I 
114TH CONGRESS 
1ST SESSION H. R. 2866 
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 
JUNE 23, 2015 
Mrs. WATSON COLEMAN (for herself, Ms. ADAMS, Ms. BASS, Mrs. BEATTY, 
Mr. BECERRA, Mr. BLUMENAUER, Ms. BROWN
of Florida, Mr. 
BUTTERFIELD, Mrs. CAPPS, Mr. CA´RDENAS, Mr. CARSON of Indiana, Ms. 
CASTOR of Florida, Ms. JUDY CHU of California, Ms. CLARK of Massa-
chusetts, Mr. CLEAVER, Mr. CLYBURN, Mr. COHEN, Mr. CONNOLLY, Mr. 
CONYERS, Mr. CROWLEY, Mr. DANNY
K. DAVIS
of Illinois, Mr. 
DELANEY, Ms. DELAURO, Mr. DESAULNIER, Mrs. DINGELL, Ms. 
EDWARDS, Mr. ELLISON, Mr. FARR, Mr. FOSTER, Ms. FUDGE, Mr. 
GARAMENDI, Mr. GRIJALVA, Mr. GUTIE´RREZ, Mr. HASTINGS, Mr. 
HONDA, Mr. ISRAEL, Ms. JACKSON LEE, Ms. EDDIE BERNICE JOHNSON 
of Texas, Ms. KAPTUR, Ms. KELLY of Illinois, Mrs. KIRKPATRICK, Ms. 
KUSTER, Mr. LANGEVIN, Mrs. LAWRENCE, Ms. LEE, Mr. LEVIN, Mr. 
LEWIS, Mr. TED LIEU of California, Mrs. CAROLYN B. MALONEY of New 
York, Mr. SEAN PATRICK MALONEY of New York, Ms. MCCOLLUM, Mr. 
MCDERMOTT, Mr. MEEKS, Ms. MOORE, Mr. MOULTON, Mr. NADLER, 
Mrs. NAPOLITANO, Mr. NORCROSS, Ms. NORTON, Mr. O’ROURKE, Mr. 
PASCRELL, Mr. PAYNE, Mr. RICHMOND, Mr. RUSH, Ms. LINDA T. 
SA´NCHEZ of California, Mr. DAVID SCOTT of Georgia, Mr. SIRES, Ms. 
SPEIER, Mr. THOMPSON of Mississippi, Mr. TONKO, Mrs. TORRES, Mr. 
VAN HOLLEN, Mr. VARGAS, Mr. VELA, Ms. MAXINE WATERS of Cali-
fornia, Ms. WILSON of Florida, Mr. MCGOVERN, Ms. BONAMICI, Mr. 
BRENDAN F. BOYLE of Pennsylvania, Mr. PETERS, and Ms. CLARKE of 
New York) introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committees on 
Ways and Means and Oversight and Government Reform, for a period 
to be subsequently determined by the Speaker, in each case for consider-
ation of such provisions as fall within the jurisdiction of the committee 
concerned 
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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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Healthy Maternity and 
Obstetric Medicine Act’’ or the ‘‘Healthy MOM Act’’. 
SEC. 2. FINDINGS AND PURPOSE. 
(a) FINDINGS.—Congress finds the following: 
(1) Pregnancy is a significant life event for mil-
lions of women in the United States each year. 
(2) For more than 30 years, our Nation, 
through the Medicaid program, has recognized that 
pregnant women need immediate access to afford-
able care, and has allowed women who meet income- 
eligibility requirements to enroll in Medicaid cov-
erage when they become pregnant. 
(3) Congress recognized the central importance 
of maternity coverage by classifying maternity and 
newborn care as one of the ten essential health bene-
fits that must now be covered on most individual 
and small group health insurance plans under sec-
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tion 1302(b)(1) of the Patient Protection and Af-
fordable Care Act (42 U.S.C. 18022(b)(1)). 
(4) Access to comprehensive maternity coverage 
allows women to access important pregnancy-related 
care, which is demonstrated to improve health out-
comes for women and newborns and reduce financial 
costs for both consumers and insurers. 
(5) Uninsured women, women with grand-
fathered and transitional health plans, self-funded 
student health plans, and catastrophic and high-de-
ductible health plans may lack access to comprehen-
sive and affordable maternity coverage. 
(6) A special enrollment period is especially im-
portant for young adults, who are at high risk for 
unintended pregnancies, yet young adults are fre-
quently enrolled in catastrophic coverage, which 
often has fewer benefits, more restrictions, and high-
er deductibles. 
(7) Timely maternity care improves the health 
of pregnant women, as well as birth outcomes and 
the health of babies throughout their lifetimes. Preg-
nancy-related maternal mortality is three to four 
times higher among women who receive no maternity 
care compared to women who do. Regular maternity 
care can detect or mitigate serious pregnancy-related 
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health complications, including preeclampsia, pla-
cental abruption, complications from diabetes, com-
plications from heart disease, and Graves’ disease, 
all of which can result in morbidity or mortality for 
the mother or newborn. 
(8) Regular maternity care can reduce preterm 
births and the health complications associated with 
preterm births. 
(9) Timely maternity care can reduce short- 
and long-term health care costs. If a woman does 
not have access to affordable maternity care during 
her pregnancy, and she or her newborn experiences 
pregnancy complications that result in health prob-
lems after birth, their insurer may end up paying 
much higher costs than if the insurer had covered 
the woman’s maternity care during her pregnancy. 
Intensive maternity care can reduce hospital and 
neonatal intensive care unit admissions among in-
fants, resulting in cost savings of $1,768 to $5,560 
per birth. For women with high-risk pregnancies, in-
tensive maternity care saves $1.37 for every $1 in-
vested in maternity care. 
(b) PURPOSE.—The purpose of this Act is to protect 
the health of women and newborns by ensuring that all 
women eligible for coverage through the Exchanges estab-
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lished under title I of the Patient Protection and Afford-
able Care Act (Public Law 111–148) can access affordable 
health coverage during their pregnancy. 
SEC. 3. PROVIDING FOR A SPECIAL ENROLLMENT PERIOD 
FOR PREGNANT WOMEN. 
(a) 
PUBLIC
HEALTH
SERVICE
ACT.—Section 
2702(b)(2) of the Public Health Service Act (42 U.S.C. 
300gg–1(b)(2)) is amended by inserting ‘‘including a spe-
cial enrollment period for pregnant women, beginning on 
the date on which the pregnancy is reported to the health 
insurance issuer’’ before the period at the end. 
(b) PATIENT PROTECTION AND AFFORDABLE CARE 
ACT.—Section 1311(c)(6) of the Patient Protection and 
Affordable Care Act (42 U.S.C. 18031(c)(6)) is amend-
ed— 
(1) in subparagraph (C), by striking ‘‘and’’ at 
the end; 
(2) by redesignating subparagraph (D) as sub-
paragraph (E); and 
(3) by inserting after subparagraph (C) the fol-
lowing new subparagraph: 
‘‘(D) a special enrollment period for preg-
nant women, beginning on the date on which 
the pregnancy is reported to the Exchange; 
and’’. 
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(c) 
SPECIAL
ENROLLMENT
PERIODS.—Section 
9801(f) of the Internal Revenue Code of 1986 (26 U.S.C. 
9801(f)) is amended by adding at the end the following 
new paragraph: 
‘‘(4) FOR PREGNANT WOMEN.— 
‘‘(A) A group health plan shall permit an 
employee who is eligible, but not enrolled, for 
coverage under the terms of the plan (or a de-
pendent of such an employee if the dependent 
is eligible, but not enrolled, for coverage under 
such terms) to enroll for coverage under the 
terms of the plan upon pregnancy, with the spe-
cial enrollment period beginning on the date on 
which the pregnancy is reported to the group 
health plan. 
‘‘(B) The Secretary shall promulgate regu-
lations with respect to the special enrollment 
period under subparagraph (A), including es-
tablishing a time period for pregnant women to 
enroll in coverage and effective date of such 
coverage.’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply with respect to plan years begin-
ning after the 2016 plan year. 
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SEC. 4. FEDERAL EMPLOYEE HEALTH BENEFIT PLANS. 
(a) IN GENERAL.—The Director of the Office of Per-
sonnel Management shall issue such regulations as are 
necessary to ensure that pregnancy is considered a change 
in family status and a qualifying life event for an indi-
vidual who is eligible to enroll, but is not enrolled, in a 
health benefit plan under chapter 89 title 5, United States 
Code. 
(b) EFFECTIVE DATE.—The requirement in sub-
section (a) shall apply with respect to any contract entered 
into under section 8902 of such title beginning 12 months 
after the date of enactment of this Act. 
Æ 
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