,,ii  #aahth ,,congress  #b;d ,session  
,s4 #cgbb  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,february #a1  
#bjbd,mr4 ,rubio 7for himself and ,mr4  
,tester7 introduced the following bill2 
which was read twice and referred to the
 ,committee on ,armed ,services  ,a     
,,bill  ,to require a report on access  
to maternal health care within the      
military health system1 and for other   
purposes4  #a4 ,short title ,this ,act  
may be cited as the ,improving ,access  
to ,maternal ,health for ,military and  
,dependent ,moms ,act of #bjbd4  #b4    
,definitions ,in this ,act3 7#a7        
,covered individual ,the term covered   
individual means-- 7,a7 a covered       
beneficiary2 or  7,b7 a dependent4  7#b7
 ,covered beneficiary2 dependent2       
,,tricare program ,the terms covered    
beneficiary1 dependent1 and ,,tricare   
program have the meanings given those   
terms in section #ajgb of title #aj1    
,united ,states ,code4  7#c7 ,maternal  
health ,the term maternal health means  

care during labor1 birthing1 prenatal   
care1 and postpartum care4  7#d7        
,maternity care desert ,the term        
maternity care desert means a county in 
the ,united ,states that does not have--
 7,a7 a hospital or birth center        
offering obstetric care2 or  7,b7 an    
obstetric provider4  7#e7 ,prenatal care
 ,the term prenatal care means medical  
care provided to maintain and improve   
fetal and maternal health during        
pregnancy4  7#f7 ,secretary ,the term   
,secretary means the ,secretary of      
,defense4  #c4 ,report on access to     
maternal health care within the military
 health system  7a7 ,in general ,not    
later than #b years after the date of   
the enactment of this ,act1 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 individuals1 
during the preceding #b-year period4    
7b7 ,contents ,the report required under
 subsection 7a7 shall include the       
following3 7#a7 ,with respect to        
military medical treatment facilities3  
7,a7 ,an analysis of the availability of
 maternal health care for covered       
individuals who access the military     
health system through such facilities4  
7,b7 ,an identification of staffing     
shortages in positions relating to      
maternal health and childbirth1         
including obstetrician-gynecologists1   
certified nurse midwives1 and labor and 
delivery nurses4  7,c7 ,a description of
 specific challenges faced by covered   
individuals in accessing maternal health
 care at such facilities4  7,d7 ,an     
analysis of the timeliness of access to 
maternal health care1 including wait    
times for and travel times to           
appointments4  7,e7 ,a description of   
how such facilities track patient       

satisfaction with maternal health       
services4  7,f7 ,a process to establish 
continuity of prenatal care and         
postpartum care for covered individuals 
who experience a permanent change of    
station during a pregnancy4  7,g7 ,an   
identification of barriers with regard  
to continuity of prenatal care and      
postpartum care during permanent changes
 of station4  7,h7 ,a description of    
military-specific health challenges     
impacting covered individuals who       
receive maternal healthcare at military 
medical treatment facilities1 and a     
description of how the ,department      
tracks such challenges4  7,i7 ,for the  
#aj-year period preceding the date of   
the submission of the report1 the amount
 of funds annually expended-- 7i7 by the
 ,department of ,defense on maternal    
health care2 and  7ii7 by covered       
individuals on out-of-pocket costs      
associated with maternal health care4   
7,j7 ,an identification of each medical 
facility of the ,department of ,defense 

located in a maternity care desert4     
7,k7 ,recommendations and legislative   
proposals-- 7i7 to address staffing     
shortages that impact the positions     
described in subparagraph 7,b72  7ii7 to
 improve the delivery and availability  
of maternal health services through     
military medical treatment facilities   
and improve patient experience2 and     
7iii7 to improve continuity of prenatal 
care and postpartum care for covered    
individuals during a permanent change of
 station4  7#b7 ,with respect to        
providers within the ,,tricare program  
network that are not located at or      
affiliated with a military medical      
treatment facility3 7,a7 ,an analysis of
 the availability of maternal health    
care for covered individuals who access 
the military health system through such 
providers4  7,b7 ,an identification of  
staffing shortages for such providers in
 positions relating to maternal health  
and childbirth1 including               
obstetrician-gynecologists1 certified   

nurse midwives1 and labor and delivery  
nurses4  7,c7 ,a description of specific
 challenges faced by covered individuals
 in accessing maternal health care from 
such providers4  7,d7 ,an analysis of   
the timeliness of access to maternal    
health care1 including wait times for   
and travel times to appointments4  7,e7 
,a description of how such providers    
track patient satisfaction with maternal
 health services4  7,f7 ,a process to   
establish continuity of prenatal care   
and postpartum care for covered         
individuals who experience a permanent  
change of station during a pregnancy4   
7,g7 ,an identification of barriers with
 regard to continuity of prenatal care  
and postpartum care during permanent    
changes of station4  7,h7 ,the number of
 dependents who choose to access        
maternal health care through such       
providers4  7,i7 ,for the #aj-year      
period preceding the date of the        
submission of the report1 the amount of 
funds annually expended-- 7i7 by the    

,department of ,defense on maternal     
health care2 and  7ii7 by covered       
individuals on out-of-pocket costs      
associated with maternal health care4   
7,j7 ,recommendations and legislative   
proposals-- 7i7 to address staffing     
shortages that impact the positions     
described in subparagraph 7,b72  7ii7 to
 improve the delivery and availability  
of maternal health services through the 
,,tricare program and improve patient   
experience2  7iii7 to improve continuity
 of prenatal care and postpartum care   
for covered individuals during a        
permanent change of station2 and  7iv7  
to improve the ability of contractors   
under the ,,tricare program to build a  
larger network of providers for maternal
 health1 including                      
obstetrician-gynecologists1 certified   
nurse midwives1 and labor and delivery  
nurses4