Supporting Healthy Moms and Babies Act
The Supporting Healthy Moms and Babies Act would expand the scope of essential health benefits to explicitly include comprehensive prenatal, childbirth, neonatal, perinatal, and postpartum care, and it would prohibit cost-sharing (copays, deductibles, coinsurance) for those benefits. The bill requires group health plans and health insurance issuers to cover these maternity and newborn care services with no cost-sharing, aligning them with the coverage requirements already applied to other essential health benefits. It would implement these changes across the major health coverage frameworks (the ACA, ERISA, and the Internal Revenue Code) and apply to plan years beginning on or after the date of enactment. A notable feature is the extended postpartum coverage: for the first year after pregnancy ends, behavioral health services related to new parenthood would be covered for both birthing and non-birthing parents. The bill defines postpartum as the 12-month period after pregnancy ends and adds several specific services to the required minimum package, including ultrasounds, care for spontaneous pregnancy loss, delivery-related services, and postpartum care for conditions exacerbated by pregnancy (like diabetes or hypertension). Overall, the act aims to reduce out-of-pocket costs for pregnancy-related care and broaden access to maternal and infant health services.
Key Points
- 1Adds maternity and newborn care to the essential health benefits, requiring comprehensive prenatal, labor and delivery, neonatal, perinatal, and postpartum care and screenings, including a detailed list of minimum covered items.
- 2The minimum coverages must include items such as licensed-provider ultrasounds, care for spontaneous pregnancy loss, delivery services (including anesthesia and fetal monitoring), and postpartum care for health conditions affected by pregnancy, plus behavioral health services for new parenthood for non-birthing parents during the first year after birth.
- 3Postpartum is defined as the 1-year period beginning after the pregnancy ends.
- 4Prohibits cost-sharing for these maternity and newborn benefits, meaning no copays, deductibles, or coinsurance for covered services, to the same extent as other essential health benefits.
- 5Applies across major health coverage structures: amendments to ACA (Section 1302), ERISA (Sec. 726), and the Internal Revenue Code (Sec. 9826), ensuring no cost-sharing for both insured and self-insured (ERISA) group plans and individual market plans.
- 6Effective for plan years beginning on or after the date of enactment of the Act.