S. 3274: Healthy Maternity and Obstetric Medicine Act

This bill, known as the Healthy Maternity and Obstetric Medicine Act, aims to enhance healthcare access for pregnant women in the United States, primarily by introducing new health insurance options and protections. The key components of the bill include:

Special Enrollment Period for Pregnant Individuals

The bill establishes a special enrollment period for pregnant individuals. This allows women to enroll in health insurance plans when their pregnancy is confirmed. The enrollment period starts from the date the pregnancy is reported or confirmed by a healthcare provider. This provision applies to health plans under the Affordable Care Act (ACA) and group health plans as well.

Coverage for Dependent Daughters

Health plans that cover dependents must include maternity care for dependents of all ages. This means that if a dependent daughter becomes pregnant, she will have access to comprehensive maternity coverage, including prenatal, delivery, and postpartum care.

Federal Employee Health Benefit Plans

The bill mandates that pregnancy be recognized as a qualifying life event for employees in federal health benefit plans. This allows federal employees to enroll in health insurance or change their plan in response to pregnancy.

Medicaid and CHIP Changes

The legislation requires improvements to Medicaid and the Children’s Health Insurance Program (CHIP) by:

• Continuing Medicaid eligibility for pregnant individuals for 12 months postpartum. This ensures mothers maintain access to healthcare services during a critical recovery period.
• Mandating that states provide consistent medical assistance during pregnancy and throughout the postpartum year.

Income Eligibility Standards

The bill seeks to modify Medicaid's income eligibility standards to ensure that pregnant individuals and infants have continued access to health coverage without arbitrary income limits, starting in 2027.

Relationship to Other Laws

Provisions in this bill do not override existing state laws or federal laws that offer greater rights and protections for individuals enrolled in health plans.

Effective Dates

The various amendments introduced by this bill are set to take effect for plan years beginning on or after January 1, 2027.

Findings and Purpose

The bill articulates findings that highlight significant disparities in maternal health, the importance of timely and comprehensive maternity care, and the need for accessible health coverage to improve outcomes for mothers and infants. It aims to reduce maternal mortality rates and improve overall health outcomes by increasing access to maternity care.

Citations

Throughout the bill, references are made to various sections of the Public Health Service Act and the Internal Revenue Code, indicating clear legislative changes aimed at enhancing maternity and postpartum care through improved health coverage.

Relevant Companies

• UNH - UnitedHealth Group: As a major health insurer, changes to enrollment periods and maternal care coverage could directly impact their policy structures and premium calculations.
• CNC - Centene Corporation: The provisions affecting Medicaid and CHIP could require adjustments in Centene's healthcare services and coverage plans.
• AET - Aetna: Similar to UnitedHealth, Aetna would need to modify its offerings to comply with new enrollment rules and coverage mandates for maternity care.