,,ii  #aag? ,,congress  #a/ ,session    
,s4 #cbci  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,novemb] #ah1 #bjba,mr4
 ,br[n 7= himself1 ,mr4 ,k+1 ,ms4       
,baldw91 ,mr4 ,casey1 ,ms4 ,smi?1 ,mr4  
,blum5?al1 ,mr4 ,van ,holl51 ,mr4       
,m]kley1 ,mr4 ,:iteh\se1 ,ms4 ,cortez   
,ma/o1 ,mr4 ,m>key1 ,mr4 ,ka9e1 ,ms4    
,klobu*>1 ,mr4 ,book]1 & ,ms4 ,ros57    
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 p]sons1 & = o!r purposes4  #a4
 ,%ort title ,?is ,act may be cit$ z !  
,heal?y ,mat]nity & ,ob/etric ,m$ic9e   
,act or ! ,heal?y ,,mom ,act4  #b4      
,provid+ = a special enrollm5t p]iod =  
pregnant individuals  7a7 ,public ,heal?
 ,s]vice ,act ,section #bgjb7;b77#b7 ( !
 ,public ,heal? ,s]vice ,act 7#db       
,u4,s4,c4 #cjj;gg-#a7;b77#b77 is am5d$  
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  7#a7 ,int]nal
 ,rev5ue ,code ,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 ,9 g5]al ,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 ,regulations ,! ,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  7#b7 ,,erisa ,section #gja7;f7 ( ! 
,employee ,retirem5t ,income ,security  
,act ( #aigd 7#bi ,u4,s4,c4 #aaha7;f77  
is am5d$ by add+ at ! end ! foll[+3     
7#d7 ,= pregnant individuals  7,a7 ,9   
g5]al ,a gr\p heal? plan or heal?       
insurance issu] 9 connection ) 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 heal?   
insurance issu] or ! pregnancy is       
confirm$ by a heal? c>e provid]4  7,b7  
,regulations ,! ,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] ! #bjba plan ye>4  #c4 
,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$-- 7#a7 9        
subsection 7e71 by ins]t+ 7o!r ?an      
subsection 7f77 aft] ?is section2 &     
7#b7 by add+ at ! end ! foll[+3  7f7    
,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 = dep5d5ts %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+ dep5d5ts1 includ+    
cov]age ( labor & deliv]y4 ,su* cov]age 
%all be provid$ to all pregnant dep5d5ts
 reg>dless ( age4  4  #d4 ,f$]al        
employee heal? b5efit plans  7a7        
,cov]age ( pregnancy ,! ,director ( !   
,(fice ( ,p]sonnel ,managem5t %all issue
 su* regulations z are necess>y to      
ensure t pregnancy is consid]$ 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
  #e4 ,cont9uation ( ,m$icaid income    
eligibility /&>d = pregnant individuals 
& infants ,section #aijb7l77#b77;,a7 ( !
 ,social ,security ,act 7#db ,u4,s4,c4  

#acif;a7l77#b77;,a77 is am5d$-- 7#a7 9  
clause 7i71 by /rik+ & n m ?an #ahe     
p]c5t2  7#b7 9 clause 7ii7-- 7,a7 9     
subclause 7,i71 by /rik+ & aft] ! comma2
  7,b7 9 subclause 7,,ii71 by /rik+ !   
p]iod at ! end & ins]t+ 1 &2 &  7,c7 by 
add+ at ! end ! foll[+3  7,,iii7 ,janu>y
 #a1 #bjbb1 is ! p]c5tage provid$ "u    
clause 7v74  2 &  7#c7 by add+ at ! end 
! foll[+ new clause3  7v7 ,! p]c5tage   
provid$ "u clause 7ii7 = m$ical         
assi/ance provid$ on or aft] ,janu>y #a1
 #bjbb1 ) 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     
#bjad2 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  #f4 ,requir+ & mak+ p]man5t   
#ab-mon? cont9u\s cov]age = pregnant &  

po/p>tum individuals "u ,m$icaid & ,,*ip
  7a7 ,m$icaid ,section #aijb ( !       
,social ,security ,act 7#db ,u4,s4,c4   
#acif;a7 is am5d$-- 7#a7 9 subsection   
7a7-- 7,a7 9 p>agraph 7#hf71 by /rik+ & 
at ! end2  7,b7 9 p>agraph 7#hg71 by    
/rik+ ! p]iod at ! end & ins]t+ 2 &2 &  
7,c7 by ins]t+ aft] p>agraph 7#hg7 !    
foll[+ new p>agraph3  7#hh7 provide t ! 
,/ate plan is 9 compliance ) subsection 
7e77#af74  2 &  7#b7 9 subsection       
7e77#af71 z add$ by section #ihab ( !   
,am]ican ,rescue ,plan ,act ( #bjba     
7,public ,law #aag-b7-- 7,a7 9          
subp>agraph 7,a71 by /rik+ ,at ! option 
( ! ,/ate1 ! ,/ate plan 7or waiv] ( su* 
,/ate plan7 may provide & ins]t+ ,a     
,/ate plan 7or waiv] ( su* ,/ate plan7  
%all provide2  7,b7 9 subp>agraph 7,b71 
9 ! matt] prec$+ clause 7i71 by /rik+ by
 a ,/ate mak+ an election "u ?is        
p>agraph & ins]t+ "u a ,/ate plan 7or a 
waiv] ( su* ,/ate plan72 &  7,c7 by     
/rik+ subp>agraph 7,c74  7b7 ,,*ip  7#a7
 ,9 g5]al ,section #bajg7;e77#a77;,j7 ( 

! ,social ,security ,act 7#db ,u4,s4,c4 
#acig;gg7e77#a77;,j771 z ins]t$ by      
section #ihbb ( ! ,am]ican ,rescue ,plan
 ,act ( #bjba 7,public ,law #aag-b71 is 
am5d$ to read z foll[s3  7,j7 ,p>agraphs
 7#e7 & 7#af7 ( section #aijb7;e7       
7relat+ to ! requirem5t to provide      
m$ical assi/ance "u ! ,/ate plan or     
waiv] consi/+ ( full b5efits dur+       
pregnancy & ?r\gh\t ! #ab-mon? po/p>tum 
p]iod "u title ,,xix7 su* t ! provision 
( assi/ance "u ! ,/ate *ild heal? plan  
or waiv] = t>get$ l[-income *ildr5 or   
t>get$ l[-income pregnant individuals   
dur+ pregnancy & ! #ab-mon? po/p>tum    
p]iod %all be requir$ & %all include    
cov]age ( all items or s]vices provid$  
to a t>get$ l[-income *ild or t>get$    
l[-income pregnant individual 7z        
applicable7 "u ! ,/ate *ild heal? plan  
or waiv]74  4  7#b7 ,con=m+ ,section    
#baab7;d77#b77;,a7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#acigll7d77#b77;,a771 z ins]t$ by       
section #ihbb ( ! ,am]ican ,rescue ,plan

 ,act ( #bjba 7,public ,law #aag-b71 is 
am5d$ by /rik+ ! mon? 9 :i* ! #fj-;day  
p]iod & all t foll[s ?r\gh pursuant to  
section #bajg7;e77#a714  7c7 ,con=m+    
am5dm5ts  7#a7 ,section #ihab7;b7 ( !   
,am]ican ,rescue ,plan ,act ( #bjba     
7,public ,law #aag-b7 is am5d$ to read z
 foll[s3  7b7 ,effective date  7#a7 ,9  
g5]al ,subject to p>agraph 7#b71 !      
am5dm5t made by subsection 7a7 %all     
apply ) respect to s]vices furni%$ on or
 aft] ! #a/ day ( ! #a/ fiscal ye> qu>t]
 t beg9s "o ye> aft] ! date ( ! enactm5t
 ( ?is ,act4  7#b7 ,exception = ,/ate   
legislation ,9 ! case ( a ,/ate plan "u 
title ,,xix ( ! ,social ,security ,act t
 ! ,secret>y ( ,heal? & ,human ,s]vices 
det]m9es requires ,/ate legislation 9   
ord] = ! respective plan to meet any    
requirem5t impos$ by am5dm5ts made by   
?is section1 ! plan %all n be reg>d$ z  
fail+ to comply ) ! requirem5ts ( su*   
title solely on ! basis ( its failure to
 meet su* an additional requirem5t be=e 
! fir/ day ( ! fir/ fiscal ye> qu>t]    

beg9n+ aft] ! close ( ! fir/ regul>     
session ( ! ,/ate legislature t beg9s   
aft] ! date ( enactm5t ( ?is ,act4 ,=   
purposes ( ! previ\s s5t5ce1 9 ! case ( 
a ,/ate t has a #b-ye> legislative      
session1 ea* ye> ( ! session %all be    
consid]$ to be a sep>ate regul> session 
( ! ,/ate legislature4  4  7#b7 ,section
 #ihbb7;b7 ( ! ,am]ican ,rescue ,plan   
,act ( #bjba 7,public ,law #aag-b7 is   
am5d$ to read z foll[s3  7b7 ,effective 
date  7#a7 ,9 g5]al ,subject to p>agraph
 7#b71 ! am5dm5ts made by subsection    
7a71 %all apply ) respect to s]vices    
furni%$ on or aft] ! #a/ day ( ! #a/    
fiscal ye> qu>t] t beg9s "o ye> aft] !  
date ( ! enactm5t ( ?is ,act4  7#b7     
,exception = ,/ate legislation ,9 ! case
 ( a ,/ate *ild heal? plan "u title     
,,xxi ( ! ,social ,security ,act t !    
,secret>y ( ,heal? & ,human ,s]vices    
det]m9es requires ,/ate legislation 9   
ord] = ! plan to meet any requirem5t    
impos$ by am5dm5ts made by ?is section1 
! respective plan %all n be reg>d$ z    

fail+ to comply ) ! requirem5ts ( su*   
title solely on ! basis ( its failure to
 meet su* an additional requirem5t be=e 
! fir/ day ( ! fir/ fiscal ye> qu>t]    
beg9n+ aft] ! close ( ! fir/ regul>     
session ( ! ,/ate legislature t beg9s   
aft] ! date ( enactm5t ( ?is ,act4 ,=   
purposes ( ! previ\s s5t5ce1 9 ! case ( 
a ,/ate t has a #b-ye> legislative      
session1 ea* ye> ( ! session %all be    
consid]$ to be a sep>ate regul> session 
( ! ,/ate legislature4  4  7d7          
,effective date ,! am5dm5ts made by     
subsections 7a7 & 7c77#a7 %all take     
effect z if includ$ 9 ! enactm5t (      
section #ihab ( ! ,am]ican ,rescue ,plan
 ,act ( #bjba 7,public ,law #aag-b74 ,! 
am5dm5ts made by subsections 7b7 &      
7c77#b7 %all take effect z if includ$ 9 
! enactm5t ( section #ihbb ( su* ,act4  
#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