,,ii #aadth ,,congress #ast ,session ,s4 #bbbj ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,october #bi1 #bjae,mr4 ,brown 7for himself1 ,mrs4 ,murray1 ,ms4 ,mikulski1 ,mr4 ,markey1 ,mr4 ,tester1 ,mr4 ,heinrich1 ,ms4 ,baldwin1 ,mr4 ,whitehouse1 ,mr4 ,casey1 ,mr4 ,schumer1 ,mr4 ,kaine1 ,mr4 ,coons1 ,mr4 ,leahy1 ,mrs4 ,gillibrand1 ,mrs4 ,feinstein1 ,mr4 ,blumenthal1 ,mr4 ,booker1 ,mr4 ,peters1 ,mr4 ,cardin1 ,mr4 ,bennet1 ,mr4 ,merkley1 ,mrs4 ,boxer1 and ,mr4 ,murphy7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to amend title ,,xxvii of the ,public ,health ,service ,act to provide for a special enrollment period for pregnant women1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,healthy ,maternity and ,obstetric ,medicine ,act or the ,healthy ,,mom ,act4 #b4 ,findings and purpose 7a7 ,findings ,congress finds the following3 7#a7 ,pregnancy is a significant life event for millions of women in the ,united ,states each year4 7#b7 ,for more than #cj years1 our ,nation1 through the ,medicaid program1 has recognized that pregnant women need immediate access to affordable care1 and has allowed women who meet income-eligibility requirements to enroll in ,medicaid coverage when they become pregnant4 7#c7 ,congress recognized the central importance of maternity coverage by classifying maternity and newborn care as one of the ten essential health benefits that must now be covered on most individual and small group health insurance plans under section #acjb7;b77#a7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjbb7;b77#a774 7#d7 ,the ,patient ,protection and ,affordable ,care ,act has greatly increased access to affordable health insurance coverage for women4 ,today1 more than #g1ejj1jjj women have access to health insurance because of the law4 ,that ,act made it illegal to deny coverage based on pre-existing conditions1 like pregnancy1 or charge women more money for their premiums4 ,that ,act also required women's preventive services like birth control to be covered without cost sharing4 7#e7 ,access to comprehensive maternity coverage allows women to access important pregnancy-related care1 which is demonstrated to improve health outcomes for women and newborns and reduce financial costs for both consumers and insurers4 7#f7 ,uninsured women1 women with grandfathered and transitional health plans1 self-funded student health plans1 and catastrophic and high-deductible health plans may lack access to comprehensive and affordable maternity coverage4 7#g7 ,employer health plans that exclude dependent daughters from maternity coverage leave young women without coverage for their pregnancy1 even though ,federal law has long held that treating pregnancy differently than other conditions is sex-based discrimination4 7#h7 ,a special enrollment period is especially important for young adults1 who are at high risk for unintended pregnancies1 yet young adults are frequently enrolled in catastrophic coverage1 which often has fewer benefits1 more restrictions1 and higher deductibles4 7#i7 ,timely maternity care improves the health of pregnant women1 as well as birth outcomes and the health of babies throughout their lifetimes4 ,pregnancy-related maternal mortality is three to four times higher among women who receive no maternity care compared to women who do4 ,regular maternity care can detect or mitigate serious pregnancy-related health complications1 including preeclampsia1 placental abruption1 complications from diabetes1 complications from heart disease1 and ,graves' disease1 all of which can result in morbidity or mortality for the mother or newborn4 7#aj7 ,regular maternity care can reduce preterm births and the health complications associated with preterm births4 7#aa7 ,timely maternity care can reduce short- and long-term health care costs4 ,if a woman does not have access to affordable maternity care during her pregnancy1 and she or her newborn experiences pregnancy complications that result in health problems after birth1 their insurer may end up paying much higher costs than if the insurer had covered the woman's maternity care during her pregnancy4 ,intensive maternity care can reduce hospital and neonatal intensive care unit admissions among infants1 resulting in cost savings of #a1gfh to #e1efj per birth4 ,for women with high-risk pregnancies1 intensive maternity care saves #a4cg for every #a invested in maternity care4 7b7 ,purpose ,the purpose of this ,act is to protect the health of women and newborns by ensuring that all women eligible for coverage through the ,exchanges established under title ,i of the ,patient ,protection and ,affordable ,care ,act 7,public ,law #aaa-adh7 and women eligible for other individual or group health plan coverage can access affordable health coverage during their pregnancy4 #c4 ,providing for a special enrollment period for pregnant individuals 7a7 ,public ,health ,service ,act ,section #bgjb7;b77#b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#a7;b77#b77 is amended by inserting including a special enrollment period for pregnant individuals1 beginning on the date on which the pregnancy is reported to the health insurance issuer before the period at the end4 7b7 ,patient protection and affordable care act ,section #acaa7;c77#f7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjca7;c77#f77 is amended-- 7#a7 in subparagraph 7,c71 by striking and at the end2 7#b7 by redesignating subparagraph 7,d7 as subparagraph 7,e72 and 7#c7 by inserting after subparagraph 7,c7 the following new subparagraph3 7,d7 a special enrollment period for pregnant individuals1 beginning on the date on which the pregnancy is reported to the ,exchange2 and 4 7c7 ,special enrollment periods ,section #ihja7;f7 of the ,internal ,revenue ,code of #aihf 7#bf ,u4,s4,c4 #ihja7;f77 is amended by adding at the end the following new paragraph3 7#d7 ,for pregnant individuals 7,a7 ,a group health plan shall permit an employee who is eligible1 but not enrolled1 for coverage under the terms of the plan 7or a dependent of such an employee if the dependent is eligible1 but not enrolled1 for coverage under such terms7 to enroll for coverage under the terms of the plan upon pregnancy1 with the special enrollment period beginning on the date on which the pregnancy is reported to the group health plan or the pregnancy is confirmed by a health care provider4 7,b7 ,the ,secretary shall promulgate regulations with respect to the special enrollment period under subparagraph 7,a71 including establishing a time period for pregnant individuals to enroll in coverage and effective date of such coverage4 4 7d7 ,effective date ,the amendments made by this section shall apply with respect to plan years beginning after the #bjaf plan year4 #d4 ,coverage of maternity care for dependent children ,section #bgai;,a of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#ai;a7 is amended by adding at the end the following3 7e7 ,coverage of maternity care ,a group health plan1 or health insurance issuer offering group or individual health insurance coverage1 that provides coverage for dependants shall ensure that such plan or coverage includes coverage for maternity care associated with pregnancy1 childbirth1 and postpartum care for all participants1 beneficiaries1 or enrollees1 including dependants1 including coverage of labor and delivery4 ,such coverage shall be provided to all pregnant dependents regardless of age4 4 #e4 ,federal employee health benefit plans 7a7 ,in general ,the ,director of the ,office of ,personnel ,management shall issue such regulations as are necessary to ensure that pregnancy is considered a change in family status and a qualifying life event for an individual who is eligible to enroll1 but is not enrolled1 in a health benefit plan under chapter #hi title #e1 ,united ,states ,code4 7b7 ,effective date ,the requirement in subsection 7a7 shall apply with respect to any contract entered into under section #hijb of such title beginning #ab months after the date of enactment of this ,act4 #f4 ,continuation of ,medicaid income eligibility standard for pregnant women and infants ,section #aijb7l77#b77;,a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7l77#b77;,a77 is amended-- 7#a7 in clause 7i71 by striking and not more than #ahe percent2 7#b7 in clause 7ii7-- 7,a7 in subclause 7,i71 by striking and after the comma2 7,b7 in subclause 7,,ii71 by striking the period at the end and inserting 1 and2 and 7,c7 by adding at the end the following3 7,,iii7 ,january #a1 #bjad1 is the percentage provided under clause 7v74 2 and 7#c7 by adding at the end the following new clause3 7v7 ,the percentage provided under clause 7ii7 for medical assistance on or after ,january #a1 #bjad1 with respect to individuals described in subparagraph 7,a7 or 7,b7 of paragraph 7#a7 shall not be less than-- 7,i7 the percentage specified for such individuals by the ,state in an amendment to its ,state plan 7whether approved or not7 as of ,january #a1 #bjad1 or 7,,ii7 if no such percentage is specified as of ,january #a1 #bjad1 the percentage established for such individuals under the ,state's authorizing legislation or provided for under the ,state's appropriations as of that date4 4 #g4 ,relationship to other laws ,nothing in this ,act 7or an amendment made by this ,act7 shall be construed to invalidate or limit the remedies1 rights1 and procedures of any ,federal law or the law of any ,state or political subdivision of any ,state or jurisdiction that provides greater or equal protection for enrollees in a group health plan or group or individual health insurance offered by a health insurance issuer4