Urge the United States House of Representatives, the United States Senate, and President Obama to pass the Prevention First Act in the 112th session of congress.

What is the Prevention First Act?

The Prevention First Act (H.R.463, S.21), was sponsored by U.S. Rep. Louise Slaughter (D-NY 28) and U.S. Senator Harry Reid (D-NV), in the 111th session of congress. The legislation combines eight bills into one complete legislative package that will increase access to contraception and family planning services.

The Prevention First Act is an omnibus family planning and women's health initiative that would expand access to preventive reproductive health care services and education programs, help protect women's reproductive health, reduce unintended pregnancies and the need for abortion, prevent the spread of sexually transmitted diseases (STDs), and provide women with the tools they need to make the best decisions possible for themselves.

It is intended to reduce the number of unintended pregnancies in the United States by increasing access to affordable family planning services, including contraception and emergency contraception for those who have been sexually assaulted and ensuring that young people receive medically accurate information about the health benefits and failure rates of contraception.

The Problem

Overview

The U.S. has one of the highest rates of unintended pregnancies among industrialized nations. Each year 3 million pregnancies, or 50 percent of all pregnancies, in the United States are unintended with half of unintended pregnancies ending in abortion. The likelihood of pregnancy is high if contraception is not used. In fact, 53 percent of all unintended pregnancies stem from just 7 percent of American women at risk for unintended pregnancy who do not use contraception.

Women with unintended pregnancies are less likely to obtain timely or adequate prenatal care, and a child born from an unintended pregnancy is at greater risk of low birth weight, dying in the first year of life, being abused, and not receiving sufficient resources for healthy development.

For most women, including women who want to have children, contraception is not an option; it is a basic health care necessity. In 2000, 34 million women - half of all women of reproductive age (15-44 years) - were in need of contraceptive services and supplies to help prevent unintended pregnancy, and half of those were in need of public support for such care.

Emergency Contraceptives

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.

Sexually transmitted diseases (STDs)

Approximately 50 young people a day, an average of two young people every hour of every day, are infected with HIV in the United States.

The U.S. has one of the highest rates of STDs among industrialized nations. In 2003, there were approximately 19 million new cases of sexually transmitted diseases (STDs) and the Center for Disease Control now reports that approximately 2.2 percent of Americans ages 14 to 39 have chlamydia.

Teens in the United States contract an estimated 9,000,000 sexually transmitted infections each year. By age 24, at least 1 in 4 sexually active people between the ages of 15 and 24 will have contracted a sexually transmitted infection.

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, together, they represent only about 32 percent of people in these ages.

Treatment for these STD infections costs the United States $15.5 billion each year. Nearly half of new STD cases are among people ages 15-24, even though these youth make up only a quarter of the sexually active population.

Sex Education and Teen Pregnancy



Teens face additional barriers regarding access to services and information. Sixty percent of teens have sex before graduating high school. In addition, the average age of marriage in the United States is 26, but 9 out of 10 individuals are sexually active prior to marriage. Efforts by conservatives to restrict access to family planning services and promote abstinence-only education programs that are prohibited from discussing the benefits of contraception, actually jeopardize adolescent health and run counter to the views of many mainstream medical groups. Abstinence-unless-married education programs do not address the reality of people's lives.

One in three girls becomes pregnant before the age of 20, and 80 percent of these pregnancies are unintended. Teen mothers are less likely to complete high school. Furthermore, children of teenage mothers have lower birth weights, are more likely to perform poorly in school, and are at greater risk of abuse and neglect. Teens have the most to lose when faced with an unintended pregnancy or an STD infection and the most to gain from avoiding it.

Poverty

Many poor and low-income women cannot afford to purchase contraceptive services and supplies on their own. About 1 in 5 women of reproductive age were uninsured in 2003, and that proportion has increased by 10 percent since 2001.

A poor woman in the United States is now nearly 4 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.

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.

Insurance

Many insurance policies exclude the vital coverage for contraceptives. 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.

While most employment-related insurance policies in the United States cover prescription drugs in general, the many do not include equitable coverage for prescription contraceptive drugs and devices. Although 21 states now have laws in place requiring insurers to provide contraceptive coverage if they cover other prescription drugs, 29 states still do not have any laws. Out of pocket expenses for contraception can be costly. Women of reproductive age currently spend 68 percent more in out-of-pocket health care costs than men, much of which is due to reproductive health-related supplies and services.

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.

The Solution

Overview

Each year, publicly funded family planning services help women to prevent an estimated 1.3 million unplanned pregnancies and 630,000 abortions. Yet these programs are struggling to meet the growing demand for subsidized family planning services without corresponding increases in funding.

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 (STIs), 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.

American women and their partners have an internationally recognized right if, when and how many children to have, but financial barriers often put this right out of reach. The ability to control fertility allows couples to achieve economic stability by facilitating greater educational achievement and participation in the workforce. At the same time reducing unintended pregnancy improves maternal health and is an important strategy in efforts to reduce maternal mortality.

By supporting programs that provide reproductive health information and services and enforce standards of medical accuracy and completeness, they will enable women and their partners to make more informed choices about whether and when they wish to become parents.

Emergency Contraceptives

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.

Improved access to emergency contraception (EC) can further reduce the staggering rates of unintended pregnancy and abortion in this country. EC prevents pregnancy after unprotected sex or a contraceptive failure. The Alan Guttmacher Institute estimates that increased use of EC accounted for up to 43 percent of the total decline in abortion rates between 1994 and 2000. In addition, EC is often the only contraceptive option for the 300,000 women who are raped each year.

Overcoming these obstacles could help ensure that more women use emergency contraception consistently and correctly.

Sexually transmitted diseases (STDs)

Increasing access to family planning services and education will improve women's health and reduce rates of unintended pregnancy, abortion, and infection with STDs. Furthermore, contraceptive use saves scarce public health dollars. For every $1 spent on providing family planning services, an estimated $3 is saved in Medicaid expenditures for pregnancy-related and newborn care.

Sex Education and Teen Pregnancy

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 sex education that includes information about both abstinence and contraception.

Comprehensive sex education programs respect the diversity of values and beliefs represented in the community and will complement and augment the sex education children receive from their families.

Improving access to contraceptive services and information does not cause non-sexually active teens to start having sex. Instead, teens need information to help them both postpone sexual activity and to protect themselves, if they become sexually active.

Teens who receive comprehensive sex 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.

Recent scientific reports by the Institute of Medicine, the American Medical Association, and the Office on National AIDS Policy stress the need for sex 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.

Insurance

Half of all women who are sexually active, but do not want to get pregnant, need publicly funded services to help them access public health programs like Medicaid and Title X, the national family planning program. These programs provide high-quality family planning services and other preventive health care to underinsured or uninsured individuals who may otherwise lack access to health care and alternative options for birth control.

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.

When states expand Medicaid coverage for family planning, they can save expenditures on other health care costs. Increasing access to family planning services will not only increase women's reproductive decision-making power, but also reduce the public health burden of unintended pregnancies.

What will the Prevention First Act do?

The Prevention First Act (H.R.463, S.21), will significantly reduce the need for abortion by helping women and families prevent unintended pregnancies by requiring health care practitioners and facilities to provide compassionate care to rape survivors including information and access to emergency contraception, requiring pharmacies to ensure that lawful prescription and over-the-counter contraceptives are dispensed to patients in-store, without discrimination or delay, and codifying the right to access birth control by stating that contraception is not abortion and shall not be treated as such in the law.

The Prevention First Act, is a package of legislative initiatives designed to address these shortcomings and expand access to preventive health care services and programs that reduce unintended pregnancy and sexually transmitted infections.

They are as follows;

1.) Prevention First Act - Title X Family Planning Services Act of 2009 - Authorizes appropriations for family planning services grants and contracts under the Public Health Service Act (PHSA). It will increase access to contraceptive services by authorizing a funding increase for the Title X family planning program to $700 million.

2.) Equity in Prescription Insurance and Contraceptive Coverage Act - Amends the Employee Retirement Income Security Act of 1974 (ERISA) and PHSA to prohibit a group health plan from excluding or restricting benefits for prescription contraceptive drugs, devices, and outpatient services if the plan provides benefits for other outpatient prescription drugs, devices, or health care services. Applies such prohibitions to coverage offered in the individual market. It would also require private health plans to cover FDA-approved prescription contraceptives and related medical services. It would also ensure that private health plans offer the same level of coverage for contraception as they do for other prescription drugs and services.

3.) Emergency Contraception Education Act - Directs the Secretary of Health and Human Services to develop and disseminate information on emergency contraception to the public and to health care providers. It will improve awareness about emergency contraception by directing the Secretary of Health and Human Services to develop and disseminate information about emergency contraception to women and health care providers. It would authorize $10 million to implement important public education initiatives.

4.) Compassionate Assistance for Rape Emergencies Act - Requires hospitals, as a condition of receiving federal funds, to offer and to provide, upon request, emergency contraception to victims of sexual assault. It will ensure that women who experience sexual assault receive factually accurate information and access to emergency contraception.

5.) At-Risk Communities Teenage Pregnancy Prevention Act - Authorizes the Secretary to award grants for teenage pregnancy prevention programs. Requires the Secretary to award grants for teenage pregnancy prevention research. It will reduce teen pregnancy by providing funding to public and private entities to establish or expand teenage pregnancy prevention programs. Provide $20 million in annual funding for competitive grants to public and private entities working to establish or expand teen pregnancy prevention programs.

6.) Truth in Contraception Act - Requires that any information concerning the use of a contraceptive provided through specified federally funded education programs be medically accurate and include health benefits and failure rates.

7.) Unintended Pregnancy Reduction Act - Amends title XIX (Medicaid) of the Social Security Act to expand Medicaid's coverage of family planning services. It would require states to extend coverage for family planning services and supplies to women who would be entitled to Medicaid funded prenatal, labor, delivery, and postpartum care if they become pregnant.

8.) Responsible Education About Life Act - Authorizes the Secretary to make grants to states to conduct sex education programs, including programs that provide education on abstinence and contraception for the prevention of teenage pregnancy and sexually transmitted diseases. It also provides comprehensive, medically accurate sex education programs that teach young people about abstinence, health, and contraceptives.

What can you do to get the Prevention First Act (H.R.463, S.21) passed?

Please write to and/or call your U.S. Representatives and Senators and President Obama tell them to pass the Prevention First Act in the 112th congress. Also ask your U.S. Representatives and Senators to co-sponsor the Prevention First Act.

Also please sign the petition below.