H.R. 3126, Healthy Maternity and Obstetric Medicine Act
Summary
H.R. 3126, the Healthy Maternity and Obstetric Medicine Act (Healthy MOM Act), was introduced in the House of Representatives May 11, 2021, by Mrs. Watson Coleman and other members. It was referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Labor, and Oversight and Reform. The bill would amend title XXVII of the Public Health Service Act to provide for a special enrollment period for pregnant women. Section 3 provides a special enrollment period for pregnant individuals beginning on the date on which the pregnancy is reported to the health insurance issuer or the Exchange, and amends the Public Health Service Act, the Patient Protection and Affordable Care Act, and the Internal Revenue Code of 1986.
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“H.R. 3126, Healthy Maternity and Obstetric Medicine Act.”
Original at www.govinfo.gov. Archived at Pandemic Darlings, https://pandemicdarlings.com/source-documents/bills-bills-117hr3126ih-bills-117hr3126ih/
, SHA-256 939399d647bc467bf4392169a548cd82bb90214ca297058cd217b1e667bc2537.Full text
I
117TH CONGRESS
1ST SESSION
H. R. 3126
To amend title XXVII of the Public Health Service Act to provide for
a special enrollment period for pregnant women, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
MAY 11, 2021
Mrs. WATSON COLEMAN (for herself, Ms. ADAMS, Ms. BASS, Mrs. BEATTY,
Mr. BISHOP of Georgia, Mr. BLUMENAUER, Ms. BONAMICI, Mr.
BRENDAN F. BOYLE of Pennsylvania, Mr. CARSON, Ms. CHU, Mr.
COHEN, Mr. CONNOLLY, Mr. COOPER, Mr. ESPAILLAT, Mr. EVANS, Mr.
FOSTER, Ms. LOIS FRANKEL of Florida, Mrs. HAYES, Mr. JOHNSON of
Georgia, Mr. JONES, Mr. KILMER, Mr. LANGEVIN, Mr. LARSON of Con-
necticut, Ms. LEE of California, Mr. LEVIN of California, Mrs. CAROLYN
B. MALONEY of New York, Mr. MEEKS, Ms. MENG, Mr. MOULTON, Ms.
NORTON, Mr. PAYNE, Mr. POCAN, Ms. ROSS, Ms. ROYBAL-ALLARD, Ms.
SEWELL, Ms. SHERRILL, Mr. SMITH of Washington, Ms. STEVENS, Ms.
STRICKLAND, Mr. SWALWELL, Ms. TLAIB, Mr. TORRES of New York,
Ms. WASSERMAN SCHULTZ, Ms. WILSON of Florida, Mr. GARCÍA of Illi-
nois, and Ms. CASTOR of Florida) introduced the following bill; which was
referred to the Committee on Energy and Commerce, and in addition to
the Committees on Ways and Means, Education and Labor, and Over-
sight and Reform, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall within
the jurisdiction of the committee concerned
A BILL
To amend title XXVII of the Public Health Service Act
to provide for a special enrollment period for pregnant
women, and for other purposes.
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1 Be it enacted by the Senate and House of Representa-
2 tives of the United States of America in Congress assembled,
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1 SECTION 1. SHORT TITLE.
2 This Act may be cited as the ‘‘Healthy Maternity and
3 Obstetric Medicine Act’’ or the ‘‘Healthy MOM Act’’.
4 SEC. 2. FINDINGS AND PURPOSE.
5 (a) FINDINGS.—Congress finds the following:
6 (1) Pregnancy is a significant life event for mil-
7 lions of women in the United States each year.
8 (2) For more than 30 years, our Nation,
9 through the Medicaid program, has recognized that
10 pregnant women need immediate access to afford-
11 able care, and has allowed women who meet income-
12 eligibility requirements to enroll in Medicaid cov-
13 erage when they become pregnant.
14 (3) Congress recognized the central importance
15 of maternity coverage by classifying maternity and
16 newborn care as one of the ten essential health bene-
17 fits that must now be covered on most individual
18 and small group health insurance plans under sec-
19 tion 1302(b)(1) of the Patient Protection and Af-
20 fordable Care Act (42 U.S.C. 18022(b)(1)).
21 (4) Congress has also recognized the significant
22 challenge of maternal mortality and the need to
23 eliminate disparities in maternal health outcomes for
24 pregnancy-related and pregnancy-associated deaths,
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25 and to improve health outcomes for both mothers
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1 and babies through passage of the Preventing Ma-
2 ternal Deaths Act of 2018 (Public Law 115–344).
3 (5) Access to comprehensive maternity coverage
4 allows women to access important pregnancy-related
5 care, which is demonstrated to improve health out-
6 comes for women and newborns and reduce financial
7 costs for both consumers and insurers.
8 (6) Uninsured women, women with grand-
9 fathered and transitional health plans, self-funded
10 student health plans, and catastrophic and high-de-
11 ductible health plans may lack access to comprehen-
12 sive and affordable maternity coverage.
13 (7) Employer health plans that exclude depend-
14 ent daughters from maternity coverage leave young
15 women without coverage for their pregnancy, even
16 though Federal law has long held that treating preg-
17 nancy differently than other conditions is sex-based
18 discrimination.
19 (8) A special enrollment period is especially im-
20 portant for young adults, who are at high risk for
21 unintended pregnancies, yet young adults are fre-
22 quently enrolled in catastrophic coverage, which
23 often has fewer benefits, more restrictions, and high-
24 er deductibles.
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1 (9) This coverage would be an equalizer for
2 communities of color. The maternal mortality rate
3 varies drastically by race and ethnicity, and where a
4 woman lives. The rising maternal mortality rate in
5 the United States is driven predominantly by the
6 disproportionately high African-American maternal
7 mortality rate, which is four times more than the
8 rate for White women.
9 (10) According to the Centers for Disease Con-
10 trol and Prevention, about 700 women die each year
11 in the United States from pregnancy-related com-
12 plications. Black and American Indian/Alaska Native
13 women are about three times more likely to die from
14 a pregnancy-related cause than White women.
15 (11) Data demonstrates that 3 in 5 pregnancy
16 related deaths could be prevented. Improving access
17 to care is one way to help prevent deaths, regardless
18 of race or ethnicity.
19 (12) Timely maternity care improves the health
20 of pregnant women, as well as birth outcomes and
21 the health of babies throughout their lifetimes. Preg-
22 nancy-related maternal mortality is three to four
23 times higher among women who receive no maternity
24 care compared to women who do. Regular maternity
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25 care can detect or mitigate serious pregnancy-related
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1 health complications, including preeclampsia, pla-
2 cental abruption, complications from diabetes, com-
3 plications from heart disease, and Graves’ disease,
4 all of which can result in morbidity or mortality for
5 the mother or newborn.
6 (13) The Centers for Disease Control and Pre-
7 vention reports that more than half of all maternal
8 deaths occur at delivery or in the first postpartum
9 year, whereas just more than one-third of preg-
10 nancy-related or pregnancy-associated deaths occur
11 while a person is still pregnant. Yet, for women eligi-
12 ble for the Medicaid program on the basis of preg-
13 nancy, such Medicaid coverage lapses at the end of
14 the month on which the 60th postpartum day lands.
15 (14) Timely maternity care and adequate
16 postpartum care can reduce short- and long-term
17 health care costs. If a woman does not have access
18 to affordable maternity care during her pregnancy,
19 and she or her newborn experiences pregnancy com-
20 plications that result in health problems after birth,
21 their insurer may end up paying much higher costs
22 than if the insurer had covered the woman’s mater-
23 nity care during her pregnancy. Intensive maternity
24 care can reduce hospital and neonatal intensive care
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25 unit admissions among infants, resulting in cost sav-
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1 ings of $1,768 to $5,560 per birth. For women with
2 high-risk pregnancies, intensive maternity care saves
3 $1.37 for every $1 invested in maternity care.
4 (b) PURPOSE.—The purpose of this Act is to protect
5 the health of women and newborns by ensuring that all
6 women eligible for coverage through the Exchanges estab-
7 lished under title I of the Patient Protection and Afford-
8 able Care Act (Public Law 111–148) and women eligible
9 for other individual or group health plan coverage can ac-
10 cess affordable health coverage during their pregnancy.
11 SEC. 3. PROVIDING FOR A SPECIAL ENROLLMENT PERIOD
12 FOR PREGNANT INDIVIDUALS.
13 (a) PUBLIC HEALTH SERVICE ACT.—Section
14 2702(b)(2) of the Public Health Service Act (42 U.S.C.
15 300gg–1(b)(2)) is amended by inserting ‘‘including a spe-
16 cial enrollment period for pregnant individuals, beginning
17 on the date on which the pregnancy is reported to the
18 health insurance issuer’’ before the period at the end.
19 (b) PATIENT PROTECTION AND AFFORDABLE CARE
20 ACT.—Section 1311(c)(6) of the Patient Protection and
21 Affordable Care Act (42 U.S.C. 18031(c)(6)) is amend-
22 ed—
23 (1) in subparagraph (C), by striking ‘‘and’’ at
24 the end;
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1 (2) by redesignating subparagraph (D) as sub-
2 paragraph (E); and
3 (3) by inserting after subparagraph (C) the fol-
4 lowing new subparagraph:
5 ‘‘(D) a special enrollment period for preg-
6 nant individuals, beginning on the date on
7 which the pregnancy is reported to the Ex-
8 change; and’’.
9 (c) SPECIAL ENROLLMENT PERIODS.—
10 (1) INTERNAL REVENUE CODE.—Section
11 9801(f) of the Internal Revenue Code of 1986 (26
12 U.S.C. 9801(f)) is amended by adding at the end
13 the following new paragraph:
14 ‘‘(4) FOR PREGNANT INDIVIDUALS.—
15 ‘‘(A) A group health plan shall permit an
16 employee who is eligible, but not enrolled, for
17 coverage under the terms of the plan (or a de-
18 pendent of such an employee if the dependent
19 is eligible, but not enrolled, for coverage under
20 such terms) to enroll for coverage under the
21 terms of the plan upon pregnancy, with the spe-
22 cial enrollment period beginning on the date on
23 which the pregnancy is reported to the group
24 health plan or the pregnancy is confirmed by a
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25 health care provider.
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1 ‘‘(B) The Secretary shall promulgate regu-
2 lations with respect to the special enrollment
3 period under subparagraph (A), including es-
4 tablishing a time period for pregnant individ-
5 uals to enroll in coverage and effective date of
6 such coverage.’’.
7 (2) ERISA.—Section 701(f) of the Employee
8 Retirement Income Security Act of 1974 (29 U.S.C.
9 1181(f)) is amended by adding at the end the fol-
10 lowing:
11 ‘‘(4) FOR PREGNANT INDIVIDUALS.—
12 ‘‘(A) A group health plan or health insur-
13 ance issuer in connection with a group health
14 plan shall permit an employee who is eligible,
15 but not enrolled, for coverage under the terms
16 of the plan (or a dependent of such an employee
17 if the dependent is eligible, but not enrolled, for
18 coverage under such terms) to enroll for cov-
19 erage under the terms of the plan upon preg-
20 nancy, with the special enrollment period begin-
21 ning on the date on which the pregnancy is re-
22 ported to the group health plan or health insur-
23 ance issuer or the pregnancy is confirmed by a
24 health care provider.
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1 ‘‘(B) The Secretary shall promulgate regu-
2 lations with respect to the special enrollment
3 period under subparagraph (A), including es-
4 tablishing a time period for pregnant individ-
5 uals to enroll in coverage and effective date of
6 such coverage.’’.
7 (d) EFFECTIVE DATE.—The amendments made by
8 this section shall apply with respect to plan years begin-
9 ning after the 2021 plan year.
10 SEC. 4. COVERAGE OF MATERNITY CARE FOR DEPENDENT
11 CHILDREN.
12 Section 2719A of the Public Health Service Act (42
13 U.S.C. 300gg–19a) is amended—
14 (1) in subsection (e), by inserting ‘‘(other than
15 subsection (f))’’ after ‘‘this section’’; and
16 (2) by adding at the end the following:
17 ‘‘(f) COVERAGE OF MATERNITY CARE.—A group
18 health plan, or health insurance issuer offering group or
19 individual health insurance coverage, that provides cov-
20 erage for dependants shall ensure that such plan or cov-
21 erage includes coverage for maternity care associated with
22 pregnancy, childbirth, and postpartum care for all partici-
23 pants, beneficiaries, or enrollees, including dependants, in-
24 cluding coverage of labor and delivery. Such coverage shall
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25 be provided to all pregnant dependents regardless of age.’’.
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1 SEC. 5. FEDERAL EMPLOYEE HEALTH BENEFIT PLANS.
2 (a) COVERAGE OF PREGNANCY.—
3 (1) IN GENERAL.—The Director of the Office of
4 Personnel Management shall issue such regulations
5 as are necessary to ensure that pregnancy is consid-
6 ered a change in family status and a qualifying life
7 event for an individual who is eligible to enroll, but
8 is not enrolled, in a health benefit plan under chap-
9 ter 89 title 5, United States Code.
10 (2) EFFECTIVE DATE.—The requirement in
11 paragraph (1) shall apply with respect to any con-
12 tract entered into under section 8902 of such title
13 beginning 12 months after the date of enactment of
14 this Act.
15 (b) DESIGNATING CERTAIN FEHBP–RELATED
16 SERVICES AS EXCEPTED SERVICES UNDER THE ANTI-
17 DEFICIENCY ACT.—
18 (1) IN GENERAL.—Section 8905 of title 5,
19 United States Code, is amended by adding at the
20 end the following:
21 ‘‘(i) Any services by an officer or employee under this
22 chapter relating to enrolling individuals in a health bene-
23 fits plan under this chapter, or changing the enrollment
24 of an individual already so enrolled due to an event de-
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25 scribed in section 5(a)(1) of the Healthy MOM Act, shall
26 be deemed, for purposes of section 1342 of title 31, serv-
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1 ices for emergencies involving the safety of human life or
2 the protection of property.’’.
3 (2) APPLICATION.—The amendment made by
4 paragraph (1) shall apply to any lapse in appropria-
5 tions beginning on or after the date of enactment of
6 this Act.
7 SEC. 6. CONTINUATION OF MEDICAID INCOME ELIGIBILITY
8 STANDARD FOR PREGNANT INDIVIDUALS
9 AND INFANTS.
10 Section 1902(l)(2)(A) of the Social Security Act (42
11 U.S.C. 1396a(l)(2)(A)) is amended—
12 (1) in clause (i), by striking ‘‘and not more
13 than 185 percent’’;
14 (2) in clause (ii)—
15 (A) in subclause (I), by striking ‘‘and’’
16 after the comma;
17 (B) in subclause (II), by striking the pe-
18 riod at the end and inserting ‘‘, and’’; and
19 (C) by adding at the end the following:
20 ‘‘(III) January 1, 2022, is the percentage pro-
21 vided under clause (v).’’; and
22 (3) by adding at the end the following new
23 clause:
24 ‘‘(v) The percentage provided under clause (ii) for
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25 medical assistance provided on or after January 1, 2022,
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1 with respect to individuals described in subparagraph (A)
2 or (B) of paragraph (1) shall not be less than—
3 ‘‘(I) the percentage specified for such individ-
4 uals by the State in an amendment to its State plan
5 (whether approved or not) as of January 1, 2014; or
6 ‘‘(II) if no such percentage is specified as of
7 January 1, 2014, the percentage established for
8 such individuals under the State’s authorizing legis-
9 lation or provided for under the State’s appropria-
10 tions as of that date.’’.
11 SEC. 7. REQUIRING AND MAKING PERMANENT 12-MONTH
12 CONTINUOUS COVERAGE FOR PREGNANT
13 AND POSTPARTUM INDIVIDUALS UNDER
14 MEDICAID AND CHIP.
15 (a) MEDICAID.—Section 1902 of the Social Security
16 Act (42 U.S.C. 1396a) is amended—
17 (1) in subsection (a)—
18 (A) in paragraph (86), by striking ‘‘and’’
19 at the end;
20 (B) in paragraph (87), by striking the pe-
21 riod at the end and inserting ‘‘; and’’; and
22 (C) by inserting after paragraph (87) the
23 following new paragraph:
24 ‘‘(88) provide that the State plan is in compli-
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25 ance with subsection (e)(16).’’; and
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1 (2) in subsection (e)(16), as added by section
2 9812 of the American Rescue Plan Act of 2021
3 (Public Law 117–2)—
4 (A) in subparagraph (A), by striking ‘‘At
5 the option of the State, the State plan (or waiv-
6 er of such State plan) may provide’’ and insert-
7 ing ‘‘A State plan (or waiver of such State
8 plan) shall provide’’;
9 (B) in subparagraph (B), in the matter
10 preceding clause (i), by striking ‘‘by a State
11 making an election under this paragraph’’ and
12 inserting ‘‘under a State plan (or a waiver of
13 such State plan)’’; and
14 (C) by striking subparagraph (C).
15 (b) CHIP.—
16 (1) IN GENERAL.—Section 2107(e)(1)(J) of the
17 Social Security Act (42 U.S.C. 1397gg(e)(1)(J)), as
18 inserted by section 9822 of the American Rescue
19 Plan Act of 2021 (Public Law 117–2), is amended
20 to read as follows:
21 ‘‘(J) Paragraphs (5) and (16) of section
22 1902(e) (relating to the requirement to provide
23 medical assistance under the State plan or
24 waiver consisting of full benefits during preg-
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25 nancy and throughout the 12-month
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1 postpartum period under title XIX) such that
2 the provision of assistance under the State child
3 health plan or waiver for targeted low-income
4 children or targeted low-income pregnant
5 women during pregnancy and the 12-month
6 postpartum period shall be required and shall
7 include coverage of all items or services pro-
8 vided to a targeted low-income child or targeted
9 low-income pregnant woman (as applicable)
10 under the State child health plan or waiver).’’.
11 (2) CONFORMING.—Section 2112(d)(2)(A) of
12 the Social Security Act (42 U.S.C. 1397ll(d)(2)(A)),
13 as inserted by section 9822 of the American Rescue
14 Plan Act of 2021 (Public Law 117–2), is amended
15 by striking ‘‘the month in which the 60-day period’’
16 and all that follows through ‘‘pursuant to section
17 2107(e)(1),’’.
18 (c) CONFORMING AMENDMENTS.—
19 (1) Section 9812(b) of the American Rescue
20 Plan Act of 2021 (Public Law 117–2) is amended
21 to read as follows:
22 ‘‘(b) EFFECTIVE DATE.—
23 ‘‘(1) IN GENERAL.—Subject to paragraph (2),
24 the amendment made by subsection (a) shall apply
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25 with respect to services furnished on or after the 1st
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1 day of the 1st fiscal year quarter that begins one
2 year after the date of the enactment of this Act.
3 ‘‘(2) EXCEPTION FOR STATE LEGISLATION.—In
4 the case of a State plan under title XIX of the So-
5 cial Security Act that the Secretary of Health and
6 Human Services determines requires State legisla-
7 tion in order for the respective plan to meet any re-
8 quirement imposed by amendments made by this
9 section, the plan shall not be regarded as failing to
10 comply with the requirements of such title solely on
11 the basis of its failure to meet such an additional re-
12 quirement before the first day of the first fiscal year
13 quarter beginning after the close of the first regular
14 session of the State legislature that begins after the
15 date of enactment of this Act. For purposes of the
16 previous sentence, in the case of a State that has a
17 2-year legislative session, each year of the session
18 shall be considered to be a separate regular session
19 of the State legislature.’’.
20 (2) Section 9822(b) of the American Rescue
21 Plan Act of 2021 (Public Law 117–2) is amended
22 to read as follows:
23 ‘‘(b) EFFECTIVE DATE.—
24 ‘‘(1) IN GENERAL.—Subject to paragraph (2),
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25 the amendments made by subsection (a), shall apply
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1 with respect to services furnished on or after the 1st
2 day of the 1st fiscal year quarter that begins one
3 year after the date of the enactment of this Act.
4 ‘‘(2) EXCEPTION FOR STATE LEGISLATION.—In
5 the case of a State child health plan under title XXI
6 of the Social Security Act that the Secretary of
7 Health and Human Services determines requires
8 State legislation in order for the plan to meet any
9 requirement imposed by amendments made by this
10 section, the respective plan shall not be regarded as
11 failing to comply with the requirements of such title
12 solely on the basis of its failure to meet such an ad-
13 ditional requirement before the first day of the first
14 fiscal year quarter beginning after the close of the
15 first regular session of the State legislature that be-
16 gins after the date of enactment of this Act. For
17 purposes of the previous sentence, in the case of a
18 State that has a 2-year legislative session, each year
19 of the session shall be considered to be a separate
20 regular session of the State legislature.’’.
21 (d) EFFECTIVE DATE.—The amendments made by
22 subsections (a) and (c)(1) shall take effect as if included
23 in the enactment of section 9812 of the American Rescue
24 Plan Act of 2021 (Public Law 117–2). The amendments
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1 made by subsections (b) and (c)(2) shall take effect as
2 if included in the enactment of section 9822 of such Act.
3 SEC. 8. RELATIONSHIP TO OTHER LAWS.
4 Nothing in this Act (or an amendment made by this
5 Act) shall be construed to invalidate or limit the remedies,
6 rights, and procedures of any Federal law or the law of
7 any State or political subdivision of any State or jurisdic-
8 tion that provides greater or equal protection for enrollees
9 in a group health plan or group or individual health insur-
10 ance offered by a health insurance issuer.
Æ
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