,,ii #aad? ,,congress #a/ ,session ,s4 #bbbj ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,octob] #bi1 #bjae,mr4 ,br[n 7= himself1 ,mrs4 ,murray1 ,ms4 ,mikulski1 ,mr4 ,m>key1 ,mr4 ,te/]1 ,mr4 ,he9ri*1 ,ms4 ,baldw91 ,mr4 ,:iteh\se1 ,mr4 ,casey1 ,mr4 ,s*um]1 ,mr4 ,ka9e1 ,mr4 ,coons1 ,mr4 ,leahy1 ,mrs4 ,gillibr&1 ,mrs4 ,fe9/e91 ,mr4 ,blum5?al1 ,mr4 ,book]1 ,mr4 ,pet]s1 ,mr4 ,c>d91 ,mr4 ,b5net1 ,mr4 ,m]kley1 ,mrs4 ,box]1 & ,mr4 ,murphy7 introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,f9ance ,a ,,bill ,to am5d title ,,xxvii ( ! ,public ,heal? ,s]vice ,act to provide = a special enrollm5t p]iod = pregnant wom51 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,heal?y ,mat]nity & ,ob/etric ,m$ic9e ,act or ! ,heal?y ,,mom ,act4 #b4 ,f9d+s & purpose 7a7 ,f9d+s ,congress f9ds ! foll[+3 7#a7 ,pregnancy is a significant life ev5t = millions ( wom5 9 ! ,unit$ ,/ates ea* ye>4 7#b7 ,= m ?an #cj ye>s1 our ,nation1 ?r\gh ! ,m$icaid program1 has recogniz$ t pregnant wom5 ne$ imm$iate access to af=dable c>e1 & has all[$ wom5 :o meet income-eligibility requirem5ts to enroll 9 ,m$icaid cov]age :5 !y become pregnant4 7#c7 ,congress recogniz$ ! c5tral importance ( mat]nity cov]age by classify+ mat]nity & newborn c>e z "o ( ! t5 ess5tial heal? b5efits t mu/ n[ be cov]$ on mo/ individual & small gr\p heal? insurance plans "u section #acjb7;b77#a7 ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7#db ,u4,s4,c4 #ahjbb7;b77#a774 7#d7 ,! ,pati5t ,protection & ,af=dable ,c>e ,act has greatly increas$ access to af=dable heal? insurance cov]age = wom54 ,today1 m ?an #g1ejj1jjj wom5 h access to heal? insurance because ( ! law4 ,t ,act made x illegal to d5y cov]age bas$ on pre-exi/+ conditions1 l pregnancy1 or *>ge wom5 m money = _! premiums4 ,t ,act also requir$ wom5's prev5tive s]vices l bir? control to be cov]$ )\t co/ %>+4 7#e7 ,access to compreh5sive mat]nity cov]age all[s wom5 to access important pregnancy-relat$ c>e1 :i* is demon/rat$ to improve heal? outcomes = wom5 & newborns & r$uce f9ancial co/s = bo? consum]s & insur]s4 7#f7 ,un9sur$ wom51 wom5 ) gr&fa!r$ & transitional heal? plans1 self-fund$ /ud5t heal? plans1 & cata/rophic & high-d$uctible heal? plans may lack access to compreh5sive & af=dable mat]nity cov]age4 7#g7 ,employ] heal? plans t exclude dep5d5t daught]s f mat]nity cov]age leave "y wom5 )\t cov]age = _! pregnancy1 ev5 ?\gh ,f$]al law has long held t treat+ pregnancy diff]5tly ?an o!r conditions is sex-bas$ discrim9ation4 7#h7 ,a special enrollm5t p]iod is especially important = "y adults1 :o are at high risk = un9t5d$ pregnancies1 yet "y adults are frequ5tly enroll$ 9 cata/rophic cov]age1 :i* (t5 has few] b5efits1 m re/rictions1 & high] d$uctibles4 7#i7 ,timely mat]nity c>e improves ! heal? ( pregnant wom51 z well z bir? outcomes & ! heal? ( babies ?r\gh\t _! lifetimes4 ,pregnancy-relat$ mat]nal mortality is ?ree to f\r times high] among wom5 :o receive no mat]nity c>e comp>$ to wom5 :o d4 ,regul> mat]nity c>e c detect or mitigate s]i\s pregnancy-relat$ heal? complications1 includ+ preeclampsia1 plac5tal abruption1 complications f diabetes1 complications f he>t disease1 & ,graves' disease1 all ( :i* c result 9 morbidity or mortality = ! "m or newborn4 7#aj7 ,regul> mat]nity c>e c r$uce pret]m bir?s & ! heal? complications associat$ ) pret]m bir?s4 7#aa7 ,timely mat]nity c>e c r$uce %ort- & long-t]m heal? c>e co/s4 ,if a woman does n h access to af=dable mat]nity c>e dur+ h] pregnancy1 & %e or h] newborn exp]i5ces pregnancy complications t result 9 heal? problems aft] bir?1 _! insur] may end up pay+ mu* high] co/s ?an if ! insur] _h cov]$ ! woman's mat]nity c>e dur+ h] pregnancy4 ,int5sive mat]nity c>e c r$uce hospital & neonatal int5sive c>e unit admissions among infants1 result+ 9 co/ sav+s ( #a1gfh to #e1efj p] bir?4 ,= wom5 ) high-risk pregnancies1 int5sive mat]nity c>e saves #a4cg = e #a inve/$ 9 mat]nity c>e4 7b7 ,purpose ,! purpose ( ?is ,act is to protect ! heal? ( wom5 & newborns by ensur+ t all wom5 eligible = cov]age ?r\gh ! ,ex*anges e/abli%$ "u title ,i ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7,public ,law #aaa-adh7 & wom5 eligible = o!r individual or gr\p heal? plan cov]age c access af=dable heal? cov]age dur+ _! pregnancy4 #c4 ,provid+ = a special enrollm5t p]iod = pregnant individuals 7a7 ,public ,heal? ,s]vice ,act ,section #bgjb7;b77#b7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg-#a7;b77#b77 is am5d$ by ins]t+ includ+ a special enrollm5t p]iod = pregnant individuals1 beg9n+ on ! date on :i* ! pregnancy is report$ to ! heal? insurance issu] be=e ! p]iod at ! end4 7b7 ,pati5t protection & af=dable c>e act ,section #acaa7;c77#f7 ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7#db ,u4,s4,c4 #ahjca7;c77#f77 is am5d$-- 7#a7 9 subp>agraph 7,c71 by /rik+ & at ! end2 7#b7 by r$esignat+ subp>agraph 7,d7 z subp>agraph 7,e72 & 7#c7 by ins]t+ aft] subp>agraph 7,c7 ! foll[+ new subp>agraph3 7,d7 a special enrollm5t p]iod = pregnant individuals1 beg9n+ on ! date on :i* ! pregnancy is report$ to ! ,ex*ange2 & 4 7c7 ,special enrollm5t p]iods ,section #ihja7;f7 ( ! ,int]nal ,rev5ue ,code ( #aihf 7#bf ,u4,s4,c4 #ihja7;f77 is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#d7 ,= pregnant individuals 7,a7 ,a gr\p heal? plan %all p]mit an employee :o is eligible1 b n enroll$1 = cov]age "u ! t]ms ( ! plan 7or a dep5d5t ( su* an employee if ! dep5d5t is eligible1 b n enroll$1 = cov]age "u su* t]ms7 to enroll = cov]age "u ! t]ms ( ! plan ^u pregnancy1 ) ! special enrollm5t p]iod beg9n+ on ! date on :i* ! pregnancy is report$ to ! gr\p heal? plan or ! pregnancy is confirm$ by a heal? c>e provid]4 7,b7 ,! ,secret>y %all promulgate regulations ) respect to ! special enrollm5t p]iod "u subp>agraph 7,a71 includ+ e/abli%+ a "t p]iod = pregnant individuals to enroll 9 cov]age & effective date ( su* cov]age4 4 7d7 ,effective date ,! am5dm5ts made by ?is section %all apply ) respect to plan ye>s beg9n+ aft] ! #bjaf plan ye>4 #d4 ,cov]age ( mat]nity c>e = dep5d5t *ildr5 ,section #bgai;,a ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg-#ai;a7 is am5d$ by add+ at ! end ! foll[+3 7e7 ,cov]age ( mat]nity c>e ,a gr\p heal? plan1 or heal? insurance issu] (f]+ gr\p or individual heal? insurance cov]age1 t provides cov]age = dep5dants %all ensure t su* plan or cov]age includes cov]age = mat]nity c>e associat$ ) pregnancy1 *ildbir?1 & po/p>tum c>e = all p>ticipants1 b5efici>ies1 or enrollees1 includ+ dep5dants1 includ+ cov]age ( labor & deliv]y4 ,su* cov]age %all be provid$ to all pregnant dep5d5ts reg>dless ( age4 4 #e4 ,f$]al employee heal? b5efit plans 7a7 ,9 g5]al ,! ,director ( ! ,(fice ( ,p]sonnel ,managem5t %all issue su* regulations z are necess>y to ensure t pregnancy is consid]$ a *ange 9 family /atus & a qualify+ life ev5t = an individual :o is eligible to enroll1 b is n enroll$1 9 a heal? b5efit plan "u *apt] #hi title #e1 ,unit$ ,/ates ,code4 7b7 ,effective date ,! requirem5t 9 subsection 7a7 %all apply ) respect to any contract ent]$ into "u section #hijb ( su* title beg9n+ #ab mon?s aft] ! date ( enactm5t ( ?is ,act4 #f4 ,cont9uation ( ,m$icaid income eligibility /&>d = pregnant wom5 & infants ,section #aijb7l77#b77;,a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7l77#b77;,a77 is am5d$-- 7#a7 9 clause 7i71 by /rik+ & n m ?an #ahe p]c5t2 7#b7 9 clause 7ii7-- 7,a7 9 subclause 7,i71 by /rik+ & aft] ! comma2 7,b7 9 subclause 7,,ii71 by /rik+ ! p]iod at ! end & ins]t+ 1 &2 & 7,c7 by add+ at ! end ! foll[+3 7,,iii7 ,janu>y #a1 #bjad1 is ! p]c5tage provid$ "u clause 7v74 2 & 7#c7 by add+ at ! end ! foll[+ new clause3 7v7 ,! p]c5tage provid$ "u clause 7ii7 = m$ical assi/ance on or aft] ,janu>y #a1 #bjad1 ) respect to individuals describ$ 9 subp>agraph 7,a7 or 7,b7 ( p>agraph 7#a7 %all n be less ?an-- 7,i7 ! p]c5tage specifi$ = su* individuals by ! ,/ate 9 an am5dm5t to its ,/ate plan 7:e!r approv$ or n7 z ( ,janu>y #a1 #bjad1 or 7,,ii7 if no su* p]c5tage is specifi$ z ( ,janu>y #a1 #bjad1 ! p]c5tage e/abli%$ = su* individuals "u ! ,/ate's au?oriz+ legislation or provid$ = "u ! ,/ate's appropriations z ( t date4 4 #g4 ,relation%ip to o!r laws ,no?+ 9 ?is ,act 7or an am5dm5t made by ?is ,act7 %all be con/ru$ to invalidate or limit ! rem$ies1 rights1 & proc$ures ( any ,f$]al law or ! law ( any ,/ate or political subdivision ( any ,/ate or jurisdiction t provides great] or equal protection = enrollees 9 a gr\p heal? plan or gr\p or individual heal? insurance (f]$ by a heal? insurance issu]4