To amend titles XIX and XXI of the Social Security Act and title XXVII of the Public Health Service Act to require no-cost coverage of human milk fortifier.
Analysis under review: This bill has generated analysis that may be too generic or incomplete. Clause-level evidence remains available below.
Summary
What This Bill Does
The bill requires Medicaid to cover human milk fortifier as a mandatory benefit starting January 2026 and mandates no-cost coverage of human milk fortifier by group health plans and individual health insurance. It relies on compliance mandates and definition changes. The main policy areas are Healthcare, Trade, and Finance.
Who Benefits and How
Human milk fortifier manufacturers could gain revenue opportunities, Families with premature infants on Medicaid could see lower costs, and Families with premature infants could see lower costs.
Who Bears the Burden and How
State Medicaid programs could face higher costs and Health insurance issuers could face higher costs.
Key Provisions
- Requires Medicaid to cover human milk fortifier as a mandatory benefit starting January 2026.
- Mandates no-cost coverage of human milk fortifier by group health plans and individual health insurance.
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers with clause-level evidence links.
At a Glance
What This Bill Does
The bill requires Medicaid to cover human milk fortifier as a mandatory benefit starting January 2026 and mandates no-cost coverage of human milk fortifier by group health plans and individual health insurance.
Key Policy Areas
Healthcare, Trade, Finance
Primary Purpose
The bill requires Medicaid to cover human milk fortifier as a mandatory benefit starting January 2026 and mandates no-cost coverage of human milk fortifier by group health plans and individual health insurance.
Policy Domains
Entire Bill
Identified Gains
- Human milk fortifier manufacturers
- Families with premature infants on Medicaid
- Families with premature infants
Identified Costs
- State Medicaid programs
- Health insurance issuers
Sponsors
Legislative Progress
IntroducedMr. McGarvey (for himself, Ms. DeLauro, and Mr. Krishnamoorthi) introduced …
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Families with premature infants, Families with premature infants on Medicaid
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
Key Definitions
Terms defined in this bill
A donor human milk-derived product furnished to infants under 1 year of age when medically necessary for premature, underweight, or medically fragile infants
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology