Supporting Healthy Moms and Babies Act
The Supporting Healthy Moms and Babies Act would make comprehensive maternity and newborn care an essential health benefit and require it to be provided with no cost-sharing. Specifically, it expands the ACA’s essential health benefits to cover prenatal through postpartum care (including labor and delivery, neonatal and perinatal care, and related screenings), and it prohibits deductibles, copays, and coinsurance for these services. The requirement would apply across private group health plans and health insurance issuers (including ERISA-regulated plans and plans in the individual market), and it would be implemented through amendments to the Public Health Service Act, ERISA, and the Internal Revenue Code. The bill also broadens postpartum coverage to include behavioral health and related services for non-birth parents during the first year after a birth. Plan years after enactment would be subject to these changes, effectively aligning these maternity and newborn benefits with the same level of coverage as other essential health benefits for qualified plans. In short, the bill aims to reduce or eliminate out-of-pocket costs for a broad set of maternity-related services and extend certain postpartum behavioral health protections to newly documenting parents, with the goal of improving maternal and infant health outcomes and financial protection during and after pregnancy.
Key Points
- 1Expands essential health benefits to include comprehensive maternity and newborn care, with minimum covered components such as licensed ultrasounds, care for miscarriage, delivery services, postpartum health (including non-preventive and behavioral health), and services required under existing federal health laws.
- 2Prohibits cost-sharing for prenatal, childbirth, neonatal, perinatal, and postpartum health care for plan years beginning after enactment, aligning group health plans and individual coverage with the way qualified health plans cover these benefits.
- 3Applies the no cost-sharing requirement across major health plan frameworks: (a) Public Health Service Act (PHSA), (b) Employee Retirement Income Security Act (ERISA), and (c) Internal Revenue Code (IRC), creating parallel provisions in each law to ensure uniform coverage.
- 4Adds postpartum coverage for non-birth parents, allowing behavioral health services related to new parenthood to be covered at no cost for the 1-year period after the child’s birth; defines postpartum as the first year after pregnancy ends.
- 5Effective for plan years beginning on or after the date of enactment; the changes are treated as if they were part of the ACA, with plan designs and compliance aligned to ensure no cost-sharing for these services.