mrs. CAPPS, Mr. CAPUANO, Mr. CARNAHAN, Mr. CHANDLER, Mr. CLAY, Mr. COHEN, Mr. CONNOLLY of Virginia, Mr. CROWLEY, Mrs. DAVIS of California, Mr. DELAHUNT, Mr. DICKS, Mr. ELLISON, Mr. ENGEL, Mr. FARR, Mr. FATTAH, Mr. FILNER, Mr. FRANK of Massachusetts, Ms. GIFFORDS, Mrs. GILLIBRAND, Mr. AL GREEN of Texas, Mr. GENE GREEN of Texas, Mr. GRIJALVA, Mr. HALL of New York, Mr. HARE, Mr. HIGGINS, Mr. HINCHEY, Ms. HIRONO, Mr. HODES, Mr. HOLT, Mr. HONDA, Mr. INSLEE, Mr. ISRAEL, Ms. JACKSON-LEE of Texas, Mr. KENNEDY, Ms. KILROY, Mr. KIND, Mr. KUCINICH, Mr. LANGEVIN, Mr. LARSEN of Washington, Mr. LEVIN, Mr. LOEBSACK, Ms. ZOE LOFGREN of California, Mrs. MALONEY, Ms. MATSUI, Ms. MCCOLLUM, Mr. MCDERMOTT, Mr. MCGOVERN, Mr. MCNERNEY, Mr. MEEKS of New York, Mr. GEORGE MILLER of California, Mr. MITCHELL, Ms. MOORE of Wisconsin, Mr. MOORE of Kansas, Mr. MURPHY of Connecticut, Mr. PATRICK J. MURPHY of Pennsylvania, Mr. NADLER of New York, Mrs. NAPOLITANO, Ms. NORTON, Mr. OLVER, Mr. PAYNE, Mr. PETERS, Ms. PINGREE of Maine, Mr. PRICE of North Carolina, Mr. RANGEL, Ms. ROYBAL-ALLARD, Mr. RUPPERSBERGER, Mr. RUSH, Mr. RYAN of Ohio, Ms. LORETTA SANCHEZ of California, Mr. SARBANES, Ms. SCHAKOWSKY, Mr. SCHIFF, Ms. SCHWARTZ, Mr. SERRANO, Mr. SHERMAN, Mr. SIRES, Mr. STARK, Ms. SUTTON, Mrs. TAUSCHER, Mr. THOMPSON of California, Ms. TSONGAS, Ms. VELAZQUEZ, Ms. WASSERMAN SCHULTZ, Mr. WELCH, Mr. WEXLER, Ms. WOOLSEY, Mr. WU, Mr. YARMUTH, and Mr. VAN HOLLEN) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means and Education and Labor, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concernedCommentsClose CommentsPermalink

To expand access to preventive health care services that help reduce unintended pregnancy, reduce abortions, and improve access to women’s health care.CommentsClose CommentsPermalink

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,CommentsClose CommentsPermalink

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

(a) Short Title- This Act may be cited as the ‘Prevention First Act of 2009’.CommentsClose CommentsPermalink





(b) Table of Contents- The table of contents for this Act is as follows:CommentsClose CommentsPermalink





Sec. 1. Short title; table of contents.CommentsClose CommentsPermalink





Sec. 2. Findings.CommentsClose CommentsPermalink

TITLE I--TITLE X OF PUBLIC HEALTH SERVICE ACT

Sec. 101. Short title.CommentsClose CommentsPermalink





Sec. 102. Authorization of appropriations.CommentsClose CommentsPermalink

TITLE II--EQUITY IN PRESCRIPTION INSURANCE AND CONTRACEPTIVE COVERAGE

Sec. 201. Short title.CommentsClose CommentsPermalink





Sec. 202. Amendments to Employee Retirement Income Security Act of 1974.CommentsClose CommentsPermalink





Sec. 203. Amendments to Public Health Service Act relating to the group market.CommentsClose CommentsPermalink





Sec. 204. Amendment to Public Health Service Act relating to the individual market.CommentsClose CommentsPermalink

TITLE III--EMERGENCY CONTRACEPTION EDUCATION AND INFORMATION

Sec. 301. Short title.CommentsClose CommentsPermalink





Sec. 302. Emergency contraception education and information programs.CommentsClose CommentsPermalink

TITLE IV--COMPASSIONATE ASSISTANCE FOR RAPE EMERGENCIES

Sec. 401. Short title.CommentsClose CommentsPermalink





Sec. 402. Survivors of sexual assault; provision by hospitals of emergency contraceptives without charge.CommentsClose CommentsPermalink

TITLE V--AT-RISK COMMUNITIES TEENAGE PREGNANCY PREVENTION ACT

Sec. 501. Short title.CommentsClose CommentsPermalink





Sec. 502. Teen pregnancy prevention.CommentsClose CommentsPermalink





Sec. 503. Research.CommentsClose CommentsPermalink

TITLE VI--ACCURACY OF CONTRACEPTIVE INFORMATION

Sec. 601. Short title.CommentsClose CommentsPermalink





Sec. 602. Accuracy of contraceptive information.CommentsClose CommentsPermalink

TITLE VII--UNINTENDED PREGNANCY REDUCTION ACT

Sec. 701. Short title.CommentsClose CommentsPermalink





Sec. 702. Medicaid; clarification of coverage of family planning services and supplies.CommentsClose CommentsPermalink





Sec. 703. Expansion of family planning services.CommentsClose CommentsPermalink





Sec. 704. Effective date.CommentsClose CommentsPermalink

TITLE VIII--RESPONSIBLE EDUCATION ABOUT LIFE ACT

Sec. 801. Short title.CommentsClose CommentsPermalink





Sec. 802. Assistance to reduce teen pregnancy, HIV/AIDS, and other sexually transmitted diseases and to support healthy adolescent development.CommentsClose CommentsPermalink





Sec. 803. Sense of Congress.CommentsClose CommentsPermalink





Sec. 804. Evaluation of programs.CommentsClose CommentsPermalink





Sec. 805. Limitations on use of funds.CommentsClose CommentsPermalink





Sec. 806. Definitions.CommentsClose CommentsPermalink





Sec. 807. Authorization of appropriations.CommentsClose CommentsPermalink

SEC. 2. FINDINGS.

The Congress finds as follows:CommentsClose CommentsPermalink





(1) Healthy People 2010 sets forth a reduction of unintended pregnancies as an important health objective for the Nation to achieve over the first decade of the new century, a goal first articulated in the 1979 Surgeon General’s Report, Healthy People, and reiterated in Healthy People 2000: National Health Promotion and Disease Prevention Objectives.CommentsClose CommentsPermalink





(2) Although the Centers for Disease Control and Prevention (referred to in this section as the ‘CDC’) included family planning in its published list of the Ten Great Public Health Achievements in the 20th Century, the United States still has one of the highest rates of unintended pregnancies among industrialized nations.CommentsClose CommentsPermalink





(3) Each year, nearly half of all pregnancies in the United States are unintended, and nearly half of unintended pregnancies end in abortion.CommentsClose CommentsPermalink





(4) In 2006, 36,200,000 women, more than half of all women of reproductive age, were in need of contraceptive services and supplies to help prevent unintended pregnancy, and nearly half of those were in need of public support for such care.CommentsClose CommentsPermalink





(5) The United States has some of the highest rates of sexually transmitted infections (referred to in this section as ‘STIs’) among industrialized nations. In 2006, there were approximately 19,000,000 new cases of STIs, almost half of them occurring in young people ages 15 to 24. According to the CDC, in addition to the burden on public health, STIs impose a tremendous economic burden with direct medical costs as high as $14,700,000,000 each year in 2006 dollars.CommentsClose CommentsPermalink





(6) Contraceptive use can improve overall health by enabling women to plan and space their pregnancies and has contributed to dramatic declines in maternal and infant mortality. Widespread use of contraceptives has been the driving force in reducing unintended pregnancies and sexually transmitted infections, and reducing the need for abortion in this nation. Contraceptive use also saves public health dollars. For every dollar spent to provide services in publicly funded family planning clinics, $4.02 in Medicaid expenses are saved because unintended births are averted.CommentsClose CommentsPermalink





(7) Reducing unintended pregnancy improves maternal health and is an important strategy in efforts to reduce maternal mortality. Women experiencing unintended pregnancy are at greater risk for physical abuse.CommentsClose CommentsPermalink





(8) A child born from an unintended pregnancy is at greater risk than a child born from an intended pregnancy of low birth weight, dying in the first year of life, being abused, and not receiving sufficient resources for healthy development.CommentsClose CommentsPermalink





(9) The ability to control fertility allows couples to achieve economic stability by facilitating greater educational achievement and participation in the workforce.CommentsClose CommentsPermalink





(10) Contraceptives are effective in preventing unintended pregnancy when used consistently and correctly. Without contraception, a sexually active woman has an 85 percent chance of becoming pregnant within a year.CommentsClose CommentsPermalink





(11) Approximately 50 percent of unintended pregnancies occur among women who do not use contraception.CommentsClose CommentsPermalink





(12) Many poor and low-income women cannot afford to purchase contraceptive services and supplies on their own. The number of women needing subsidized services has increased by more than 1,000,000 (seven percent) since 2000. A poor woman in the United States is now nearly four times as likely as a more affluent woman to have an unplanned pregnancy. Between 1994 and 2001, unintended pregnancy among low-income women increased by 29 percent, while unintended pregnancy decreased by 20 percent among women with higher incomes.CommentsClose CommentsPermalink





(13) Public health programs, such as the Medicaid program and family planning programs under title X of the Public Health Service Act, provide high-quality family planning services and other preventive health care to underinsured or uninsured individuals who may otherwise lack access to health care.CommentsClose CommentsPermalink





(14) Medicaid has become an essential source of support for the provision of subsidized family planning services and supplies. It is the single largest source of public funds supporting these services. In 2001, the program provided six in ten of all public dollars spent on family planning services. In 2006, 12 percent of women of reproductive age (7,300,000 women between the ages of 15 and 44) looked to Medicaid for their care and 37 percent of poor women of reproductive age rely upon Medicaid.CommentsClose CommentsPermalink





(15) Approximately 1,400,000 unintended pregnancies and 600,000 abortions are averted each year because of services provided in publicly funded clinics. In 2006, title X service providers performed more than 2,400,000 Pap tests, 2,400,000 breast exams, and 5,800,000 tests for STIs, including 652,426 HIV tests and 2,300,000 Chlamydia tests. One in four women who obtain reproductive health services from a medical provider does so at a publicly funded clinic.CommentsClose CommentsPermalink





(16) The stagnant funding for public family planning programs in combination with the increasing demand for subsidized services; the rising costs of contraceptive services and supplies, and the high cost of improved screening and treatment for cervical cancer and sexually transmitted infections has diminished the ability of clinics receiving funds under title X of the Public Health Services Act to adequately serve all those in need. At present, clinics are able to reach just 41 percent of the women needing subsidized services. Had title X funding kept up with inflation since FY 1980, it would now be funded at $759,000,000, instead of its fiscal year 2007 funding level of $283,000,000. Taking inflation into account, funding for title X in constant dollars is 63 percent lower today than it was in FY 1980.CommentsClose CommentsPermalink





(17) While the Medicaid program remains the largest source of subsidized family planning services, States are facing significant budgetary pressures to cut their Medicaid programs, putting many women at risk of losing coverage for family planning services.CommentsClose CommentsPermalink





(18) In addition, eligibility under the Medicaid program in many States is severely restricted, which leaves family planning services financially out of reach for many poor women. Many States have demonstrated tremendous success with Medicaid family planning waivers that allow States to expand access to Medicaid family planning services. However, the administrative burden of applying for a waiver poses a significant barrier to States that would like to expand their coverage of family planning programs through Medicaid.CommentsClose CommentsPermalink





(19) As of December 2008, 27 States offered expanded family planning benefits as a result of Medicaid family planning waivers. The cost-effectiveness of these waivers was affirmed by a recent evaluation funded by the Centers for Medicare & Medicaid Services. This evaluation of six waivers found that all family planning programs under such waivers resulted in significant savings to both the Federal and State governments. Moreover, the researchers found measurable reductions in unintended pregnancy.CommentsClose CommentsPermalink





(20) Although employer-sponsored health plans have improved coverage of contraceptive services and supplies, largely in response to State contraceptive coverage laws, there is still significant room for improvement. The ongoing lack of coverage in health insurance plans, particularly in self-insured and individual plans, continues to place effective forms of contraception beyond the financial reach of many women.CommentsClose CommentsPermalink





(21) Including contraceptive coverage in private health care plans saves employers money. Not covering contraceptives in employee health plans costs employers 15 to 17 percent more than providing such coverage.CommentsClose CommentsPermalink





(22) Approved for use by the Food and Drug Administration, emergency contraception is a safe and effective way to prevent unintended pregnancy after unprotected sex. Research confirms that easier access to emergency contraceptives does not increase sexual risk-taking or sexually transmitted diseases.CommentsClose CommentsPermalink





(23) The available evidence shows that many women do not know about emergency contraception, do not know where to get it, or are unable to access it. Overcoming these obstacles could help ensure that more women use emergency contraception consistently and correctly.CommentsClose CommentsPermalink





(24) 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. As such, it is critically important that teens receive accurate, unbiased information about contraception.CommentsClose CommentsPermalink





(25) The American Medical Association, the American Nurses Association, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American Public Health Association, and the Society for Adolescent Medicine, support responsible sexuality education that includes information about both abstinence and contraception.CommentsClose CommentsPermalink





(26) 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.CommentsClose CommentsPermalink





(27) Government-funded abstinence-only-until-marriage programs are precluded from discussing contraception except to talk about failure rates. An October 2006 report by the Government Accountability Office found that the Department of Health and Human Services does not review the materials of recipients of grants administered by such Department for scientific accuracy and requires grantees to review their own materials for scientific accuracy. The GAO also reported on the Department’s total lack of appropriate and customary measurements to determine if funded programs are effective. In addition, a separate letter from the Government Accountability Office found that the Department of Health and Human Services is in violation of Federal law by failing to enforce a requirement under the Public Health Service Act that federally funded grantees working to address the prevention of sexually transmitted diseases, including abstinence-only-until-marriage programs, must provide medically accurate information about the effectiveness of condoms.CommentsClose CommentsPermalink





(28) Recent scientific reports by the Institute of Medicine, the American Medical Association, and the Office on National AIDS Policy stress the need for sexuality education that includes messages about abstinence and provides young people with information about contraception for the prevention of teen pregnancy, HIV/AIDS, and other sexually transmitted diseases.CommentsClose CommentsPermalink





(29) A 2006 statement from the American Public Health Association (referred to in this section as ‘APHA’) states that APHA ‘recognizes the importance of abstinence education, but only as part of a comprehensive sexuality education program . . . APHA calls for repealing current Federal funding for abstinence-only programs and replacing it with funding for a new Federal program to promote comprehensive sexuality education, combining information about abstinence with age-appropriate sexuality education.’.CommentsClose CommentsPermalink





(30) Comprehensive sexuality education programs respect the diversity of values and beliefs represented in the community and will complement and augment the sexuality education children receive from their families.CommentsClose CommentsPermalink





(31) Over 60 percent of the 56,300 annual new cases of HIV infections in the United States occur in youth ages 13 through 24. African-American and Latino youth have been disproportionately affected by the HIV/AIDS epidemic. In 2005, Blacks and Latinos accounted for 84 percent of all new HIV infections among 13- to 19-year-olds and 76 percent of HIV infections among 20- to 24-year-olds in the United States even though, Black and Latinos represent only about 32 percent of people in these ages. Teens in the United States contract an estimated 9,000,000 sexually transmitted infections each year. By age 24, at least one in four sexually active people between the ages of 15 and 24 will have contracted a sexually transmitted infection.CommentsClose CommentsPermalink





(32) Approximately 50 young people a day, an average of 2 young people every hour of every day, are infected with HIV in the United States.CommentsClose CommentsPermalink

TITLE I--TITLE X OF PUBLIC HEALTH SERVICE ACTCommentsClose CommentsPermalink

SEC. 101. SHORT TITLE.

This title may be cited as the ‘Title X Family Planning Services Act of 2009’.CommentsClose CommentsPermalink

SEC. 102. AUTHORIZATION OF APPROPRIATIONS.

Section 1001(d) of the Public Health Service Act is amended by striking all that follows ‘there are authorized to be appropriated’ and inserting ‘$700,000,000 for fiscal year 2010 and such sums as may be necessary for each subsequent fiscal year’.CommentsClose CommentsPermalink

TITLE II--EQUITY IN PRESCRIPTION INSURANCE AND CONTRACEPTIVE COVERAGECommentsClose CommentsPermalink

SEC. 201. SHORT TITLE.

This title may be cited as the ‘Equity in Prescription Insurance and Contraceptive Coverage Act of 2009’.CommentsClose CommentsPermalink

SEC. 202. AMENDMENTS TO EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974.

(a) In General- Subpart B of part 7 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185 et seq.) is amended by adding at the end the following:CommentsClose CommentsPermalink

‘SEC. 715. STANDARDS RELATING TO BENEFITS FOR CONTRACEPTIVES.

‘(a) Requirements for Coverage- A group health plan, and a health insurance issuer providing health insurance coverage in connection with a group health plan, may not--CommentsClose CommentsPermalink





‘(1) exclude or restrict benefits for prescription contraceptive drugs or devices approved by the Food and Drug Administration, or generic equivalents approved as substitutable by the Food and Drug Administration, if such plan or coverage provides benefits for other outpatient prescription drugs or devices; orCommentsClose CommentsPermalink





‘(2) exclude or restrict benefits for outpatient contraceptive services if such plan or coverage provides benefits for other outpatient health care services.CommentsClose CommentsPermalink





‘(b) Prohibitions- A group health plan, and a health insurance issuer providing health insurance coverage in connection with a group health plan, may not--CommentsClose CommentsPermalink





‘(1) deny to an individual eligibility, or continued eligibility, to enroll or to renew coverage under the terms of the plan because of the individual’s or enrollee’s use or potential use of items or services that are covered in accordance with the requirements of this section;CommentsClose CommentsPermalink





‘(2) provide monetary payments or rebates to a covered individual to encourage such individual to accept less than the minimum protections available under this section;CommentsClose CommentsPermalink





‘(3) penalize or otherwise reduce or limit the reimbursement of a health care professional because such professional prescribed contraceptive drugs or devices, or provided contraceptive services, described in subsection (a), in accordance with this section; orCommentsClose CommentsPermalink





‘(4) provide incentives (monetary or otherwise) to a health care professional to induce such professional to withhold from a covered individual contraceptive drugs or devices, or contraceptive services, described in subsection (a).CommentsClose CommentsPermalink





‘(c) Rules of Construction-CommentsClose CommentsPermalink





‘(1) IN GENERAL- Nothing in this section shall be construed--CommentsClose CommentsPermalink





‘(A) as preventing a group health plan and a health insurance issuer providing health insurance coverage in connection with a group health plan from imposing deductibles, coinsurance, or other cost-sharing or limitations in relation to--CommentsClose CommentsPermalink





‘(i) benefits for contraceptive drugs under the plan or coverage, except that such a deductible, coinsurance, or other cost-sharing or limitation for any such drug shall be consistent with those imposed for other outpatient prescription drugs otherwise covered under the plan or coverage;CommentsClose CommentsPermalink





‘(ii) benefits for contraceptive devices under the plan or coverage, except that such a deductible, coinsurance, or other cost-sharing or limitation for any such device shall be consistent with those imposed for other outpatient prescription devices otherwise covered under the plan or coverage; andCommentsClose CommentsPermalink





‘(iii) benefits for outpatient contraceptive services under the plan or coverage, except that such a deductible, coinsurance, or other cost-sharing or limitation for any such service shall be consistent with those imposed for other outpatient health care services otherwise covered under the plan or coverage;CommentsClose CommentsPermalink





‘(B) as requiring a group health plan and a health insurance issuer providing health insurance coverage in connection with a group health plan to cover experimental or investigational contraceptive drugs or devices, or experimental or investigational contraceptive services, described in subsection (a), except to the extent that the plan or issuer provides coverage for other experimental or investigational outpatient prescription drugs or devices, or experimental or investigational outpatient health care services; orCommentsClose CommentsPermalink





‘(C) as modifying, diminishing, or limiting the rights or protections of an individual under any other Federal law.CommentsClose CommentsPermalink





‘(2) LIMITATIONS- As used in paragraph (1), the term ‘limitation’ includes--CommentsClose CommentsPermalink





‘(A) in the case of a contraceptive drug or device--CommentsClose CommentsPermalink





‘(i) restricting the type of health care professionals that may prescribe such drugs or devices;CommentsClose CommentsPermalink





‘(ii) utilization review provisions; andCommentsClose CommentsPermalink





‘(iii) limits on the volume of prescription drugs or devices that may be obtained on the basis of a single consultation with a professional; orCommentsClose CommentsPermalink





‘(B) in the case of an outpatient contraceptive service--CommentsClose CommentsPermalink





‘(i) restricting the type of health care professionals that may provide such services;CommentsClose CommentsPermalink





‘(ii) utilization review provisions;CommentsClose CommentsPermalink





‘(iii) requirements relating to second opinions prior to the coverage of such services; andCommentsClose CommentsPermalink





‘(iv) requirements relating to preauthorizations prior to the coverage of such services.CommentsClose CommentsPermalink





‘(d) Notice Under Group Health Plan- The imposition of the requirements of this section shall be treated as a material modification in the terms of the plan described in section 102(a)(1), for purposes of assuring notice of such requirements under the plan, except that the summary description required to be provided under the last sentence of section 104(b)(1) with respect to such modification shall be provided by not later than 60 days after the first day of the first plan year in which such requirements apply.CommentsClose CommentsPermalink





‘(e) Preemption- Nothing in this section shall be construed to preempt any provision of State law to the extent that such State law establishes, implements, or continues in effect any standard or requirement that provides coverage or protections for participants or beneficiaries that are greater than the coverage or protections provided under this section.CommentsClose CommentsPermalink





‘(f) Definitions- In this section:CommentsClose CommentsPermalink





‘(1) OUTPATIENT CONTRACEPTIVE SERVICES- The term ‘outpatient contraceptive services’ means consultations, examinations, procedures, and medical services, provided on an outpatient basis and related to the use of contraceptive methods (including natural family planning) to prevent an unintended pregnancy.CommentsClose CommentsPermalink





‘(2) OUTPATIENT HEALTH CARE SERVICES- The term ‘outpatient health care services’ means outpatient services provided by a health care professional.’.CommentsClose CommentsPermalink





(b) Clerical Amendment- The table of contents in section 1 of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1001) is amended by inserting after the item relating to section 714 the following:CommentsClose CommentsPermalink





‘Sec. 715. Standards relating to benefits for contraceptives.’.CommentsClose CommentsPermalink





(c) Effective Date- The amendments made by this section shall apply with respect to plan years beginning on or after January 1, 2010.CommentsClose CommentsPermalink

SEC. 203. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT RELATING TO THE GROUP MARKET.

(a) In General- Subpart 2 of part A of title XXVII of the Public Health Service Act (42 U.S.C. 300gg-4 et seq.) is amended by adding at the end the following:CommentsClose CommentsPermalink

‘SEC. 2708. STANDARDS RELATING TO BENEFITS FOR CONTRACEPTIVES.

‘(a) Requirements for Coverage- A group health plan, and a health insurance issuer providing health insurance coverage in connection with a group health plan, may not--CommentsClose CommentsPermalink





‘(1) exclude or restrict benefits for prescription contraceptive drugs or devices approved by the Food and Drug Administration, or generic equivalents approved as substitutable by the Food and Drug Administration, if such plan or coverage provides benefits for other outpatient prescription drugs or devices; orCommentsClose CommentsPermalink





‘(2) exclude or restrict benefits for outpatient contraceptive services if such plan or coverage provides benefits for other outpatient health care services.CommentsClose CommentsPermalink





‘(b) Prohibitions- A group health plan, and a health insurance issuer providing health insurance coverage in connection with a group health plan, may not--CommentsClose CommentsPermalink





‘(1) deny to an individual eligibility, or continued eligibility, to enroll or to renew coverage under the terms of the plan because of the individual’s or enrollee’s use or potential use of items or services that are covered in accordance with the requirements of this section;CommentsClose CommentsPermalink





‘(2) provide monetary payments or rebates to a covered individual to encourage such individual to accept less than the minimum protections available under this section;CommentsClose CommentsPermalink





‘(3) penalize or otherwise reduce or limit the reimbursement of a health care professional because such professional prescribed contraceptive drugs or devices, or provided contraceptive services, described in subsection (a), in accordance with this section; orCommentsClose CommentsPermalink





‘(4) provide incentives (monetary or otherwise) to a health care professional to induce such professional to withhold from covered individual contraceptive drugs or devices, or contraceptive services, described in subsection (a).CommentsClose CommentsPermalink





‘(c) Rules of Construction-CommentsClose CommentsPermalink





‘(1) IN GENERAL- Nothing in this section shall be construed--CommentsClose CommentsPermalink





‘(A) as preventing a group health plan and a health insurance issuer providing health insurance coverage in connection with a group health plan from imposing deductibles, coinsurance, or other cost-sharing or limitations in relation to--CommentsClose CommentsPermalink





‘(i) benefits for contraceptive drugs under the plan or coverage, except that such a deductible, coinsurance, or other cost-sharing or limitation for any such drug shall be consistent with those imposed for other outpatient prescription drugs otherwise covered under the plan or coverage;CommentsClose CommentsPermalink





‘(ii) benefits for contraceptive devices under the plan or coverage, except that such a deductible, coinsurance, or other cost-sharing or limitation for any such device shall be consistent with those imposed for other outpatient prescription devices otherwise covered under the plan or coverage; andCommentsClose CommentsPermalink





‘(iii) benefits for outpatient contraceptive services under the plan or coverage, except that such a deductible, coinsurance, or other cost-sharing or limitation for any such service shall be consistent with those imposed for other outpatient health care services otherwise covered under the plan or coverage;CommentsClose CommentsPermalink





‘(B) as requiring a group health plan and a health insurance issuer providing health insurance coverage in connection with a group health plan to cover experimental or investigational contraceptive drugs or devices, or experimental or investigational contraceptive services, described in subsection (a), except to the extent that the plan or issuer provides coverage for other experimental or investigational outpatient prescription drugs or devices, or experimental or investigational outpatient health care services; orCommentsClose CommentsPermalink





‘(C) as modifying, diminishing, or limiting the rights or protections of an individual under any other Federal law.CommentsClose CommentsPermalink





‘(2) LIMITATIONS- As used in paragraph (1), the term ‘limitation’ includes--CommentsClose CommentsPermalink





‘(A) in the case of a contraceptive drug or device--CommentsClose CommentsPermalink





‘(i) restricting the type of health care professionals that may prescribe such drugs or devices;CommentsClose CommentsPermalink





‘(ii) utilization review provisions; andCommentsClose CommentsPermalink





‘(iii) limits on the volume of prescription drugs or devices that may be obtained on the basis of a single consultation with a professional; orCommentsClose CommentsPermalink





‘(B) in the case of an outpatient contraceptive service--CommentsClose CommentsPermalink





‘(i) restricting the type of health care professionals that may provide such services;CommentsClose CommentsPermalink





‘(ii) utilization review provisions;CommentsClose CommentsPermalink





‘(iii) requirements relating to second opinions prior to the coverage of such services; andCommentsClose CommentsPermalink





‘(iv) requirements relating to preauthorizations prior to the coverage of such services.CommentsClose CommentsPermalink





‘(d) Notice- A group health plan under this part shall comply with the notice requirement under section 715(d) of the Employee Retirement Income Security Act of 1974 with respect to the requirements of this section as if such section applied to such plan.CommentsClose CommentsPermalink





‘(e) Preemption- Nothing in this section shall be construed to preempt any provision of State law to the extent that such State law establishes, implements, or continues in effect any standard or requirement that provides coverage or protections for enrollees that are greater than the coverage or protections provided under this section.CommentsClose CommentsPermalink





‘(f) Definitions- In this section:CommentsClose CommentsPermalink





‘(1) OUTPATIENT CONTRACEPTIVE SERVICES- The term ‘outpatient contraceptive services’ means consultations, examinations, procedures, and medical services, provided on an outpatient basis and related to the use of contraceptive methods (including natural family planning) to prevent an unintended pregnancy.CommentsClose CommentsPermalink





‘(2) OUTPATIENT HEALTH CARE SERVICES- The term ‘outpatient health care services’ means outpatient services provided by a health care professional.’.CommentsClose CommentsPermalink





(b) Effective Date- The amendments made by this section shall apply with respect to group health plans for plan years beginning on or after January 1, 2010.CommentsClose CommentsPermalink

SEC. 204. AMENDMENT TO PUBLIC HEALTH SERVICE ACT RELATING TO THE INDIVIDUAL MARKET.

(a) In General- Part B of title XXVII of the Public Health Service Act (42 U.S.C. 300gg-41 et seq.) is amended by adding at the end of subpart 2 the following:CommentsClose CommentsPermalink

‘SEC. 2754. STANDARDS RELATING TO BENEFITS FOR CONTRACEPTIVES.

‘The provisions of section 2708 shall apply to health insurance coverage offered by a health insurance issuer in the individual market in the same manner as such provisions apply to health insurance coverage offered by a health insurance issuer in connection with a group health plan in the small or large group market.’.CommentsClose CommentsPermalink





(a) Effective Date- The amendment made by this section shall apply with respect to health insurance coverage offered, sold, issued, renewed, in effect, or operated in the individual market on or after January 1, 2010.CommentsClose CommentsPermalink

TITLE III--EMERGENCY CONTRACEPTION EDUCATION AND INFORMATIONCommentsClose CommentsPermalink

SEC. 301. SHORT TITLE.

This title may be cited as the ‘Emergency Contraception Education Act of 2009’.CommentsClose CommentsPermalink

SEC. 302. EMERGENCY CONTRACEPTION EDUCATION AND INFORMATION PROGRAMS.

(a) Definitions- For purposes of this section:CommentsClose CommentsPermalink





(1) EMERGENCY CONTRACEPTION- The term ‘emergency contraception’ means a drug or device (as such terms are defined in section 201 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 321)) or a drug regimen that--CommentsClose CommentsPermalink





(A) is used after sexual relations;CommentsClose CommentsPermalink





(B) prevents pregnancy, by preventing ovulation, fertilization of an egg, or implantation of an egg in a uterus; andCommentsClose CommentsPermalink





(C) is approved by the Food and Drug Administration.CommentsClose CommentsPermalink





(2) HEALTH CARE PROVIDER- The term ‘health care provider’ means an individual who is licensed or certified under State law to provide health care services and who is operating within the scope of such license.CommentsClose CommentsPermalink





(3) INSTITUTION OF HIGHER EDUCATION- The term ‘institution of higher education’ has the same meaning given such term in section 101(a) of the Higher Education Act of 1965 (20 U.S.C. 1001(a)).CommentsClose CommentsPermalink





(4) SECRETARY- The term ‘Secretary’ means the Secretary of Health and Human Services.CommentsClose CommentsPermalink





(b) Emergency Contraception Public Education Program-CommentsClose CommentsPermalink





(1) IN GENERAL- The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall develop and disseminate to the public information on emergency contraception.CommentsClose CommentsPermalink





(2) DISSEMINATION- The Secretary may disseminate information under paragraph (1) directly or through arrangements with nonprofit organizations, consumer groups, institutions of higher education, Federal, State, or local agencies, clinics, and the media.CommentsClose CommentsPermalink





(3) INFORMATION- The information disseminated under paragraph (1) shall include, at a minimum, a description of emergency contraception and an explanation of the use, safety, efficacy, and availability of such contraception.CommentsClose CommentsPermalink





(c) Emergency Contraception Information Program for Health Care Providers-CommentsClose CommentsPermalink





(1) IN GENERAL- The Secretary, acting through the Administrator of the Health Resources and Services Administration and in consultation with major medical and public health organizations, shall develop and disseminate to health care providers information on emergency contraception.CommentsClose CommentsPermalink





(2) INFORMATION- The information disseminated under paragraph (1) shall include, at a minimum--CommentsClose CommentsPermalink





(A) information describing the use, safety, efficacy, and availability of emergency contraception;CommentsClose CommentsPermalink





(B) a recommendation regarding the use of such contraception in appropriate cases; andCommentsClose CommentsPermalink





(C) information explaining how to obtain copies of the information developed under subsection (b) for distribution to the patients of the providers.CommentsClose CommentsPermalink





(d) Authorization of Appropriations- There are authorized to be appropriated to carry out this section such sums as may be necessary for each of the fiscal years 2010 through 2014.CommentsClose CommentsPermalink

TITLE IV--COMPASSIONATE ASSISTANCE FOR RAPE EMERGENCIESCommentsClose CommentsPermalink

SEC. 401. SHORT TITLE.

This title may be cited as the ‘Compassionate Assistance for Rape Emergencies Act of 2009’.CommentsClose CommentsPermalink

SEC. 402. SURVIVORS OF SEXUAL ASSAULT; PROVISION BY HOSPITALS OF EMERGENCY CONTRACEPTIVES WITHOUT CHARGE.

(a) In General- Federal funds may not be provided to a hospital under any health-related program, unless the hospital meets the conditions specified in subsection (b) in the case of--CommentsClose CommentsPermalink





(1) any woman who presents at the hospital and states that she is a victim of sexual assault, or is accompanied by someone who states she is a victim of sexual assault; andCommentsClose CommentsPermalink





(2) any woman who presents at the hospital whom hospital personnel have reason to believe is a victim of sexual assault.CommentsClose CommentsPermalink





(b) Assistance for Victims- The conditions specified in this subsection regarding a hospital and a woman described in subsection (a) are as follows:CommentsClose CommentsPermalink





(1) The hospital promptly provides the woman with medically and factually accurate and unbiased written and oral information about emergency contraception, including information explaining that--CommentsClose CommentsPermalink





(A) emergency contraception does not cause an abortion; andCommentsClose CommentsPermalink





(B) emergency contraception is effective in most cases in preventing pregnancy after unprotected sex.CommentsClose CommentsPermalink





(2) The hospital promptly offers emergency contraception to the woman, and promptly provides such contraception to her on her request.CommentsClose CommentsPermalink





(3) The information provided pursuant to paragraph (1) is in clear and concise language, is readily comprehensible, and meets such conditions regarding the provision of the information in languages other than English as the Secretary may establish.CommentsClose CommentsPermalink





(4) The services described in paragraphs (1) through (3) are not denied because of the inability of the woman or her family to pay for the services.CommentsClose CommentsPermalink





(c) Definitions- For purposes of this section:CommentsClose CommentsPermalink





(1) The term ‘emergency contraception’ means a drug, drug regimen, or device that--CommentsClose CommentsPermalink





(A) is used postcoitally;CommentsClose CommentsPermalink





(B) prevents pregnancy by delaying ovulation, preventing fertilization of an egg, or preventing implantation of an egg in a uterus; andCommentsClose CommentsPermalink





(C) is approved by the Food and Drug Administration.CommentsClose CommentsPermalink





(2) The term ‘hospital’ has the meanings given such term in title XVIII of the Social Security Act, including--CommentsClose CommentsPermalink





(A) the meaning given such term in section 1861(e) of such Act;CommentsClose CommentsPermalink





(B) the meaning given the term ‘psychiatric hospital’ in section 1861(f) of such Act;CommentsClose CommentsPermalink





(C) the meaning given to the term ‘critical access hospital’ under section 1861(mm) of such Act; andCommentsClose CommentsPermalink





(D) the meaning applicable such title for purposes of making payments for emergency services to hospitals that do not have agreements in effect under such title.CommentsClose CommentsPermalink





(3) The term ‘Secretary’ means the Secretary of Health and Human Services.CommentsClose CommentsPermalink





(4) The term ‘sexual assault’ means coitus in which the woman involved does not consent or lacks the legal capacity to consent.CommentsClose CommentsPermalink





(d) Effective Date; Agency Criteria- This section takes effect upon the expiration of the 180-day period beginning on the date of the enactment of this title. Not later than 30 days prior to the expiration of such period, the Secretary shall publish in the Federal Register criteria for carrying out this section.CommentsClose CommentsPermalink

TITLE V--AT-RISK COMMUNITIES TEENAGE PREGNANCY PREVENTION ACTCommentsClose CommentsPermalink

SEC. 501. SHORT TITLE.

This title may be cited as the ‘At-Risk Communities Teenage Pregnancy Prevention Act of 2009’.CommentsClose CommentsPermalink

SEC. 502. TEEN PREGNANCY PREVENTION.

(a) Teenage Pregnancy Prevention Grants- Part P of title III of the Public Health Service Act (42 U.S.C. 280g et seq.) is amended by inserting at the end the following section:CommentsClose CommentsPermalink

‘SEC. 399U. TEENAGE PREGNANCY PREVENTION GRANTS.

‘(a) Authority- The Secretary may award on a competitive basis grants to public and private entities to establish or expand teenage pregnancy prevention programs.CommentsClose CommentsPermalink





‘(b) Grant Recipients- Grant recipients under this section may include State and local not-for-profit coalitions working to prevent teenage pregnancy; State, local, and tribal agencies; schools; entities that provide after-school programs; and community and faith-based groups.CommentsClose CommentsPermalink





‘(c) Priority- In selecting grant recipients under this section, the Secretary shall give--CommentsClose CommentsPermalink





‘(1) highest priority to applicants seeking assistance for programs targeting communities or populations in which--CommentsClose CommentsPermalink





‘(A) teenage pregnancy or birth rates are higher than the corresponding State average; orCommentsClose CommentsPermalink





‘(B) teenage pregnancy or birth rates are increasing; andCommentsClose CommentsPermalink





‘(2) priority to applicants seeking assistance for programs that--CommentsClose CommentsPermalink





‘(A) will benefit underserved or at-risk populations such as young males or immigrant youths; orCommentsClose CommentsPermalink





‘(B) will take advantage of other available resources and be coordinated with other programs that serve youth, such as workforce development and after-school programs.CommentsClose CommentsPermalink





‘(d) Use of Funds- Funds received by an entity as a grant under this section may only be used for programs that--CommentsClose CommentsPermalink





‘(1) replicate or substantially incorporate the elements of one or more teenage pregnancy prevention programs that have been proven (on the basis of rigorous scientific research) to delay sexual intercourse or sexual activity, increase condom or contraceptive use without increasing sexual activity, or reduce teenage pregnancy;CommentsClose CommentsPermalink





‘(2) incorporate one or more of the following strategies for preventing teenage pregnancy: encouraging teenagers to delay sexual activity; sex and HIV education; interventions for sexually active teenagers; preventive health services; youth development programs; service learning programs; and outreach or media programs;CommentsClose CommentsPermalink





‘(3) provide information that is age-appropriate, factually and medically accurate and complete, and scientifically based; andCommentsClose CommentsPermalink





‘(4) provide any information, activities, and services that are directed toward a particular population group in a language and cultural context that is most appropriate for individual in such group.CommentsClose CommentsPermalink





‘(e) Relation to Abstinence-Only Programs- Funds under this section are not intended for use by abstinence-only education programs. Abstinence-only education programs that receive Federal funds through the Maternal and Child Health Block Grant, the Administration for Children and Families, the Adolescent Family Life Program, and any other program that uses the definition of ‘abstinence education’ found in section 510(b) of the Social Security Act are ineligible for funding under this section.CommentsClose CommentsPermalink





‘(f) Applications- Each entity seeking a grant under this section shall submit an application to the Secretary at such time and in such form, is made in such manner, and contains such agreements, assurances, and information as the Secretary determines to be necessary to carry out the program involved.CommentsClose CommentsPermalink





‘(g) Matching Funds-CommentsClose CommentsPermalink





‘(1) IN GENERAL- The Federal share of the cost of an activity carried out with a grant under this section may not exceed 75 percent of cost of the activity.CommentsClose CommentsPermalink





‘(2) Applicant’S SHARE- The applicant’s share of the cost of a program shall be provided in cash or in kind.CommentsClose CommentsPermalink





‘(h) Maintenance of Effort- As condition of making a grant under this section to an entity during any fiscal year, the Secretary shall require that the entity expend, during such fiscal year, not less than the amount of funds from non-Federal sources expended by such entity for teenage pregnancy prevention during the fiscal year preceding the first fiscal year for which such grant is made to such entity.CommentsClose CommentsPermalink





‘(i) Evaluations-CommentsClose CommentsPermalink





‘(1) IN GENERAL- The Secretary shall--CommentsClose CommentsPermalink





‘(A) conduct or provide for a rigorous evaluation of 10 percent of programs for which a grant is awarded under this section for the purpose of determining the effectiveness of such programs;CommentsClose CommentsPermalink





‘(B) collect and analyze data relating to program effectiveness on each program for which a grant is awarded under this section; andCommentsClose CommentsPermalink





‘(C) upon completion of the evaluations referred to in subparagraph (A), submit to the Congress a report that includes a detailed statement on the effectiveness of grants under this section.CommentsClose CommentsPermalink





‘(2) COOPERATION BY GRANTEES- Each grant recipient under this section shall provide such information and cooperation as may be required by the Secretary for purposes of an evaluation or data collection under paragraph (1).CommentsClose CommentsPermalink





‘(j) Definition- For purposes of this section, the term ‘rigorous scientific research’ means research based on a program evaluation that--CommentsClose CommentsPermalink





‘(1) measured impact of the program on sexual or contraceptive behavior, pregnancy or childbearing;CommentsClose CommentsPermalink





‘(2) employed an experimental or quasi-experimental design with well-constructed and appropriate comparison groups; andCommentsClose CommentsPermalink





‘(3) had a sample size large enough (at least 100 in the combined treatment and control group) and a follow-up interval long enough (at least 6 months) to draw valid conclusions about such impact.CommentsClose CommentsPermalink





‘(k) Authorization of Appropriations- There are authorized to be appropriated to carry out this section such sums as may be necessary for fiscal year 2010 and each subsequent fiscal year.’.CommentsClose CommentsPermalink





(b) Technical Corrections- Part P of title III of the Public Health Service Act (42 U.S.C. 280g et seq.) is amended by--CommentsClose CommentsPermalink





(1) redesignating the second section 399R (as added by section 2 of Public Law 110-373) as section 399S; andCommentsClose CommentsPermalink





(2) redesignating the third section 399R (as added by section 3 of Public Law 110-374) as section 399T.CommentsClose CommentsPermalink

SEC. 503. RESEARCH.

(a) In General- The Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention, shall make grants to public or nonprofit private entities to conduct, support, and coordinate research on the prevention of teen pregnancy in eligible communities, including research on the factors contributing to the disproportionate rates of teen pregnancy in such communities.CommentsClose CommentsPermalink





(b) Research- In carrying out subsection (a), the Secretary of Health and Human Services shall support research that--CommentsClose CommentsPermalink





(1) investigates and determines the incidence and prevalence of teen pregnancy in communities described in such subsection;CommentsClose CommentsPermalink





(2) examines--CommentsClose CommentsPermalink





(A) the extent of the impact of teen pregnancy on--CommentsClose CommentsPermalink





(i) the health and well-being of teenagers in the communities; andCommentsClose CommentsPermalink





(ii) the scholastic achievement of such teenagers;CommentsClose CommentsPermalink





(B) the variance in the rates of teen pregnancy by--CommentsClose CommentsPermalink





(i) location (such as inner cities, inner suburbs, and outer suburbs);CommentsClose CommentsPermalink





(ii) population subgroup (such as Hispanic, Asian-Pacific Islander, African-American, and Native American); andCommentsClose CommentsPermalink





(iii) level of acculturation;CommentsClose CommentsPermalink





(C) the importance of the physical and social environment as a factor in placing communities at risk of increased rates of teen pregnancy; andCommentsClose CommentsPermalink





(D) the importance of aspirations as a factor affecting young women’s risk of teen pregnancy; andCommentsClose CommentsPermalink





(3) is used to develop--CommentsClose CommentsPermalink





(A) measures to address race, ethnicity, socioeconomic status, environment, and educational attainment and the relationship to the incidence and prevalence of teen pregnancy; andCommentsClose CommentsPermalink





(B) efforts to link the measures to relevant databases, including health databases.CommentsClose CommentsPermalink





(c) Priority- In making grants under subsection (a), the Secretary of Health and Human Services shall give priority to research that incorporates--CommentsClose CommentsPermalink





(1) interdisciplinary approaches; orCommentsClose CommentsPermalink





(2) a strong emphasis on community-based participatory research.CommentsClose CommentsPermalink





(d) Requirements- A grant may be made under this section only if--CommentsClose CommentsPermalink





(1) the applicant agrees that all information provided pursuant to the grant will be age-appropriate, factually and medically accurate and complete, and scientifically based;CommentsClose CommentsPermalink





(2) the applicant agrees that information, activities, and services under the grant that are directed toward a particular population group will be provided in the language and cultural context that is most appropriate for individuals in such group; andCommentsClose CommentsPermalink





(3) an application for the grant is submitted to the Secretary of Health and Human Services and the application is in such form, is made in such manner, and contains such agreements, assurances, and information as the Secretary of Health and Human Services determines to be necessary to carry out the program involved.CommentsClose CommentsPermalink





(e) Authorization of Appropriations- For the purpose of carrying out this section, there is authorized to be appropriated such sums as may be necessary for each of the fiscal years 2010 through 2014.CommentsClose CommentsPermalink

TITLE VI--ACCURACY OF CONTRACEPTIVE INFORMATIONCommentsClose CommentsPermalink

SEC. 601. SHORT TITLE.

This title may be cited as the ‘Truth in Contraception Act of 2009’.CommentsClose CommentsPermalink

SEC. 602. ACCURACY OF CONTRACEPTIVE INFORMATION.

Notwithstanding any other provision of law, any information concerning the use of a contraceptive provided through any federally funded sex education, family life education, abstinence education, comprehensive health education, or character education program shall be medically accurate and shall include health benefits and failure rates relating to the use of such contraceptive.CommentsClose CommentsPermalink

TITLE VII--UNINTENDED PREGNANCY REDUCTION ACTCommentsClose CommentsPermalink

SEC. 701. SHORT TITLE.

This title may be cited as the ‘Unintended Pregnancy Reduction Act of 2009’.CommentsClose CommentsPermalink

SEC. 702. MEDICAID; CLARIFICATION OF COVERAGE OF FAMILY PLANNING SERVICES AND SUPPLIES.

Section 1937(b) of the Social Security Act (42 U.S.C. 1396u-7(b)) is amended by adding at the end the following:CommentsClose CommentsPermalink





‘(5) COVERAGE OF FAMILY PLANNING SERVICES AND SUPPLIES- Notwithstanding the previous provisions of this section, a State may not provide for medical assistance through enrollment of an individual with benchmark coverage or benchmark-equivalent coverage under this section unless such coverage includes, for any individual described in section 1905(a)(4)(c)), medical assistance for family planning services and supplies in accordance with such section.’.CommentsClose CommentsPermalink

SEC. 703. EXPANSION OF FAMILY PLANNING SERVICES.

(a) Coverage as a Mandatory Categorically Needy Group-CommentsClose CommentsPermalink





(1) IN GENERAL- Section 1902(a)(10)(A)(I) of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)(I)) is amended--CommentsClose CommentsPermalink





(A) in subclause (VI), by striking ‘or’ at the end;CommentsClose CommentsPermalink





(B) in subclause (VII), by adding ‘or’ at the end; andCommentsClose CommentsPermalink





(C) by adding at the end the following new subclause:CommentsClose CommentsPermalink





‘(VIII) who are described in subsection (dd) (relating to individuals who meet the income standards for pregnant women);’.CommentsClose CommentsPermalink





(2) GROUP DESCRIBED- Section 1902 of the Social Security Act (42 U.S.C. 1396a) is amended by adding at the end the following new subsection:CommentsClose CommentsPermalink





‘(dd)(1) Individuals described in this subsection are individuals who--CommentsClose CommentsPermalink





‘(A) meet at least the income eligibility standards established under the State plan as of January 1, 2009, for pregnant women or such higher income eligibility standard for such women as the State may establish; andCommentsClose CommentsPermalink





‘(B) are not pregnant.CommentsClose CommentsPermalink





‘(2) At the option of a State, individuals described in this subsection may include individuals who are determined to meet the income eligibility standards referred to in paragraph (1)(A) under the terms and conditions applicable to making eligibility determinations for medical assistance under this title under a waiver to provide the benefits described in clause (XV) of the matter following subparagraph (G) of section 1902(a)(10) granted to the State under section 1115 as of January 1, 2007.’.CommentsClose CommentsPermalink





(3) LIMITATION ON BENEFITS- Section 1902(a)(10) of the Social Security Act (42 U.S.C. 1396a(a)(10)) is amended in the matter following subparagraph (G)--CommentsClose CommentsPermalink





(A) by striking ‘and (XIV)’ and inserting ‘(XIV)’; andCommentsClose CommentsPermalink





(B) by striking the semicolon at the end and inserting ‘, and (XV) the medical assistance made available to an individual described in subsection (dd) who is eligible for medical assistance only because of subparagraph (A)(10)(I)(VIII) shall be limited to family planning services and supplies described in 1905(a)(4)(C) and, at the State’s option, medical diagnosis or treatment services that are provided in conjunction with a family planning service in a family planning setting provided during the period in which such an individual is eligible;’.CommentsClose CommentsPermalink





(4) CONFORMING AMENDMENTS- Section 1905(a) of the Social Security Act (42 U.S.C. 1396d(a)) is amended in the matter preceding paragraph (1)--CommentsClose CommentsPermalink





(A) in clause (xii), by striking ‘or’ at the end;CommentsClose CommentsPermalink





(B) in clause (xiii), by adding ‘or’ at the end; andCommentsClose CommentsPermalink





(C) by inserting after clause (xiii) the following:CommentsClose CommentsPermalink





‘(xiv) individuals described in section 1902(dd),’.CommentsClose CommentsPermalink





(b) Presumptive Eligibility-CommentsClose CommentsPermalink





(1) IN GENERAL- Title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) is amended by inserting after section 1920B the following:CommentsClose CommentsPermalink

‘PRESUMPTIVE ELIGIBILITY FOR FAMILY PLANNING SERVICES

‘Sec. 1920C. (a) State Option- A State plan approved under section 1902 may provide for making medical assistance available to an individual described in section 1902(dd) (relating to individuals who meet the income eligibility standard for pregnant women in the State) during a presumptive eligibility period. In the case of an individual described in section 1902(dd) who is eligible for medical assistance only because of subparagraph (A)(10)(I)(VIII), such medical assistance may be limited to family planning services and supplies described in 1905(a)(4)(C) and, at the State’s option, medical diagnosis or treatment services that are provided in conjunction with a family planning service in a family planning setting provided during the period in which such an individual is eligible.CommentsClose CommentsPermalink





‘(b) Definitions- For purposes of this section:CommentsClose CommentsPermalink





‘(1) PRESUMPTIVE ELIGIBILITY PERIOD- The term ‘presumptive eligibility period’ means, with respect to an individual described in subsection (a), the period that--CommentsClose CommentsPermalink





‘(A) begins with the date on which a qualified entity determines, on the basis of preliminary information, that the individual is described in section 1902(dd); andCommentsClose CommentsPermalink





‘(B) ends with (and includes) the earlier of--CommentsClose CommentsPermalink





‘(i) the day on which a determination is made with respect to the eligibility of such individual for services under the State plan; orCommentsClose CommentsPermalink





‘(ii) in the case of such an individual who does not file an application by the last day of the month following the month during which the entity makes the determination referred to in subparagraph (A), such last day.CommentsClose CommentsPermalink





‘(2) QUALIFIED ENTITY-CommentsClose CommentsPermalink





‘(A) IN GENERAL- Subject to subparagraph (B), the term ‘qualified entity’ means any entity that--CommentsClose CommentsPermalink





‘(i) is eligible for payments under a State plan approved under this title; andCommentsClose CommentsPermalink





‘(ii) is determined by the State agency to be capable of making determinations of the type described in paragraph (1)(A).CommentsClose CommentsPermalink





‘(B) REGULATIONS- The Secretary may issue regulations further limiting those entities that may become qualified entities in order to prevent fraud and abuse and for other reasons.CommentsClose CommentsPermalink





‘(C) RULE OF CONSTRUCTION- Nothing in this paragraph shall be construed as preventing a State from limiting the classes of entities that may become qualified entities, consistent with any limitations imposed under subparagraph (B).CommentsClose CommentsPermalink





‘(c) Administration-CommentsClose CommentsPermalink





‘(1) IN GENERAL- The State agency shall provide qualified entities with--CommentsClose CommentsPermalink





‘(A) such forms as are necessary for an application to be made by an individual described in subsection (a) for medical assistance under the State plan; andCommentsClose CommentsPermalink





‘(B) information on how to assist such individuals in completing and filing such forms.CommentsClose CommentsPermalink





‘(2) NOTIFICATION REQUIREMENTS- A qualified entity that determines under subsection (b)(1)(A) that an individual described in subsection (a) is presumptively eligible for medical assistance under a State plan shall--CommentsClose CommentsPermalink





‘(A) notify the State agency of the determination within 5 working days after the date on which determination is made; andCommentsClose CommentsPermalink





‘(B) inform such individual at the time the determination is made that an application for medical assistance is required to be made by not later than the last day of the month following the month during which the determination is made.CommentsClose CommentsPermalink





‘(3) APPLICATION FOR MEDICAL ASSISTANCE- In the case of an individual described in subsection (a) who is determined by a qualified entity to be presumptively eligible for medical assistance under a State plan, the individual shall apply for medical assistance by not later than the last day of the month following the month during which the determination is made.CommentsClose CommentsPermalink





‘(d) Payment- Notwithstanding any other provision of this title, medical assistance that--CommentsClose CommentsPermalink





‘(1) is furnished to an individual described in subsection (a) during a presumptive eligibility period by an entity that is eligible for payments under the State plan; andCommentsClose CommentsPermalink





‘(2) is included in the care and services covered by the State plan,CommentsClose CommentsPermalink





shall be treated as medical assistance provided by such plan for purposes of clause (4) of the first sentence of section 1905(b).’.CommentsClose CommentsPermalink





(2) CONFORMING AMENDMENTS-CommentsClose CommentsPermalink





(A) Section 1902(a)(47) of the Social Security Act (42 U.S.C. 1396a(a)(47)) is amended by inserting before the semicolon at the end the following: ‘and provide for making medical assistance available to individuals described in subsection (a) of section 1920C during a presumptive eligibility period in accordance with such section.’.CommentsClose CommentsPermalink





(B) Section 1903(u)(1)(D)(v) of such Act (42 U.S.C. 1396b(u)(1)(D)(v)) is amended--CommentsClose CommentsPermalink





(i) by striking ‘or for’ and inserting ‘, for’; andCommentsClose CommentsPermalink





(ii) by inserting before the period the following: ‘, or for medical assistance provided to an individual described in subsection (a) of section 1920C during a presumptive eligibility period under such section’.CommentsClose CommentsPermalink

SEC. 704. EFFECTIVE DATE.

(a) In General- Except as provided in paragraph (2), the amendments made by this title take effect on October 1, 2010.CommentsClose CommentsPermalink





(b) Extension of Effective Date for State Law Amendment- In the case of a State plan under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) which the Secretary of Health and Human Services determines requires State legislation in order for the plan to meet the additional requirements imposed by the amendments made by this title, the State plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet these additional requirements before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of the enactment of this Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session is considered to be a separate regular session of the State legislature.CommentsClose CommentsPermalink

TITLE VIII--RESPONSIBLE EDUCATION ABOUT LIFE ACTCommentsClose CommentsPermalink

SEC. 801. SHORT TITLE.

This title may be cited as the ‘Responsible Education About Life Act of 2009’.CommentsClose CommentsPermalink

SEC. 802. ASSISTANCE TO REDUCE TEEN PREGNANCY, HIV/AIDS, AND OTHER SEXUALLY TRANSMITTED DISEASES AND TO SUPPORT HEALTHY ADOLESCENT DEVELOPMENT.

(a) In General- The Secretary of Health and Human Services may make grants to eligible States to conduct sex education programs, including programs that provide education on both abstinence and contraception for the prevention of teenage pregnancy and sexually transmitted diseases, including HIV/AIDS.CommentsClose CommentsPermalink





(b) Requirements for Sex Education Programs- For purposes of this title, a sex education program is a program that--CommentsClose CommentsPermalink





(1) is age-appropriate and medically accurate;CommentsClose CommentsPermalink





(2) stresses the value of abstinence while not ignoring those young people who have had or are having sexual intercourse;CommentsClose CommentsPermalink





(3) provides information about the health benefits and side effects of all contraceptive and barrier methods used--CommentsClose CommentsPermalink





(A) as a means to prevent pregnancy; andCommentsClose CommentsPermalink





(B) to reduce the risk of contracting sexually transmitted disease, including HIV/AIDS;CommentsClose CommentsPermalink





(4) encourages family communication between parent and child about sexuality;CommentsClose CommentsPermalink





(5) teaches young people the skills to make responsible decisions about sexuality, including how to avoid unwanted verbal, physical, and sexual advances and how to avoid making verbal, physical, and sexual advances that are not wanted by the other party;CommentsClose CommentsPermalink





(6) teaches young people how alcohol and drug use can affect responsible decision making; andCommentsClose CommentsPermalink





(7) does not teach or promote religion;CommentsClose CommentsPermalink





(c) Additional Activities- In carrying out a program of sex education, a State may expend a grant under subsection (a) to carry out educational and motivational activities that help young people--CommentsClose CommentsPermalink





(1) gain knowledge about the physical, emotional, biological, and hormonal changes of adolescence and subsequent stages of human maturation;CommentsClose CommentsPermalink





(2) develop the knowledge and skills necessary to ensure and protect their sexual and reproductive health from unintended pregnancy and sexually transmitted disease, including HIV/AIDS throughout their lifespan;CommentsClose CommentsPermalink





(3) gain knowledge about the specific involvement and responsibility of males in sexual decision making;CommentsClose CommentsPermalink





(4) develop healthy attitudes and values about adolescent growth and development, body image, racial and ethnic diversity, and other related subjects;CommentsClose CommentsPermalink





(5) develop and practice healthy life skills, including goal-setting, decision making, negotiation, communication, and stress management;CommentsClose CommentsPermalink





(6) develop healthy relationships, including skills to prevent dating and sexual violence;CommentsClose CommentsPermalink





(7) promote self-esteem and positive interpersonal skills focusing on relationship dynamics, including friendships, dating, romantic involvement, marriage and family interactions; andCommentsClose CommentsPermalink





(8) prepare for the adult world by focusing on educational and career success, including developing skills for employment, job seeking, independent living, financial self-sufficiency, and workplace productivity.CommentsClose CommentsPermalink

SEC. 803. SENSE OF CONGRESS.

It is the sense of Congress that while States are not required under this title to provide matching funds, with respect to grants authorized under section 802(a), they are encouraged to do so.CommentsClose CommentsPermalink

SEC. 804. EVALUATION OF PROGRAMS.

(a) In General- For the purpose of evaluating the effectiveness of programs of sex education carried out with a grant under section 802, evaluations of such programs shall be carried out in accordance with subsections (b) and (c)).CommentsClose CommentsPermalink





(b) National Evaluation-CommentsClose CommentsPermalink





(1) IN GENERAL- The Secretary shall provide for a national evaluation of a representative sample of programs of sex education carried out with grants under section 802 to determine--CommentsClose CommentsPermalink





(A) the effectiveness of such programs in helping to delay the initiation of sexual intercourse and other high-risk behaviors;CommentsClose CommentsPermalink





(B) the effectiveness of such programs in preventing adolescent pregnancy;CommentsClose CommentsPermalink





(C) the effectiveness of such programs in preventing sexually transmitted disease, including HIV/AIDS;CommentsClose CommentsPermalink





(D) the effectiveness of such programs in increasing contraceptive knowledge and contraceptive behaviors when sexual intercourse occurs; andCommentsClose CommentsPermalink





(E) a list of best practices based upon essential programmatic components of evaluated programs that have led to success in subparagraphs (A) through (D).CommentsClose CommentsPermalink





(2) GRANT CONDITION- A condition for the receipt of a grant under section 802 is that the State involved agree to cooperate with the evaluation under paragraph (1).CommentsClose CommentsPermalink





(3) REPORTS- The Secretary shall submit to Congress--CommentsClose CommentsPermalink





(A) not later than the end of each fiscal year during the 5-year period beginning with fiscal year 2010, an interim report on the national evaluation under paragraph (1); andCommentsClose CommentsPermalink





(B) not later than March 31, 2015, a final report providing the results of such national evaluation.CommentsClose CommentsPermalink





(c) Individual State Evaluations-CommentsClose CommentsPermalink





(1) IN GENERAL- A condition for the receipt of a grant under section 802 is that the State involved agree to provide for the evaluation of the programs of family education carried out with the grant in accordance with the following:CommentsClose CommentsPermalink





(A) The evaluation will be conducted by an external, independent entity.CommentsClose CommentsPermalink





(B) The purposes of the evaluation will be the determination of--CommentsClose CommentsPermalink





(i) the effectiveness of such programs in helping to delay the initiation of sexual intercourse and other high-risk behaviors;CommentsClose CommentsPermalink





(ii) the effectiveness of such programs in preventing adolescent pregnancy;CommentsClose CommentsPermalink





(iii) the effectiveness of such programs in preventing sexually transmitted disease, including HIV/AIDS; andCommentsClose CommentsPermalink





(iv) the effectiveness of such programs in increasing contraceptive knowledge and contraceptive behaviors when sexual intercourse occurs.CommentsClose CommentsPermalink

SEC. 805. LIMITATIONS ON USE OF FUNDS.

(a) Limitations on Secretary- Of the amounts appropriated for a fiscal year for purposes of this title, the Secretary may not use more than--CommentsClose CommentsPermalink





(1) 7 percent of such amounts for administrative expenses related to carrying out this title for that fiscal year; andCommentsClose CommentsPermalink





(2) 10 percent of such amounts for the national evaluation under section 804(b).CommentsClose CommentsPermalink





(b) Limitations to States- Of amounts provided to an eligible State under the section 802(a), the eligible entity may not use more than 10 percent of the grant to conduct any evaluation under section 804(c).CommentsClose CommentsPermalink

SEC. 806. DEFINITIONS.

For purposes of this title:CommentsClose CommentsPermalink





(1) The term ‘age-appropriate’ refers to topics, messages, and teaching methods suitable to particular ages or age groups of children and adolescents, based on developing cognitive, emotional, and behavioral capacity typical for the age or age group.CommentsClose CommentsPermalink





(2) The term ‘eligible State’ means a State that submits to the Secretary an application for a grant under section 802 that is in such form, is made in such manner, and contains such agreements, assurances, and information as the Secretary determines to be necessary to carry out this title.CommentsClose CommentsPermalink





(3) The term ‘HIV/AIDS’ means the human immunodeficiency virus, and includes acquired immune deficiency syndrome.CommentsClose CommentsPermalink





(4) The term ‘medically accurate’, with respect to information, means information that is supported by research, recognized as accurate and objective by leading medical, psychological, psychiatric, and public health organizations and agencies, and where relevant, published in peer review journals.CommentsClose CommentsPermalink





(5) The term ‘Secretary’ means the Secretary of Health and Human Services.CommentsClose CommentsPermalink

SEC. 807. AUTHORIZATION OF APPROPRIATIONS.

For the purpose of carrying out this title, there are authorized to be appropriated such sums as may be necessary for each of the fiscal years 2010 through 2014.CommentsClose CommentsPermalink