To amend title XXVII of the Public Health Service Act to limit cost sharing for prenatal services in certain circumstances.
Summary
What This Bill Does
The bill amends the Public Health Service Act to add a new section limiting cost-sharing for prenatal services when pregnancy ends in miscarriage or stillbirth. Effective for plan years beginning on or after January 1, 2027 and prohibits health plans from imposing cost-sharing (deductibles, coinsurance, copayments) on prenatal services that exceed what would have applied to the bundled payment if the pregnancy had not ended in miscarriage. It relies on compliance mandates and product standards. The main policy areas are Finance and Healthcare.
Who Benefits and How
Pregnant individuals who subsequently experience pregnancy loss could see lower costs, Individuals who experience miscarriage or stillbirth could see lower costs, and Healthcare providers offering prenatal services could gain revenue opportunities.
Who Bears the Burden and How
Health insurance companies offering group and individual coverage with bundled maternity payments would take on compliance duties, Self-insured employer group health plans with bundled maternity benefits would take on compliance duties, and Health insurance carriers with bundled maternity payment structures could lose revenue opportunities.
Key Provisions
- Amends the Public Health Service Act to add a new section limiting cost-sharing for prenatal services when pregnancy ends in miscarriage or stillbirth. Effective for plan years beginning on or after January 1, 2027.
- Prohibits health plans from imposing cost-sharing (deductibles, coinsurance, copayments) on prenatal services that exceed what would have applied to the bundled payment if the pregnancy had not ended in miscarriage...
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 amends the Public Health Service Act to add a new section limiting cost-sharing for prenatal services when pregnancy ends in miscarriage or stillbirth. Effective for plan years beginning on or after January 1, 2027 and prohibits health plans from imposing cost-sharing (deductibles, coinsurance, copayments) on prenatal services that exceed what would have applied to the bundled payment if the pregnancy had not ended in miscarriage.
Key Policy Areas
Finance, Healthcare
Primary Purpose
The bill amends the Public Health Service Act to add a new section limiting cost-sharing for prenatal services when pregnancy ends in miscarriage or stillbirth. Effective for plan years beginning on or after January 1, 2027 and prohibits health plans from imposing cost-sharing (deductibles, coinsurance, copayments) on prenatal services that exceed what would have applied to the bundled payment if the pregnancy had not ended in miscarriage.
Policy Domains
Section 2 - Amendment to Public Health Service Act
Identified Gains
- Pregnant individuals who subsequently experience pregnancy loss
- Individuals who experience miscarriage or stillbirth
- Healthcare providers offering prenatal services
Identified Costs
- Health insurance companies offering group and individual coverage with bundled maternity payments
- Self-insured employer group health plans with bundled maternity benefits
- Health insurance carriers with bundled maternity payment structures
- Group health plans offering bundled maternity benefits
Sponsors
Legislative Progress
IntroducedMr. Vindman (for himself and Mrs. Miller-Meeks) introduced the following …
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Health insurance carriers with bundled maternity payment structures, Health insurance companies offering group and individual coverage with bundled maternity payments
Group health plans offering bundled maternity benefits, Self-insured employer group health plans with bundled maternity benefits
Individuals who experience miscarriage or stillbirth, Pregnant individuals who subsequently experience pregnancy loss
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
- "plan_or_coverage"
- → Group health plan or group/individual health insurance coverage
Key Definitions
Terms defined in this bill
Deductibles, coinsurance, and copayments imposed on covered services
A payment arrangement where items and services furnished to an individual relating to the birth of a child are paid as a single package, including prenatal services such as imaging tests and office visits
Items and services furnished prior to birth, including imaging tests and office visits
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