I 

117TH CONGRESS 

1ST SESSION H. R. 2598 

To amend title XVIII, XIX, and XXI of the Social Security Act and title 

XXVII of the Public Health Service Act to expand access to maternal 

health care, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 15, 2021 

Ms. PRESSLEY introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on 

Ways and Means, and Education and Labor, for a period to be subsequently determined by the Speaker, in each case for consideration of such 

provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To amend title XVIII, XIX, and XXI of the Social Security 

Act and title XXVII of the Public Health Service Act 

to expand access to maternal health care, and for other 

purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘COVID–19 Safe Birth5 ing Act’’. 


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1 SEC. 2. EXPANDING ACCESS TO MATERNAL CARE IN HOS2 PITALS. 

3 Section 1866(a)(1) of the Social Security Act (42 

4 U.S.C. 1395cc(a)(1)) is amended— 

5 (1) in subparagraph (X), by striking at the end 

6 ‘‘and’’; 

7 (2) in subparagraph (Y)(ii)(V), by striking the 

8 period at the end and inserting ‘‘; and’’; and 

9 (3) by inserting after subparagraph (Y)(ii)(V), 

10 the following new subparagraph: 

11 ‘‘(Z) beginning 30 days after the date of 

12 enactment of this subparagraph, in the case of 

13 a hospital— 

14 ‘‘(i) to require that such hospital per15 mits a pregnant or birthing person to be 

16 accompanied by an individual of the preg17 nant or birthing person’s choosing (in ad18 dition to a doula or other perinatal health 

19 worker) during labor, delivery, and recov20 ery; with necessary, evidence based, and 

21 non-discriminatory exceptions; 

22 ‘‘(ii) to require that such hospital does 

23 not implement any policies that restrict 

24 hospital access or birthing options for 

25 pregnant or birthing persons, unless such 

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1 municated to the patient without threat or 

2 intimidation, and applied without discrimi3 nation on the basis of race, gender iden4 tity, socio-economic status, religion, sexual 

5 orientation, marital status, age, disability, 

6 national origin, and immigration status; 

7 and 

8 ‘‘(iii) with respect to the care of a 

9 pregnant or birthing person, to require the 

10 communication of and informed consent 

11 (without threat or intimidation) to the im12 plementation of policies pursuant to clause 

13 (ii) by the pregnant or birthing person, in 

14 accordance with consent protocols of the 

15 hospital in the case of inability of a person 

16 to provide consent.’’. 

17 SEC. 3. EXPANDING MEDICARE AND MEDICAID COVERAGE 

18 OF TELEHEALTH SERVICES THAT ARE MA19 TERNAL HEALTH CARE SERVICES. 

20 (a) REMOVAL OF CERTAIN MEDICARE REQUIRE21 MENTS FOR MATERNAL HEALTH CARE SERVICES.—Sec22 tion 1834(m) of the Social Security Act (42 U.S.C. 

23 1395m(m)) is amended— 


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1 (1) in paragraph (4)(C)(i), by striking ‘‘para2 graphs (5), (6), and (7)’’ and inserting ‘‘paragraphs 

3 (5), (6), (7), and (9)’’; and 

4 (2) by adding at the end the following new 

5 paragraph: 

6 ‘‘(9) TREATMENT OF MATERNITY HEALTH

7 CARE SERVICES.—With respect to telehealth services 

8 that are maternal health care services, notwith9 standing any other provision of this subsection— 

10 ‘‘(A) the requirements described in para11 graph (4)(C) shall not apply; 

12 ‘‘(B) the term ‘originating site’ means sites 

13 at which the eligible telehealth individual is lo14 cated at the time the service is furnished via a 

15 telecommunications system; and 

16 ‘‘(C) there shall be no restrictions on ac17 cess to such telehealth services through use of 

18 telephone based on the use of video capabilities 

19 or lack of such capabilities.’’. 

20 (b) MEDICAID COVERAGE.—Section 1905(a) of the 

21 Social Security Act (42 U.S.C. 1396d(a)) is amended— 

22 (1) in paragraph (5)(A), by inserting ‘‘(and in 

23 the case of physicians’ services that are maternal 

24 health care services, including via telehealth)’’ after 

25 ‘‘or elsewhere’’; 


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1 (2) in paragraph (17), by inserting ‘‘, including 

2 services furnished via telehealth,’’ before ‘‘fur3 nished’’; 

4 (3) in paragraph (21), by inserting ‘‘, including 

5 services furnished via telehealth,’’ after ‘‘furnished’’; 

6 and 

7 (4) in paragraph (28), by inserting ‘‘, including 

8 such services furnished via telehealth to the extent 

9 such services may be performed under State law by 

10 freestanding birth centers’’ before the semicolon at 

11 the end. 

12 SEC. 4. ENSURING COVERAGE OF CERTAIN MATERNAL 

13 HEALTH CARE SERVICES. 

14 (a) MAKING CERTAIN MEDICAID COVERAGE OF CER15 TAIN PRENATAL AND POSTPARTUM SERVICES A STATE

16 PLAN REQUIREMENT.— 

17 (1) STATE MEDICAID PLANS.— 

18 (A) IN GENERAL.—Section 1902 of the So19 cial Security Act (42 U.S.C. 1396a) is amend20 ed— 

21 (i) in subsection (a)— 

22 (I) in paragraph (86), by striking 

23 ‘‘and’’ at the end; 


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1 (II) in paragraph (87), by strik2 ing at the end the period and insert3 ing ‘‘; and’’; and 

4 (III) by inserting after paragraph 

5 (87) the following new paragraph: 

6 ‘‘(88) provide that the State plan is in compli7 ance with subsection (e)(16).’’; and 

8 (ii) in subsection (e)(16)— 

9 (I) in subparagraph (A), by strik10 ing ‘‘At the option of the State, the 

11 State plan (or waiver of such State 

12 plan) may provide’’ and inserting ‘‘A 

13 State plan (or waiver of such State 

14 plan) shall provide’’; 

15 (II) in subparagraph (B)— 

16 (aa) in the matter preceding 

17 clause (i), by striking ‘‘by a State 

18 making an election under this 

19 paragraph’’ and inserting ‘‘under 

20 a State plan (or a waiver os such 

21 State plan)’’; 

22 (bb) in clause (i), by striking 

23 at the end ‘‘and’’; 


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1 (cc) in clause (ii), by strik2 ing the period at the end and in3 serting ‘‘; and’’; and 

4 (dd) by adding at the end 

5 the following new clause: 

6 ‘‘(iii) include as pregnancy-related 

7 medical assistance a comprehensive num8 ber of prenatal appointments and 

9 screenings furnished by a maternity care 

10 provider (as defined in section 2730(b)(1) 

11 of the Public Health Service Act), 

12 perinatal health worker (as defined in sec13 tion 2730(b)(2) of the Public Health Serv14 ice Act), or community-based provider and 

15 as postpartum-related medical assistance a 

16 full-spectrum of postpartum care furnished 

17 by such a provider.’’; and 

18 (III) by striking subparagraph 

19 (C). 

20 (B) NO COST SHARING OR SIMILAR

21 CHARGES FOR CERTAIN SERVICES.—Section 

22 1916(a)(2) of the Social Security Act (42 

23 U.S.C. 1396o(a)(2)) is amended— 

24 (i) in subparagraph (F), by striking at 

25 the end ‘‘or’’; 


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1 (ii) in subparagraph (G), by striking 

2 ‘‘; and’’ and inserting ‘‘; or’’; and 

3 (iii) by adding at the end the fol4 lowing new subparagraph: 

5 ‘‘(H) appointments, screenings, 

6 and care required to be included as 

7 pregnancy-related and postpartum-re8 lated medical assistance under section 

9 1902(e)(16)(B)(iii); and’’. 

10 (2) APPLYING REQUIREMENT UNDER CHIP.— 

11 Section 2107(e)(1)(J) of the Social Security Act (42 

12 U.S.C. 1397gg(e)(1)(J)) is amended to read as fol13 lows: 

14 ‘‘(J) Paragraphs (5) and (16) of section 

15 1902(e) (relating to the requirement to provide 

16 medical assistance under the State plan or 

17 waiver consisting of full benefits during preg18 nancy and throughout the 12-month 

19 postpartum period under title XIX) such that 

20 the provision of assistance under the State child 

21 health plan or waiver for targeted low-income 

22 children or targeted low-income pregnant 

23 women during pregnancy and the 12-month 

24 postpartum period shall be required and shall 

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1 vided to a targeted low-income child or targeted 

2 low-income pregnant woman (as applicable) 

3 under the State child health plan or waiver), in4 cluding the appointments, screenings, and care 

5 required to be included as pregnancy-related 

6 and postpartum-related medical assistance 

7 under section 1902(e)(16)(B)(iii).’’. 

8 (3) EFFECTIVE DATE.— 

9 (A) IN GENERAL.—Except as provided in 

10 paragraph (2), the amendments made by this 

11 section shall take effect on the date of the en12 actment of this Act and shall apply to services 

13 furnished on or after the date that is 30 days 

14 after the date of enactment of this Act. 

15 (B) EXCEPTION IF STATE LEGISLATION

16 REQUIRED.—In the case of a State plan for 

17 medical assistance under title XIX of the Social 

18 Security Act or State child health plan for child 

19 health assistance under title XXI of such Act 

20 which the Secretary of Health and Human 

21 Services determines requires State legislation 

22 (other than legislation appropriating funds) in 

23 order for the plan to meet the additional re24 quirement imposed by the amendments made by 

25 this subsection, the State plan or State child 


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1 health plan shall not be regarded as failing to 

2 comply with the requirements of such title sole3 ly on the basis of its failure to meet this addi4 tional requirement before the first day of the 

5 first calendar quarter beginning after the close 

6 of the first regular session of the State legisla7 ture that begins after the date of the enactment 

8 of this Act. For purposes of the previous sen9 tence, in the case of a State that has a 2-year 

10 legislative session, each year of such session 

11 shall be deemed to be a separate regular session 

12 of the State legislature. 

13 (b) PRIVATE HEALTH PLANS.—Subpart II of part A 

14 of title XXVII of the Public Health Service Act (42 U.S.C. 

15 300gg–11 et seq.) is amended by adding at the end the 

16 following new section: 

17 ‘‘SEC. 2730. COVERAGE OF PRENATAL AND POSTPARTUM 

18 SERVICES. 

19 ‘‘(a) IN GENERAL.—Beginning 30 days after the date 

20 of enactment of this section, a group health plan and a 

21 health insurance issuer offering group or individual health 

22 insurance coverage shall provide coverage for and shall not 

23 impose any cost sharing requirements for— 

24 ‘‘(1) a comprehensive number of prenatal ap25 pointments and screenings furnished by a maternity 


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1 care provider, perinatal health worker, or commu2 nity-based provider; and 

3 ‘‘(2) a full-spectrum of postpartum care fur4 nished by such a provider for at least a year after 

5 birth or the end of pregnancy. 

6 ‘‘(b) DEFINITIONS.—For purposes of this section: 

7 ‘‘(1) MATERNITY CARE PROVIDER.—The term 

8 ‘maternity care provider’ means a health care pro9 vider who— 

10 ‘‘(A) is a physician, physician assistant, or 

11 midwife who meets at a minimum the inter12 national definition of the midwife and global 

13 standards for midwifery education as estab14 lished by the International Confederation of 

15 Midwives, nurse practitioner, or clinical nurse 

16 specialist; and 

17 ‘‘(B) has a focus on maternal or perinatal 

18 health. 

19 ‘‘(2) PERINATAL HEALTH WORKER.—The term 

20 ‘perinatal health worker’ means a doula, community 

21 health worker, peer supporter, breastfeeding and lac22 tation educator or counselor, nutritionist or dieti23 tian, childbirth educator, social worker, home visitor, 

24 language interpreter, or navigator.’’. 


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1 SEC. 5. ENSURING FREE TESTING, VACCINE, AND TREAT2 MENT FOR COVID–19 TO PREGNANT PERSONS 

3 AND TO INFANTS, REGARDLESS OF INSUR4 ANCE STATUS OR SOURCE OF INSURANCE. 

5 (a) EXPANSION OF COVERAGE OF TESTING FOR

6 COVID–19 TO OTHER PRIVATE PLANS.—Section 6001(a) 

7 of the Families First Coronavirus Response Act (Public 

8 Law 116–127) is amended by striking ‘‘A group health 

9 plan and a health insurance issuer offering group or indi10 vidual health insurance coverage (including a grand11 fathered health plan (as defined in section 1251(e) of the 

12 Patient Protection and Affordable Care Act))’’ and insert13 ing ‘‘A group health plan, a health insurance issuer offer14 ing group or individual health insurance coverage (includ15 ing a grandfathered health plan (as defined in section 

16 1251(e) of the Patient Protection and Affordable Care 

17 Act)), short-term limited duration insurance, association 

18 health plans and health care sharing ministries’’. 

19 (b) REQUIREMENT TO PROVIDE COVERAGE FOR

20 COVID–19 TREATMENT AFTER THE COVID–19 EMER21 GENCY PERIOD.— 

22 (1) STATE MEDICAID PLANS.— 

23 (A) PLANS WITH TRADITIONAL COST

24 SHARING.—Subsections (a)(2)(F) and (b)(2)(F) 

25 of section 1916 of the Social Security Act (42 

26 U.S.C. 1396o) are each amended by striking 


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1 ‘‘that is administered during any portion of the 

2 emergency period described in such section be3 ginning on or after the date of the enactment 

4 of this subparagraph (and the administration of 

5 such product)’’. 

6 (B) PLANS WITH ALTERNATIVE COST

7 SHARING.—Section 1916A(b)(3)(B)(xi) of the 

8 Social Security Act (42 U.S.C. 1396o– 

9 1(b)(3)(B)(xi)) is amended by striking ‘‘that is 

10 furnished during any such portion’’. 

11 (2) PRIVATE PLANS.—Section 6001(a) of the 

12 Families First Coronavirus Response Act (Public 

13 Law 116–127), as amended by paragraph (1), is 

14 further amended by striking ‘‘furnished during any 

15 portion of the emergency period defined in para16 graph (1)(B) of section 1135(g) of the Social Secu17 rity Act (42 U.S.C. 1320b–5(g)) beginning on or 

18 after the date of the enactment of this Act’’. 

19 (c) STATE MEDICAID PLAN REQUIREMENT TO PRO20 VIDE COVERAGE OF TESTING FOR COVID–19 FOR UNIN21 SURED PREGNANT PERSONS.—Section 1902(a)(10) of the 

22 Social Security Act (42 U.S.C. 1396a(a)(10)) is amend23 ed— 

24 (1) in subparagraph (F), by striking at the end 

25 ‘‘and’’; 


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1 (2) in subparagraph (G), by adding at the end 

2 ‘‘and’’; and 

3 (3) by inserting after subparagraph (G) the fol4 lowing new subparagraph: 

5 ‘‘(H) for making a clinical diagnostic lab6 oratory test administered for the detection of 

7 SARS–CoV–2 or the diagnosis of the virus that 

8 causes COVID–19 and the administration of 

9 such test available to an uninsured pregnant in10 dividual.’’. 

Æ 


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