,,iib  #aaf? ,,congress  #b;d ,session  
,h4 ,r4 #diif  ,,9 ,,! ,,s5ate ,,( ,,!  
,,unit$ ,,/ates  ,septemb] #cj          
7legislative day1 ,septemb] #bi71 #bjbj 
,receiv$2 read twice & ref]r$ to !      
,committee on ,f9ance  ,,an ,,act  ,to  
am5d title ,,xix ( ! ,social ,security  
,act to provide = a ,/ate option "u !   
,m$icaid program to provide = & ext5d   
cont9u\s cov]age = c]ta9 individuals1 & 
= o!r purposes4  #a4 ,%ort title ,?is   
,act may be cit$ z ! ,help+ ,m$icaid    
,(f] ,mat]nity ,s]vices ,act ( #bjbj or 
! ,help+ ,,moms ,act ( #bjbj4  #b4      
,modifications to c]ta9 cov]age "u      
,m$icaid & ,,*ip = pregnant & po/p>tum  
wom5  7a7 ,/ate option ,section         
#aijb7;e7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #acif;a7e77 is am5d$ by  
add+ at ! end ! foll[+ new p>agraph3    
7#af7 ,ext5d+ c]ta9 cov]age = pregnant &
 po/p>tum wom5 ,at ! option ( ! ,/ate1 !
 ,/ate plan 7or waiv] ( su* ,/ate plan7 
may provide t an individual :o1 :ile    
pregnant1 is eligible = & has receiv$   

m$ical assi/ance "u ! ,/ate plan approv$
 "u ?is title 7or waiv] ( su* plan7     
7includ+ dur+ a p]iod ( retroactive     
eligibility "u subsection 7a77#cd77     
%all1 9 addition to rema9+ eligible "u  
p>agraph 7#e7 = all pregnancy-relat$ &  
po/p>tum m$ical assi/ance available "u !
 ,/ate plan 7or wavi]7 ?r\gh ! la/ day (
 ! mon? 9 :i* ! #fj-;day p]iod 7beg9n+  
on ! la/ day ( h] pregnancy7 ends1 rema9
 eligible "u ! ,/ate plan 7or waiv]7 =  
m$ical assi/ance & su* m$ical assi/ance 
%all include all s]vices cov]$ "u !     
,/ate plan 7or waiv]7 t is n less 9     
am\nt1 duration1 or scope1 or is det]m9$
 by ! ,secret>y to be sub/antially      
equival5t1 to ! m$ical assi/ance        
available = an individual describ$ 9    
subsection 7a77#aj77;,a77i7 = ! p]iod   
beg9n+ on ! fir/ day occurr+ aft] ! end 
( su* #fj-;day p]iod & end+ on ! la/ day
 ( ! mon? 9 :i* ! "o-ye> p]iod 7beg9n+  
on ! la/ day ( h] pregnancy7 ends4  4   
7b7 ,application to ,,*ip  7#a7 ,9 g5]al
 ,section #bajg7;e77#a7 ( ! ,social     

,security ,act 7#db ,u4,s4,c4           
#acig;gg7e77#a77 is am5d$-- 7,a7 by     
r$esignat+ subp>agraphs 7,j7 ?r\gh 7,s7 
z subp>agraphs 7,k7 ?r\gh 7,t71         
respectively2 &  7,b7 by ins]t+ aft]    
subp>agraph 7,i7 ! foll[+ new           
subp>agraph3  7,j7 ,9 ! case ( a ,/ate t
 has elect$ to apply ! option "u section
 #aijb7;e77#af7 ) respect to cov]age =  
pregnant & po/p>tum wom5 "u title ,,xix1
 ! provisions ( su* section ) respect to
 cov]age ( pregnant & po/p>tum wom5 "u  
?is title1 except t su* cov]age %all be 
requir$ & n at ! option ( ! ,/ate4  4   
7#b7 ,optional cov]age ( t>get$         
l[-income pregnant wom5 ,section        
#baab7;d77#b77;,a7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#acigll7d77#b77;,a77 is am5d$ by ins]t+ 
aft] #fj-;day p]iod ! foll[+3 1 or1 9 ! 
case t section #aijb7;e77#af7 applies to
 ! ,/ate *ild heal? plan 7or waiv] ( su*
 plan7 pursuant to section              
#bajg7;e77#a71 ! #a-ye> p]iod4  7c7     
,effective date ,! am5dm5ts made by ?is 

section %all apply ) respect to ,/ate   
elections made "u p>agraph 7#af7 (      
section #aijb7;e7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #acif;a7e771 z add$ 
by subsection 7a71 "u title ,,xix ( !   
,social ,security ,act 7#db ,u4,s4,c4   
#acif et seq47 on or aft] ! fir/ day ( !
 fir/ fiscal ye> qu>t] beg9n+ at lea/ "o
 ye> aft] ! date ( ! enactm5t ( ?is     
,act4  #c4 ,,macpac report  7a7 ,9 g5]al
 ,n lat] ?an #a ye> aft] ! date ( !     
enactm5t ( ?is ,act1 ! ,m$icaid & ,,*ip 
,paym5t & ,access ,commission 7ref]r$ to
 9 ?is section z ,,macpac7 %all publi% a
 report on ! cov]age ( d\la s]vices "u  
,/ate ,m$icaid programs1 :i* %all at a  
m9imum include ! foll[+3 7#a7 ,in=mation
 ab\t cov]age = d\la s]vices "u ,/ate   
,m$icaid programs t curr5tly provide    
cov]age = su* s]vices1 includ+ ! type ( 
d\la s]vices (f]$ 7su* z pr5atal1 labor 
& deliv]y1 po/p>tum support1 & also     
community-bas$ & traditional d\la       
s]vices74  7#b7 ,an analysis ( b>ri]s to
 cov]+ d\la s]vices "u ,/ate ,m$icaid   

programs4  7#c7 ,an id5tification (     
effective /rategies to increase ! use ( 
d\la s]vices 9 ord] to provide bett] c>e
 & a*ieve bett] mat]nal & infant heal?  
outcomes1 includ+ /rategies t ,/ates may
 use to recruit1 tra91 & c]tify a div]se
 d\la work=ce1 p>ticul>ly f und]s]v$    
communities1 communities ( color1 &     
communities fac+ l+ui/ic or cultural    
b>ri]s4  7#d7 ,recomm5dations =         
legislative & adm9i/rative actions to   
increase access to d\la s]vices 9 ,/ate 
,m$icaid programs1 includ+ actions t    
ensure d\las may e>n a liv+ wage t      
acc\nts = _! "t & co/s associat$ )      
provid+ c>e4  7b7 ,/akehold]            
consultation ,9 develop+ ! report       
requir$ "u subsection 7a71 ,,macpac %all
 consult ) relevant /akehold]s1         
includ+-- 7#a7 ,/ates2  7#b7            
organizations repres5t+ consum]s1       
includ+ ^? t are disproportionately     
impact$ by poor mat]nal heal? outcomes2 
7#c7 organizations & individuals        
repres5t+ d\la s]vices provid]s1 includ+

 community-bas$ d\la programs & ^? :o   
s]ve und]s]v$ communities1 includ+      
communities ( color1 & communities fac+ 
l+ui/ic or cultural b>ri]s2 &  7#d7     
organizations repres5t+ heal? c>e       
provid]s4  #d4 ,,gao report  7a7 ,9     
g5]al ,n lat] ?an #b ye>s aft] ! date ( 
! enactm5t ( ?is ,act & e five ye>s     
!reaft]1 ! ,comptroll] ,g5]al ( ! ,unit$
 ,/ates %all submit to ,congress a      
report on ! ,/ate adoption1 "u !        
,m$icaid program "u title ,,xix ( !     
,social ,security ,act 7#db ,u4,s4,c4   
#acif et seq47 & ! ,*ildr5's ,heal?     
,insurance ,program "u title ,,xxi ( su*
 ,act1 ( ext5d+ cov]age to #cfe days    
po/p>tum pursuant to ! provisions ( 7&  
am5dm5ts made by ?is ,act74 ,su* report 
%all include ! in=mation &              
recomm5dations describ$ 9 subsection 7b7
 & %all also id5tify ongo+ gaps 9       
cov]age =-- 7#a7 pregnant wom5 "u !     
,m$icaid program & ! ,*ildr5's ,heal?   
,insurance ,program2 &  7#b7 po/p>tum   
wom5 "u ! ,m$icaid program & ! ,*ildr5's

 ,heal? ,insurance ,program :o receiv$  
assi/ance "u ei!r su* program dur+ _!   
pregnancy4  7b7 ,cont5t ( report ,!     
report "u subsection 7a7 %all include ! 
foll[+3 7#a7 ,in=mation reg>d+ ! ext5t  
to :i* ,/ates h elect$ to ext5d cov]age 
to #cfe days po/p>tum pursuant to !     
provisions ( 7& am5dm5ts made by ?is    
,act71 includ+ :i* ,/ates make !        
election & :51 impacts on p]9atal       
insurance *urn 9 ^? ,/ates comp>$ to    
,/ates t did n make su* election1 o!r   
heal? impacts ( su* election includ+    
reg>d+ mat]nal mortality & morbidity    
rates1 & impacts on ,/ate & ,f$]al      
,m$icaid sp5d+4  7#b7 ,in=mation ab\t ! 
abilities1 successes1 & *all5ges ( ,/ate
 ,m$icaid ag5cies 9-- 7,a7 transition+  
_! eligibility sy/ems to incorporate su*
 an election by a ,/ate & 9 det]m9+ :e!r
 pregnant & po/p>tum wom5 are eligible  
"u ano!r insurance af=dability program2 
&  7,b7 transition+ any su* wom5 :o are 
s eligible to cov]age "u su* a program1 
pursuant to section #aidc7;b77#c7 ( !   

,social ,security ,act 7#db ,u4,s4,c    
#acifw-#c7;b77#c774  7#c7 ,in=mation on 
factors contribut+ to ongo+ gaps 9      
cov]age result+ f wom5 transition+ f    
cov]age "u ! ,m$icaid program or        
,*ildr5's ,heal? ,insurance ,program t  
disproportionately impact und]s]v$      
populations1 includ+ l[-income wom51    
wom5 ( color1 wom5 :o reside 9 a heal?  
pr(essional %ortage area 7z def9$ 9     
section #ccb7;a77#a77;,a7 ( ! ,public   
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#bed;e7a77#a77;,a7771 or :o are memb]s (
 a m$ically und]s]v$ population 7z def9$
 by section #ccj7;b77#c7 ( su* ,act 7#db
 ,u4,s4,c4 #bed;b7b77#c77;,a7774  7#d7  
,recomm5dations = address+ & r$uc+ su*  
gaps 9 cov]age4  7#e7 ,su* o!r in=mation
 z ! ,comptroll] ,g5]al det]m9es        
appropriate4  #e4 ,report on ,m$icaid   
bundl$ paym5ts = pregnancy-relat$       
s]vices ,n lat] ?an #b ye>s aft] ! date 
( ! enactm5t ( ?is ,act1 ! ,m$icaid &   
,,*ip ,paym5t ,advisory ,commission %all
 submit to ,congress a report conta9+ an

 analysis ( ! use ( bundl$ paym5ts =    
reimburs+ heal? c>e provid]s ) respect  
to pregnancy-relat$ s]vices furni%$ "u  
,/ate plans 7or waiv]s ( su* plans7 "u  
title ,,xix ( ! ,social ,security ,act  
7#db ,u4,s4,c4 #acif et seq474  #f4     
,sunset ( limit on maximum rebate am\nt 
= s+le s\rce drugs & innovator multiple 
s\rce drugs ,section #aibg7;c77#b77;,d7 
( ! ,social ,security ,act 7#db         
,u4,s4,c4 #acifr-#h7;c77#b77;,d77 is    
am5d$ by ins]t+ aft] ,decemb] #ca1      
#bjji1 ! foll[+3 & be=e ,janu>y #a1     
#bjbc14  #g4 ,m$icaid ,improvem5t ,fund 
,section #aida7;b77#c7 ( ! ,social      
,security ,act 7#db ,u4,s4,c            
#acifw-#a7;b77#c77 is am5d$-- 7#a7 9    
subp>agraph 7,a71 by /rik+ = fiscal ye> 
#bjbe & !reaft]1 #a1ifj1jjj1jjj & ins]t+
 = fiscal ye> #bjbb & !reaft]1          
#i1bhf1jjj1jjj2 &  7#b7 9 subp>agraph   
7,b71 by /rik+ fiscal ye> #bjbe & ins]t+
 fiscal ye> #bjbb4  #h4 ,det]m9ation (  
budget>y effects ,! budget>y effects (  
?is ,act1 = ! purpose ( comply+ ) !     

,/atutory ,pay-,z-,y-,g ,act ( #bjaj1   
%all be det]m9$ by ref]5ce to ! late/   
/atem5t titl$ ,budget>y ,effects (      
,,paygo ,legislation = ?is ,act1        
submitt$ = pr9t+ 9 ! ,congressional     
,record by ! ,*airman ( ! ,h\se ,budget 
,committee1 provid$ t su* /atem5t has   
be5 submitt$ prior to ! vote on passage4
  ,pass$ ! ,h\se ( ,repres5tatives      
,septemb] #bi1 #bjbj4;,*]yl ,l4         
,johnson1,cl]k