WASHINGTON – In advance of the Health Insurance Marketplace’s open enrollment period starting next week, U.S. Senators Ben Cardin and Barbara A. Mikulski (Both D-Md.), with 21 of their Senate colleagues, introduced legislation Thursday that would increase access to prenatal and maternity care. The Healthy Maternity and Obstetric Medicine Act (Healthy MOM Act) would create a special enrollment period (SEP) so pregnant individuals can enroll in or change their healthcare plans once they become pregnant.
“There should never be a question that becoming a mom is a life-changing event,” said Senator Cardin. “The Affordable Care Act provided coverage for preventive and basic health services, including maternity benefits, because prenatal care helps prevent illnesses and diseases in both expectant mothers and children, minimizing the need for costly care later. Ensuring women have access to coverage for prenatal care as soon as they become pregnant is essential for improved health of the mother and the health of her child.”
“Prenatal health care plays a crucial role in reducing risk and promoting health in women and infants,” Senator Mikulski said. “When we made sure that being a woman is no longer a pre-existing condition, we cured a sickness in the American health care system. It’s time to do it again, and ensure that when a woman becomes pregnant, she has the opportunity to enroll in the coverage she needs for the care she deserves.”
Individuals who become pregnant during the Health Insurance Marketplace’s open enrollment period – which begins on Nov. 1, 2015 – can change their plans or enroll in a new plan, but an individual who becomes pregnant outside that period cannot because pregnancy is not considered a “qualifying life event.” Some major life changes – like getting married, giving birth, or adopting a child – are considered “qualifying life events” that make individuals eligible for an SEP, allowing them to enroll in or change their health care plans through HealthCare.gov. Because pregnancy is not currently classified as a “qualifying life event” under law, some mothers who become pregnant and are unable to change their insurance status may forgo critical prenatal care or pay significant out-of-pocket medical costs – risking the health and safety of both mother and baby.
The Healthy MOM Act would address this coverage gap by creating an SEP for pregnant women, ensuring mothers have access to the health care options that best fit their maternity and prenatal needs. Specifically, the Healthy MOM Act would:
- Create an SEP in the Health Insurance Marketplace for pregnant individuals so that they can enroll in or change their healthcare plan;
- Enable the Director of the Office of Personnel Management to establish an SEP for pregnancy for those eligible to receive coverage, but who do not currently receive coverage, through the Federal Employees Health Benefits Program;
- Ensure comprehensive coverage of maternity care – including labor and delivery – for dependent children covered by group health plans and other forms of employer-sponsored coverage; and
- Protect existing income eligibility levels for pregnant women and infants covered by Medicaid.
According to the U.S. Health Resources and Services Administration (HRSA), more than one million babies are born to mothers that did not receive adequate prenatal care each year. Nationwide, maternal mortality rates are three to four times higher for mothers who do not receive prenatal care compared with mothers who do, and babies of mothers who do not receive prenatal care are five times more likely to die and three times as likely to be born prematurely compared with mothers who receive adequate care.
For a section-by-section summary, click here.
In addition to Senators Cardin and Mikulski, the Healthy MOM Act was introduced by Senator Sherrod Brown (D-Ohio), Patty Murray (D-Wash.), Ed Markey (D-Mass.), Jon Tester (D-Mont.), Martin Heinrich (D-N.M.), Tammy Baldwin (D-Wis.), Sheldon Whitehouse (D-R.I.), Robert P. Casey, Jr. (D-Pa.), Charles Schumer (D-N.Y.), Tim Kaine (D-Va.), Chris Coons (D-Del.), Patrick Leahy (D-Vt.), Kirsten Gillibrand (D-N.Y.), Dianne Feinstein (D-Calif.), Richard Blumenthal (D-Conn.), Cory Booker (D-N.J.), Gary Peters (D-Mich.), Michael Bennet (D-Colo.), Jeff Merkley (D-Ore.), Barbara Boxer (D-Calif.), and Christopher Murphy (D-Conn.). A similar bill was introduced in the U.S. House of Representatives by Rep. Bonnie Watson Coleman (D-NJ-12) earlier this year and has 97 cosponsors including Reps. John Delaney, Donna Edwards and Chris Van Hollen (All D-Md.).
The Healthy MOM Act is endorsed by the following organizations: American College of Nurse-Midwives; American Congress of Obstetricians and Gynecologists; Association of Women’s Health, Obstetric and Neonatal Nurses; Maryland Women’s Coalition for Health Care Reform; EverThrive Illinois; Families USA; March of Dimes; NARAL Pro Choice Oregon; National Health Law Program; National Patient Advocate Foundation; National Women’s Law Center;; MomsRising; Ohio Hospital Association; Ohio MetroHealth System; Ohio Public Health Association; URGE: Unite for Reproductive & Gender Equity; and Young Invincibles.