I 

118TH CONGRESS 

1ST SESSION H. R. 6716 

To amend title XXVII of the Public Health Service Act to provide for 

a special enrollment period for pregnant women, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

DECEMBER 11, 2023 

Mrs. WATSON COLEMAN (for herself, Mr. BOYLE of Pennsylvania, Ms. WILSON of Florida, Mr. PAYNE, Mr. GRIJALVA, Mr. JOHNSON of Georgia, 

Mr. EVANS, Mr. CONNOLLY, Ms. CHU, Mr. TORRES of New York, Mr. 

POCAN, Ms. LEE of California, Mr. COHEN, Ms. NORTON, Mr. CARSON, 

Mrs. HAYES, Ms. CROCKETT, Mr. MEEKS, Mr. CARTER of Louisiana, Mr. 

JACKSON of Illinois, Ms. STEVENS, Ms. BONAMICI, Mr. SWALWELL, Ms. 

MENG, Ms. LOIS FRANKEL of Florida, and Ms. SHERRILL) introduced 

the following bill; which was referred to the Committee on Energy and 

Commerce, and in addition to the Committees on Ways and Means, Education and the Workforce, and Oversight and Accountability, 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 XXVII of the Public Health Service Act 

to provide for a special enrollment period for pregnant 

women, 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, 


ddrumheller on DSK120RN23PROD with BILLS
2 

•HR 6716 IH

1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Healthy Maternity and 

3 Obstetric Medicine Act’’ or the ‘‘Healthy MOM Act’’. 

4 SEC. 2. FINDINGS; PURPOSE. 

5 (a) FINDINGS.—Congress finds the following: 

6 (1) Pregnancy is a significant life event for mil7 lions of women in the United States each year. 

8 (2) For more than 30 years, our Nation, 

9 through the Medicaid program, has recognized that 

10 pregnant women need immediate access to afford11 able care, and has allowed women who meet income12 eligibility requirements to enroll in Medicaid cov13 erage when they become pregnant. 

14 (3) Congress recognized the central importance 

15 of maternity coverage by classifying maternity and 

16 newborn care as one of the ten essential health bene17 fits that must now be covered on most individual 

18 and small group health insurance plans under sec19 tion 1302(b)(1) of the Patient Protection and Af20 fordable Care Act (42 U.S.C. 18022(b)(1)). 

21 (4) Congress has also recognized the significant 

22 challenge of maternal mortality and the need to 

23 eliminate disparities in maternal health outcomes for 

24 pregnancy-related and pregnancy-associated deaths, 

25 and to improve health outcomes for both mothers 


ddrumheller on DSK120RN23PROD with BILLS
3 

•HR 6716 IH

1 and babies through passage of the Preventing Ma2 ternal Deaths Act of 2018 (Public Law 115–344). 

3 (5) Access to comprehensive maternity coverage 

4 allows women to access important pregnancy-related 

5 care, which is demonstrated to improve health out6 comes for women and newborns and reduce financial 

7 costs for both consumers and insurers. 

8 (6) Uninsured women, women with grand9 fathered and transitional health plans, self-funded 

10 student health plans, and catastrophic and high-de11 ductible health plans may lack access to comprehen12 sive and affordable maternity coverage. 

13 (7) Employer health plans that exclude depend14 ent daughters from maternity coverage leave young 

15 women without coverage for their pregnancy, even 

16 though Federal law has long held that treating preg17 nancy differently than other conditions is sex-based 

18 discrimination. 

19 (8) A special enrollment period is especially im20 portant for young adults, who are at high risk for 

21 unintended pregnancies, yet young adults are fre22 quently enrolled in catastrophic coverage, which 

23 often has fewer benefits, more restrictions, and high24 er deductibles. 


ddrumheller on DSK120RN23PROD with BILLS
4 

•HR 6716 IH

1 (9) This coverage would be an equalizer for 

2 communities of color. The maternal mortality rate 

3 varies drastically by race and ethnicity, and where a 

4 woman lives. The rising maternal mortality rate in 

5 the United States is driven predominantly by the 

6 disproportionately high African-American maternal 

7 mortality rate, which is four times more than the 

8 rate for White women. 

9 (10) According to the Centers for Disease Con10 trol and Prevention, about 700 women die each year 

11 in the United States from pregnancy-related com12 plications. Black and American Indian/Alaska Native 

13 women are about three times more likely to die from 

14 a pregnancy-related cause than White women. 

15 (11) Data demonstrates that 3 in 5 pregnancy 

16 related deaths could be prevented. Improving access 

17 to care is one way to help prevent deaths, regardless 

18 of race or ethnicity. 

19 (12) Timely maternity care improves the health 

20 of pregnant women, as well as birth outcomes and 

21 the health of babies throughout their lifetimes. Preg22 nancy-related maternal mortality is three to four 

23 times higher among women who receive no maternity 

24 care compared to women who do. Regular maternity 

25 care can detect or mitigate serious pregnancy-related 


ddrumheller on DSK120RN23PROD with BILLS
5 

•HR 6716 IH

1 health complications, including preeclampsia, pla2 cental abruption, complications from diabetes, com3 plications from heart disease, and Graves’ disease, 

4 all of which can result in morbidity or mortality for 

5 the mother or newborn. 

6 (13) The Centers for Disease Control and Pre7 vention reports that more than half of all maternal 

8 deaths occur at delivery or in the first postpartum 

9 year, whereas just more than one-third of preg10 nancy-related or pregnancy-associated deaths occur 

11 while a person is still pregnant. Yet, for women eligi12 ble for the Medicaid program on the basis of preg13 nancy, such Medicaid coverage lapses at the end of 

14 the month on which the 60th postpartum day lands. 

15 (14) Timely maternity care and adequate 

16 postpartum care can reduce short- and long-term 

17 health care costs. If a woman does not have access 

18 to affordable maternity care during her pregnancy, 

19 and she or her newborn experiences pregnancy com20 plications that result in health problems after birth, 

21 their insurer may end up paying much higher costs 

22 than if the insurer had covered the woman’s mater23 nity care during her pregnancy. Intensive maternity 

24 care can reduce hospital and neonatal intensive care 

25 unit admissions among infants, resulting in cost savVerDate Sep 11 2014 22:49 Dec 28, 2023 Jkt 049200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H6716.IH H6716

ddrumheller on DSK120RN23PROD with BILLS
6 

•HR 6716 IH

1 ings of $1,768 to $5,560 per birth. For women with 

2 high-risk pregnancies, intensive maternity care saves 

3 $1.37 for every $1 invested in maternity care. 

4 (b) PURPOSE.—The purpose of this Act is to protect 

5 the health of women and newborns by ensuring that all 

6 women eligible for coverage through the Exchanges estab7 lished under title I of the Patient Protection and Afford8 able Care Act (Public Law 111–148) and women eligible 

9 for other individual or group health plan coverage can ac10 cess affordable health coverage during their pregnancy. 

11 SEC. 3. PROVIDING FOR A SPECIAL ENROLLMENT PERIOD 

12 FOR PREGNANT INDIVIDUALS. 

13 (a) PUBLIC HEALTH SERVICE ACT.—Section 

14 2702(b)(2) of the Public Health Service Act (42 U.S.C. 

15 300gg–1(b)(2)) is amended by inserting ‘‘, including a 

16 special enrollment period for pregnant individuals, begin17 ning on the date on which the pregnancy is reported to 

18 the health insurance issuer’’ before the period at the end. 

19 (b) PATIENT PROTECTION AND AFFORDABLE CARE

20 ACT.—Section 1311(c)(6) of the Patient Protection and 

21 Affordable Care Act (42 U.S.C. 18031(c)(6)) is amend22 ed— 

23 (1) in subparagraph (C), by striking ‘‘and’’ at 

24 the end; 


ddrumheller on DSK120RN23PROD with BILLS
7 

•HR 6716 IH

1 (2) by redesignating subparagraph (D) as sub2 paragraph (E); and 

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

5 ‘‘(D) a special enrollment period for preg6 nant individuals, beginning on the date on 

7 which such pregnancy is reported to the Ex8 change; and’’. 

9 (c) SPECIAL ENROLLMENT PERIODS.— 

10 (1) INTERNAL REVENUE CODE.—Section 

11 9801(f) of the Internal Revenue Code of 1986 (26 

12 U.S.C. 9801(f)) is amended by adding at the end 

13 the following new paragraph: 

14 ‘‘(4) FOR PREGNANT INDIVIDUALS.— 

15 ‘‘(A) A group health plan shall permit an 

16 employee who is eligible, but not enrolled, for 

17 coverage under the terms of the plan (or a de18 pendent of such an employee if the dependent 

19 is eligible, but not enrolled, for coverage under 

20 such terms) to enroll for coverage under the 

21 terms of the plan upon pregnancy, with the spe22 cial enrollment period beginning on the date on 

23 which the pregnancy is reported to the group 

24 health plan or the pregnancy is confirmed by a 

25 health care provider. 


ddrumheller on DSK120RN23PROD with BILLS
8 

•HR 6716 IH

1 ‘‘(B) The Secretary shall promulgate regu2 lations with respect to the special enrollment 

3 period under subparagraph (A), including es4 tablishing a time period for pregnant individ5 uals to enroll in coverage and effective date of 

6 such coverage.’’. 

7 (2) ERISA.—Section 701(f) of the Employee 

8 Retirement Income Security Act of 1974 (29 U.S.C. 

9 1181(f)) is amended by adding at the end the fol10 lowing: 

11 ‘‘(4) FOR PREGNANT INDIVIDUALS.— 

12 ‘‘(A) A group health plan or health insur13 ance issuer in connection with a group health 

14 plan shall permit an employee who is eligible, 

15 but not enrolled, for coverage under the terms 

16 of the plan (or a dependent of such an employee 

17 if the dependent is eligible, but not enrolled, for 

18 coverage under such terms) to enroll for cov19 erage under the terms of the plan upon preg20 nancy, with the special enrollment period begin21 ning on the date on which the pregnancy is re22 ported to the group health plan or health insur23 ance issuer or the pregnancy is confirmed by a 

24 health care provider. 


ddrumheller on DSK120RN23PROD with BILLS
9 

•HR 6716 IH

1 ‘‘(B) The Secretary shall promulgate regu2 lations with respect to the special enrollment 

3 period under subparagraph (A), including es4 tablishing a time period for pregnant individ5 uals to enroll in coverage and effective date of 

6 such coverage.’’. 

7 (d) EFFECTIVE DATE.—The amendments made by 

8 this section shall apply with respect to plan years begin9 ning on or after January 1, 2025. 

10 SEC. 4. COVERAGE OF MATERNITY CARE FOR DEPENDENT 

11 CHILDREN. 

12 Section 2719A of the Public Health Service Act (42 

13 U.S.C. 300gg–19a) is amended— 

14 (1) in subsection (e), by inserting ‘‘(other than 

15 subsection (f))’’ after ‘‘this section’’; and 

16 (2) by adding at the end the following: 

17 ‘‘(f) COVERAGE OF MATERNITY CARE.—Not later 

18 than January 1, 2025, a group health plan, or health in19 surance issuer offering group or individual health insur20 ance coverage, that provides coverage for dependents shall 

21 ensure that such plan or coverage includes coverage for 

22 maternity care associated with pregnancy, childbirth, and 

23 postpartum care for all participants, beneficiaries, or en24 rollees, including dependents, including coverage of labor 


ddrumheller on DSK120RN23PROD with BILLS
10 

•HR 6716 IH

1 and delivery. Such coverage shall be provided to all preg2 nant dependents regardless of age.’’. 

3 SEC. 5. FEDERAL EMPLOYEE HEALTH BENEFIT PLANS. 

4 (a) COVERAGE OF PREGNANCY.— 

5 (1) IN GENERAL.—The Director of the Office of 

6 Personnel Management shall issue such regulations 

7 as are necessary to ensure that pregnancy is consid8 ered a change in family status and a qualifying life 

9 event for an individual who is eligible to enroll, but 

10 is not enrolled, in a health benefit plan under chap11 ter 89 title 5, United States Code. 

12 (2) EFFECTIVE DATE.—The requirement in 

13 paragraph (1) shall apply with respect to any con14 tract entered into under section 8902 of such title 

15 beginning 12 months after the date of enactment of 

16 this Act. 

17 (b) DESIGNATING CERTAIN FEHBP-RELATED

18 SERVICES AS EXCEPTED SERVICES UNDER THE ANTI19 DEFICIENCY ACT.— 

20 (1) IN GENERAL.—Section 8905 of title 5, 

21 United States Code, is amended by adding at the 

22 end the following: 

23 ‘‘(j) Any services by an officer or employee under this 

24 chapter relating to enrolling individuals in a health bene25 fits plan under this chapter, or changing the enrollment 


ddrumheller on DSK120RN23PROD with BILLS
11 

•HR 6716 IH

1 of an individual already so enrolled due to an event de2 scribed in section 5(a)(1) of the Healthy MOM Act, shall 

3 be deemed, for purposes of section 1342 of title 31, serv4 ices for emergencies involving the safety of human life or 

5 the protection of property.’’. 

6 (2) APPLICATION.—The amendment made by 

7 paragraph (1) shall apply to any lapse in appropria8 tions beginning on or after the date of enactment of 

9 this Act. 

10 SEC. 6. CONTINUATION OF MEDICAID INCOME ELIGIBILITY 

11 STANDARD FOR PREGNANT INDIVIDUALS 

12 AND INFANTS. 

13 Section 1902(l)(2)(A) of the Social Security Act (42 

14 U.S.C. 1396a(l)(2)(A)) is amended— 

15 (1) in clause (i), by striking ‘‘and not more 

16 than 185 percent’’; 

17 (2) in clause (ii)— 

18 (A) in subclause (I), by striking ‘‘and’’ 

19 after the comma; 

20 (B) in subclause (II), by striking the pe21 riod at the end and inserting ‘‘, and’’; and 

22 (C) by adding at the end the following: 

23 ‘‘(III) January 1, 2025, is the percentage pro24 vided under clause (v).’’; and 


ddrumheller on DSK120RN23PROD with BILLS
12 

•HR 6716 IH

1 (3) by adding at the end the following new 

2 clause: 

3 ‘‘(v) The percentage provided under clause (ii) for 

4 medical assistance provided on or after January 1, 2025, 

5 with respect to individuals described in subparagraph (A) 

6 or (B) of paragraph (1) shall not be less than— 

7 ‘‘(I) the percentage specified for such individ8 uals by the State in an amendment to its State plan 

9 (whether approved or not) as of January 1, 2025; or 

10 ‘‘(II) if no such percentage is specified as of 

11 January 1, 2025, the percentage established for 

12 such individuals under the State’s authorizing legis13 lation or provided for under the State’s appropria14 tions as of that date.’’. 

15 SEC. 7. REQUIRING AND MAKING PERMANENT 12-MONTH 

16 CONTINUOUS COVERAGE FOR PREGNANT 

17 AND POSTPARTUM INDIVIDUALS UNDER 

18 MEDICAID AND CHIP. 

19 (a) MEDICAID.—Section 1902 of the Social Security 

20 Act (42 U.S.C. 1396a) is amended— 

21 (1) in subsection (a)— 

22 (A) in paragraph (86), by striking ‘‘and’’ 

23 at the end; 

24 (B) in paragraph (87), by striking the pe25 riod at the end and inserting ‘‘; and’’; and 


ddrumheller on DSK120RN23PROD with BILLS
13 

•HR 6716 IH

1 (C) by inserting after paragraph (87) the 

2 following new paragraph: 

3 ‘‘(88) provide that the State plan is in compli4 ance with subsection (e)(16).’’; and 

5 (2) in subsection (e)(16), as added by section 

6 9812 of the American Rescue Plan Act of 2021 

7 (P.L. 117–2)— 

8 (A) in subparagraph (A), by striking ‘‘At 

9 the option of the State, the State plan (or waiv10 er of such State plan) may provide’’ and insert11 ing ‘‘A State plan (or waiver of such State 

12 plan) shall provide’’; 

13 (B) in subparagraph (B), in the matter 

14 preceding clause (i), by striking ‘‘by a State 

15 making an election under this paragraph’’ and 

16 inserting ‘‘under a State plan (or a waiver of 

17 such State plan)’’; and 

18 (C) by striking subparagraph (C). 

19 (b) CHIP.— 

20 (1) IN GENERAL.—Section 2107(e)(1)(J) of the 

21 Social Security Act (42 U.S.C. 1397gg(e)(1)(J)), as 

22 inserted by section 9822 of the American Rescue 

23 Plan Act of 2021 (P.L. 117–2), is amended to read 

24 as follows: 


ddrumheller on DSK120RN23PROD with BILLS
14 

•HR 6716 IH

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

2 1902(e) (relating to the requirement to provide 

3 medical assistance under the State plan or 

4 waiver consisting of full benefits during preg5 nancy and throughout the 12-month 

6 postpartum period under title XIX) such that 

7 the provision of assistance under the State child 

8 health plan or waiver for targeted low-income 

9 children or targeted low-income pregnant 

10 women during pregnancy and the 12-month 

11 postpartum period shall be required and shall 

12 include coverage of all items or services pro13 vided to a targeted low-income child or targeted 

14 low-income pregnant woman (as applicable) 

15 under the State child health plan or waiver).’’. 

16 (2) CONFORMING.—Section 2112(d)(2)(A) of 

17 the Social Security Act (42 U.S.C. 1397ll(d)(2)(A)), 

18 as inserted by section 9822 of the American Rescue 

19 Plan Act of 2021 (P.L. 117–2), is amended by strik20 ing ‘‘the month in which the 60-day period’’ and all 

21 that follows through ‘‘pursuant to section 

22 2107(e)(1),’’. 

23 (c) CONFORMING AMENDMENTS.— 


ddrumheller on DSK120RN23PROD with BILLS
15 

•HR 6716 IH

1 (1) Section 9812(b) of the American Rescue 

2 Plan Act of 2021 (P.L. 117–2) is amended to read 

3 as follows: 

4 ‘‘(b) EFFECTIVE DATE.— 

5 ‘‘(1) IN GENERAL.—Subject to paragraph (2), 

6 the amendment made by subsection (a) shall apply 

7 with respect to services furnished on or after the 1st 

8 day of the 1st fiscal year quarter that begins one 

9 year after the date of the enactment of this Act. 

10 ‘‘(2) EXCEPTION FOR STATE LEGISLATION.—In 

11 the case of a State plan under title XIX of the So12 cial Security Act that the Secretary of Health and 

13 Human Services determines requires State legisla14 tion in order for the respective plan to meet any re15 quirement imposed by amendments made by this 

16 section, the plan shall not be regarded as failing to 

17 comply with the requirements of such title solely on 

18 the basis of its failure to meet such an additional re19 quirement before the first day of the first fiscal year 

20 quarter beginning after the close of the first regular 

21 session of the State legislature that begins after the 

22 date of enactment of this Act. For purposes of the 

23 previous sentence, in the case of a State that has a 

24 2-year legislative session, each year of the session 


ddrumheller on DSK120RN23PROD with BILLS
16 

•HR 6716 IH

1 shall be considered to be a separate regular session 

2 of the State legislature.’’. 

3 (2) Section 9822(b) of the American Rescue 

4 Plan Act of 2021 (P.L. 117–2) is amended to read 

5 as follows: 

6 ‘‘(b) EFFECTIVE DATE.— 

7 ‘‘(1) IN GENERAL.—Subject to paragraph (2), 

8 the amendments made by subsection (a), shall apply 

9 with respect to services furnished on or after the 1st 

10 day of the 1st fiscal year quarter that begins one 

11 year after the date of the enactment of this Act. 

12 ‘‘(2) EXCEPTION FOR STATE LEGISLATION.—In 

13 the case of a State child health plan under title XXI 

14 of the Social Security Act that the Secretary of 

15 Health and Human Services determines requires 

16 State legislation in order for the plan to meet any 

17 requirement imposed by amendments made by this 

18 section, the respective plan shall not be regarded as 

19 failing to comply with the requirements of such title 

20 solely on the basis of its failure to meet such an ad21 ditional requirement before the first day of the first 

22 fiscal year quarter beginning after the close of the 

23 first regular session of the State legislature that be24 gins after the date of enactment of this Act. For 

25 purposes of the previous sentence, in the case of a 


ddrumheller on DSK120RN23PROD with BILLS
17 

•HR 6716 IH

1 State that has a 2-year legislative session, each year 

2 of the session shall be considered to be a separate 

3 regular session of the State legislature.’’. 

4 (d) EFFECTIVE DATE.—The amendments made by 

5 subsections (a) and (c)(1) shall take effect as if included 

6 in the enactment of section 9812 of the American Rescue 

7 Plan Act of 2021 (P.L. 117–2). The amendments made 

8 by subsections (b) and (c)(2) shall take effect as if in9 cluded in the enactment of section 9822 of such Act. 

10 SEC. 8. RELATIONSHIP TO OTHER LAWS. 

11 Nothing in this Act (or an amendment made by this 

12 Act) shall be construed to invalidate or limit the remedies, 

13 rights, and procedures of any Federal law or the law of 

14 any State or political subdivision of any State or jurisdic15 tion that provides greater or equal protection for enrollees 

16 in a group health plan or group or individual health insur17 ance offered by a health insurance issuer. 

Æ 


ddrumheller on DSK120RN23PROD with BILLS