“A bill to prevent cost-sharing requirements for prenatal, childbirth, neonatal, perinatal, or postpartum health care.”
No CRS summary available for this bill.
This section revises the essential health benefits (EHB) requirements under the Patient Protection and Affordable Care Act to mandate that the maternity and newborn care category include comprehensive prenatal, labor and delivery, neonatal, perinatal, and postpartum care and screenings (defined as the 1-year period beginning immediately after pregnancy ends). At a minimum, such care must cover (1) ultrasounds by a licensed provider; (2) services related to spontaneous pregnancy loss or miscarriage; (3) delivery services, including anesthesiology, fetal monitoring, specialist consultations, and postpartum health services; (4) services required under specified public health, ERISA, and tax laws; (5) non-preventive postpartum care, including behavioral health services, for pregnancy-exacerbated or -related conditions such as diabetes, hypertension, and obesity; and (6) for legal parents who do not give birth, behavioral health services related to new parenthood for the 1-year period beginning on the date of the child's birth. (EHBs apply to nongrandfathered health plans in the individual and small group markets.) The requirements apply to plan years beginning on or after the date of enactment.
This section amends the Public Health Service Act, ERISA, and the Internal Revenue Code to require group health plans and health insurance issuers offering group or individual health insurance coverage to provide maternity and newborn care (i.e., benefits described in ACA section 1302(b)(1)(D), as covered by qualified health plans) without any cost-sharing requirements (i.e., as defined in ACA section 1302(c)(3)), for plan years beginning on or after the date of enactment. (Thus, enrollees receive such coverage—covering prenatal, childbirth, neonatal, perinatal, and postpartum care—free of deductibles, copayments, or coinsurance.)