Congress Pushes to Improve Female Troops' Access to Birth Control

Female service members and their dependents will have the same access to birth control as their insured civilian counterparts under legislation introduced in the Senate and House this week.

Sen. Jeanne Shaheen, D-New Hampshire, filed her bill on Wednesday, and Rep. Jackie Speier, D-California, followed up with a House version on Thursday. Both lawmakers filed similar bills last year, but they failed to pass.

Under Shaheen's bill, women receiving health care through Tricare -- as service members or dependents -- would have access to all FDA-approved contraception with no health insurance co-pay, regardless of where they receive it. While active-duty female troops are covered for free, their dependents are not.

The bill also mandates that female service members have access to counseling contraception options at specific points in their service, including pre-deployment physicals, during health care visits while deployed, and during annual physical examinations.

Shaheen said it is "wrong that women in the military don't have the same protections civilian women do to get the comprehensive care they need and deserve. No woman should be worried about how they will afford their contraception or find family planning services, and it's time we come together to fix that for our women in uniform and military families."

"It should be a no-brainer that women who rely on Tricare have standard contraceptive coverage," said retired Navy Capt. Glenna Tinney, military advocacy program coordinator of the Battered Women's Justice Project. That includes all FDA-approved contraceptive methods and any related education and counseling without cost sharing, she said.

These all are covered for women under the Affordable Care Act. Recently, Tricare was ordered to make its breast-feeding supply coverage consistent with the ACA, though it has yet to issue policy guidance on what is covered and Tricare officials continue to tell women that the old rules still apply.

Shaheen so far has 23 co-sponsors, all but one -- Sen. Bernie Sanders, I-Vermont -- a Democrat, while the 65 co-sponsors on Speier's legislation all are Democrat.

A Shaheen staff member speaking on background anticipates the bill will pick up Republican support, as did her 2012 bill expanding access to abortion for service women who are victims of rape and incest.

"There is a path forward" to passage, the staffer told Military.com.

Retired Army Maj. Gen. Donna Barbisch, now a senior policy adviser at the Center for Disaster Medical Science, University of California, Irvine, who is also supporting Shaheen's bill, said service women "deserve the same access to care as the people they protect."

There are about 1.1 million women of reproductive age covered by military health care, according to the Center for American Progress, a Washington think-tank. That is just over a quarter of the estimated 4 million women enrolled in Tricare either as service members or dependents, according to Out of Range: Obstacles to Reproductive and Sexual Health Care in the Military.

Currently, service members have a range of contraception options. These include birth control pills without co-pay if it is generic brand and by mail-order, or through a military treatment facility.

Julia Rugg and Donna Barry, two of the report's authors, wrote on the CAP website Wednesday that while Tricare covers the most commonly used methods of contraception, other methods commonly used by women are not, including condoms and spermicidal foams, jellies and sprays.

The authors said about 62 percent of U.S. women of reproductive age use some form of birth control. On military bases, usage rates range from 50 percent to 88 percent for the same group.

But given barriers to accessing contraception, use of contraceptives drops 39 percent to 77 percent upon deployment, Rugg and Barry said. The report also argues for the kind of mandatory screenings that Shaheen and Speier call for in their bills.

Deployments are one of the reasons these are necessary, the report states, citing a 2009 study that found that many female troops did not receive gynecological screenings prior to a deployment. Some 10 percent did not receive an annual gynecological exam, which includes a screening for cervical cancer, in the year before deploying. Also, more than 16 percent were not screened within six months of a deployment.

Erica Hunt, interim chief executive officer of the Service Women's Action Network, also endorsed Shaheen's legislation, arguing that having "strong, and healthy service members ensures operational and military readiness."

-- Amy Bushatz contributed to this report.

-- Bryant Jordan can be reached at bryant.jordan@military.com.