,,ii #aaith ,,congress #b;d ,session ,s4 #eeci ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,september #bd1 #bjbf,mrs4 ,murray 7for herself1 ,ms4 ,cortez ,masto1 ,ms4 ,hirono1 ,ms4 ,baldwin1 ,mr4 ,bennet1 ,mr4 ,blumenthal1 ,mr4 ,booker1 ,ms4 ,cantwell1 ,ms4 ,duckworth1 ,mr4 ,fetterman1 ,mr4 ,gallego1 ,mrs4 ,gillibrand1 ,ms4 ,hassan1 ,mr4 ,heinrich1 ,mr4 ,hickenlooper1 ,mr4 ,kaine1 ,ms4 ,klobuchar1 ,mr4 ,markey1 ,mr4 ,merkley1 ,mr4 ,padilla1 ,mr4 ,reed1 ,ms4 ,rosen1 ,mr4 ,sanders1 ,mr4 ,schatz1 ,mr4 ,schiff1 ,mrs4 ,shaheen1 ,ms4 ,smith1 ,mr4 ,van ,hollen1 ,mr4 ,warner1 ,ms4 ,warren1 ,mr4 ,whitehouse1 and ,mr4 ,wyden7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to require group health plans and group or individual health insurance coverage to provide coverage for over-the-counter contraceptives4 #a4 ,short title ,this ,act may be cited as the ,affordability is ,access ,act of #bjbf4 #b4 ,purpose ,the purpose of this ,act is to ensure timely access to affordable birth control by requiring coverage without cost-sharing for contraceptives that are approved1 granted1 or cleared by1 or otherwise legally marketed under regulation by1 the ,food and ,drug ,administration for use without a prescription4 #c4 ,findings ,the ,senate finds the following3 7#a7 ,birth control is critical health care that almost all women1 as well as many trans men and nonbinary people1 will use at some point in their lifetimes4 7#b7 ,access to the full range of reproductive health care1 including birth control coverage as guaranteed under ,federal law1 provides individuals with the opportunity to lead healthy lives and get the care they need to reach their goals4 7#c7 ,contraceptive access is associated with health benefits for women1 newborns1 families1 and communities and can lower the risk of harm to maternal and infant health4 7#d7 ,an estimated #ge1fjj1jjj women of reproductive age 7ages #ae through #di7 live in the ,united ,states4 ,among the #cf1cjj1jjj of such women who are sexually active and not seeking children1 #hg percent use a form of birth control4 7#e7 ,the birth control benefit enacted under the ,patient ,protection and ,affordable ,care ,act 7,public ,law #aaa-adh7 has been a crucial step forward in advancing access to birth control and has helped ensure #fb1ajj1jjj women have the power to decide for themselves if and when to become pregnant4 7#f7 ,despite legal requirements for birth control coverage and access to services1 gaps remain for millions of individuals4 ,twenty-five percent of current and prospective contraceptive users are not using their preferred method1 and of those women1 #ah percent say it is because of cost4 ,as a result1 many women have gone without the birth control they want to use1 also creating inconsistent use4 ,access to birth control is particularly difficult for the #ba1djj1jjj women in need of publicly funded contraception that live in a county with a contraceptive access gap and lack reasonable access to a health center that offers the full range of contraceptive methods4 7#g7 ,due to systemic discrimination1 people paid low wages1 people of color1 ,,lgbtq individuals1 immigrants1 and people with disabilities are more likely to face barriers to1 and lack access to1 health coverage and health care providers4 7#h7 ,there are numerous social and economic factors that make it harder to access birth control1 including rising income and wealth inequality1 gaps in insurance coverage1 and barriers to accessing health providers4 7#i7 ,leading health experts support over-the-counter birth control pills4 #d4 ,sense of the ,senate ,it is the sense of the ,senate that-- 7#a7 in order to increase access to oral birth control1 such birth control must be both easier to obtain and affordable and1 to make such birth control either easier to obtain or more affordable1 but not both1 is to leave unacceptable barriers in place2 7#b7 women are often denied coverage for the newer contraceptive products on the market1 even though contraceptives are required by law to be covered at #ajj percent1 which both limits patients' options and discourages the development of new contraceptive products2 7#c7 it is imperative that the entities that research and develop oral birth control and whose medical and scientific experts have developed clinical and other evidence that oral birth control for routine1 daily use is safe and effective when sold without a prescription1 apply to the ,food and ,drug ,administration for review and approval for sale of such birth control without a prescription2 7#d7 upon the receipt of such an application1 the ,food and ,drug ,administration should determine whether the oral birth control meets the rigorous safety1 efficacy1 and quality standards for over-the-counter use under the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cja et seq471 and if the product meets those standards1 the ,food and ,drug ,administration should approve the application without delay2 and 7#e7 if and when the ,food and ,drug ,administration approves an oral birth control that is available over-the-counter1 such birth control should be covered by health insurance1 without a prescription and without cost-sharing4 #e4 ,clarifying coverage requirements ,the ,secretaries of ,health and ,human ,services1 ,labor1 and the ,treasury shall clarify that coverage of contraceptives pursuant to section #bgac7;a77#d7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#ac7;a77#d77 includes coverage of-- 7#a7 all over-the-counter contraceptives approved1 granted1 or cleared by the ,food and ,drug ,administration1 even if the enrollee does not have a prescription for the contraceptive2 and 7#b7 all prescription contraceptives approved1 granted1 or cleared by the ,food and ,drug ,administration1 except that1 in the case of any prescription drug contraceptive for which there is at least one drug or drug-led combination product that is a therapeutic equivalent 7as defined in section #cad4c7;b7 of title #ba1 ,code of ,federal ,regulations 7or any successor regulations771 such coverage shall be required with respect to only one such contraceptive among such therapeutically equivalent drugs or drug-led combination products4 #f4 ,rules of construction 7a7 ,non-,interference with ,,fda regulation ,nothing in this ,act shall be construed to modify or interfere with ,food and ,drug ,administration processes to review or approve1 or otherwise determine the safety and efficacy of1 and make available1 non-prescription drugs or devices1 modify or interfere with the scientific and medical considerations of the ,food and ,drug ,administration1 or alter any other authority of the ,food and ,drug ,administration4 7b7 ,non-,preemption ,nothing in this ,act preempts any provision of ,federal or ,state law to the extent that such ,federal or ,state law provides protections for consumers that are greater than the protections provided for in this ,act4 #g4 ,duties of retailers to ensure access to contraception for use without a prescription 7a7 ,in general ,any retailer that stocks contraception that is approved1 granted1 or cleared by1 or otherwise legally marketed under regulation by1 the ,food and ,drug ,administration for use without a prescription may not interfere with an individual's access to or purchase of such contraception or access to medically accurate1 comprehensive information about such contraception4 7b7 ,limitation ,nothing in this section shall prohibit a retailer that stocks over-the-counter contraceptive products from refusing to provide an individual with such contraceptive product that is approved1 granted1 or cleared by1 or otherwise legally marketed under regulation by1 the ,food and ,drug ,administration if the individual is unable to pay for the contraceptive product1 directly1 through insurance coverage1 or through other payment mechanism4