HR3762-119

What This Bill Does

The Supporting Healthy Moms and Babies Act expands required maternity and postpartum insurance coverage. Section 2 amends the ACA essential health benefits statute so maternity and newborn care must include comprehensive prenatal, labor and delivery, neonatal, perinatal, and postpartum care and screenings. Minimum covered services include ultrasounds by licensed providers, care related to spontaneous pregnancy loss or miscarriage, delivery services such as anesthesiology, fetal monitoring, specialist consultations, and postpartum health services, coverage required by related federal maternal-health provisions, non-preventive postpartum care including behavioral health services for conditions exacerbated by pregnancy or resulting from pregnancy such as diabetes, hypertension, and obesity, and behavioral health services for legal parents of a new child who did not physically give birth for one year after birth. Section 3 adds parallel no-cost-sharing requirements to the Public Health Service Act, ERISA, and Internal Revenue Code so group health plans and health insurance issuers must cover those benefits to the same extent as qualified health plans and may not impose deductibles, copayments, or coinsurance for them. The bill shifts costs from patients at the point of care to insurers, employer plans, and plan sponsors.

Who Benefits and How

Pregnant patients benefit from required coverage of prenatal, labor, delivery, neonatal, perinatal, and postpartum services without cost sharing. Patients experiencing miscarriage benefit because spontaneous pregnancy loss services are expressly included. Postpartum patients benefit from non-preventive care and behavioral health services for pregnancy-related or pregnancy-exacerbated conditions. New legal parents who did not give birth benefit from one year of behavioral health services related to new parenthood. Maternal health providers benefit if coverage and no-cost-sharing rules reduce payment barriers for covered care.

Who Bears the Burden and How

Health insurance issuers must cover the expanded benefits without cost sharing. Employer group health plans must adjust plan design under ERISA and tax-code rules. Plan administrators must update claims systems, notices, and benefit summaries for the new required services. Employers sponsoring health plans may face higher premium or plan costs. Federal regulators must enforce parallel requirements across ACA, Public Health Service Act, ERISA, and Internal Revenue Code authorities.

Key Provisions

• Expands ACA essential health benefits to comprehensive prenatal, childbirth, neonatal, perinatal, and postpartum care.
• Requires coverage of miscarriage care, delivery services, specialist consultations, and postpartum health services.
• Requires postpartum behavioral health coverage for pregnancy-related or pregnancy-exacerbated conditions.
• Provides one year of behavioral health services for legal parents who did not give birth.
• Prohibits cost sharing for the covered services in group and individual health coverage.
• Amends Public Health Service Act, ERISA, and Internal Revenue Code plan rules.