H.R. 9996: No Surprise Bills for New Moms Act

This bill would require most employer health plans and health insurance issuers to give newborns temporary coverage right after birth, even before the baby is formally added to the plan.

What the bill changes

• For group health plans and health insurance issuers that provide group or individual coverage, a newborn would be covered for 30 days after birth for any services that the parent’s plan already covers.
• The parent would then get a special enrollment period of at least 60 days after that 30-day coverage window to formally enroll the newborn in the health plan.
• If the plan receives a claim for care given to the newborn and the baby is not enrolled, the plan would have to promptly notify the parent that the newborn is not enrolled.

Where it applies

• The bill amends federal health coverage laws under the Public Health Service Act, ERISA (the law covering most employer-sponsored health plans), and the Internal Revenue Code.
• It applies to plan years beginning on or after the date the law is enacted.

Plain-language effect

In simple terms, the bill is meant to reduce gaps in coverage for newborns. If a parent already has health coverage, the newborn would automatically have coverage for the first 30 days after birth, giving the family time to complete enrollment paperwork without risking an uncovered gap for early medical care.

Relevant Companies

• UNH — UnitedHealth Group, which operates health insurance businesses that would need to follow the new newborn coverage and enrollment rules.
• CI — The Cigna Group, which offers employer and individual health coverage that could be affected by the new requirements.
• HUM — Humana, which provides health insurance products that may need operational changes to comply with the bill.
• ELV — Elevance Health, whose insurance plans could be affected by the newborn coverage and notification rules.
• AET — Aetna, a CVS Health business, which administers health plans that would likely need to implement the new enrollment and claims-notification process.
• OSCR — Oscar Health, if its plans are subject to the individual market provisions covered by the bill.
• CVS — CVS Health, through its insurance operations, could be indirectly affected by compliance changes in administered health plans.