Healthy MOM Act
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 creates congressional findings establishing the legislative rationale for maternal health coverage reforms, creates a mandatory special enrollment period for pregnant individuals across all health insurance market segments: individual/small group plans (amends Public Health Service Act), ACA Exchange plans (amends ACA Section, and directs the Office of Personnel Management to classify pregnancy as a qualifying life event and change in family status for Federal Employee Health Benefits (FEHB) program enrollment. It relies on compliance mandates, exemptions, and liability protections. The main policy areas are Healthcare, Finance, and Labor.
Who Benefits and How
Pregnant individuals without health insurance would be affected, Pregnant individuals and infants on Medicaid would be affected, and Pregnant federal employees and dependents would be affected.
Who Bears the Burden and How
State Medicaid programs (in states that had not opted in) would be affected, States with eligibility above 185% FPL would be affected, and State Medicaid programs would be affected.
Key Provisions
- Creates congressional findings establishing the legislative rationale for maternal health coverage reforms.
- Creates a mandatory special enrollment period for pregnant individuals across all health insurance market segments: individual/small group plans (amends Public Health Service Act), ACA Exchange plans (amends ACA Section...
- Directs the Office of Personnel Management to classify pregnancy as a qualifying life event and change in family status for Federal Employee Health Benefits (FEHB) program enrollment.
- Amends Social Security Act Section 1902(l)(2)(A) to remove the 185% FPL cap on Medicaid eligibility for pregnant individuals and infants, and establishes a ratchet/floor mechanism: from January 1, 2027, states must...
- Requires converts the optional 12-month postpartum Medicaid/CHIP coverage extension (originally created by the American Rescue Plan Act) into a mandatory requirement for all states.
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 creates congressional findings establishing the legislative rationale for maternal health coverage reforms, creates a mandatory special enrollment period for pregnant individuals across all health insurance market segments: individual/small group plans (amends Public Health Service Act), ACA Exchange plans (amends ACA Section, and directs the Office of Personnel Management to classify pregnancy as a qualifying life event and change in family status for Federal Employee Health Benefits (FEHB) program enrollment.
Key Policy Areas
Healthcare, Finance, Labor
Primary Purpose
The bill creates congressional findings establishing the legislative rationale for maternal health coverage reforms, creates a mandatory special enrollment period for pregnant individuals across all health insurance market segments: individual/small group plans (amends Public Health Service Act), ACA Exchange plans (amends ACA Section, and directs the Office of Personnel Management to classify pregnancy as a qualifying life event and change in family status for Federal Employee Health Benefits (FEHB) program enrollment.
Policy Domains
Whole bill
Identified Gains
- Pregnant individuals without health insurance
- Pregnant individuals and infants on Medicaid
- Pregnant federal employees and dependents
- Postpartum individuals on Medicaid
- Postpartum individuals on CHIP
Identified Costs
- State Medicaid programs (in states that had not opted in)
- States with eligibility above 185% FPL
- State Medicaid programs
- State CHIP programs
- Health insurance issuers (individual/small group market)
Sponsors
Legislative Progress
In CommitteeMs. Alsobrooks (for herself, Ms. Baldwin, Mr. Blumenthal, Ms. Cortez …
Read twice and referred to the Committee on Health, Education, …
Introduced in Senate
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Black and American Indian/Alaska Native women, Communities of color (disproportionate benefit due to higher Medicaid enrollment), Dependent daughters excluded from maternity coverage
State CHIP programs, State Medicaid programs, State Medicaid programs (in states that had not opted in)
ACA Health Insurance Exchanges, Employer-sponsored group health plans, FEHB plan carriers
Maternity and postpartum care providers, Maternity care providers (OB-GYNs, hospitals, midwives), Maternity care providers in Medicaid-heavy states
Federal Medicaid/CHIP budget (increased FMAP outlays), Office of Personnel Management
Federal employees during government shutdowns, Pregnant federal employees and dependents
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
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