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 Com-
mittee on Energy and Commerce, and in addition to the Committees on 
Ways and Means, and Education and Labor, for a period to be subse-
quently 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. 
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 ‘‘COVID–19 Safe Birth-
ing Act’’. 
VerDate Sep 11 2014 
22:39 Jun 08, 2021
Jkt 019200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H2598.IH
H2598
pbinns on DSKJLVW7X2PROD with BILLS
SEC. 2. EXPANDING ACCESS TO MATERNAL CARE IN HOS-
PITALS. 
Section 1866(a)(1) of the Social Security Act (42 
U.S.C. 1395cc(a)(1)) is amended— 
(1) in subparagraph (X), by striking at the end 
‘‘and’’; 
(2) in subparagraph (Y)(ii)(V), by striking the 
period at the end and inserting ‘‘; and’’; and 
(3) by inserting after subparagraph (Y)(ii)(V), 
the following new subparagraph: 
‘‘(Z) beginning 30 days after the date of 
enactment of this subparagraph, in the case of 
a hospital— 
‘‘(i) to require that such hospital per-
mits a pregnant or birthing person to be 
accompanied by an individual of the preg-
nant or birthing person’s choosing (in ad-
dition to a doula or other perinatal health 
worker) during labor, delivery, and recov-
ery; with necessary, evidence based, and 
non-discriminatory exceptions; 
‘‘(ii) to require that such hospital does 
not implement any policies that restrict 
hospital access or birthing options for 
pregnant or birthing persons, unless such 
policies are necessary, evidence-based, com-
VerDate Sep 11 2014 
22:39 Jun 08, 2021
Jkt 019200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H2598.IH
H2598
pbinns on DSKJLVW7X2PROD with BILLS
municated to the patient without threat or 
intimidation, and applied without discrimi-
nation on the basis of race, gender iden-
tity, socio-economic status, religion, sexual 
orientation, marital status, age, disability, 
national origin, and immigration status; 
and 
‘‘(iii) with respect to the care of a 
pregnant or birthing person, to require the 
communication of and informed consent 
(without threat or intimidation) to the im-
plementation of policies pursuant to clause 
(ii) by the pregnant or birthing person, in 
accordance with consent protocols of the 
hospital in the case of inability of a person 
to provide consent.’’. 
SEC. 3. EXPANDING MEDICARE AND MEDICAID COVERAGE 
OF TELEHEALTH SERVICES THAT ARE MA-
TERNAL HEALTH CARE SERVICES. 
(a) REMOVAL
OF CERTAIN MEDICARE REQUIRE-
MENTS FOR MATERNAL HEALTH CARE SERVICES.—Sec-
tion 1834(m) of the Social Security Act (42 U.S.C. 
1395m(m)) is amended— 
VerDate Sep 11 2014 
22:39 Jun 08, 2021
Jkt 019200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H2598.IH
H2598
pbinns on DSKJLVW7X2PROD with BILLS
(1) in paragraph (4)(C)(i), by striking ‘‘para-
graphs (5), (6), and (7)’’ and inserting ‘‘paragraphs 
(5), (6), (7), and (9)’’; and 
(2) by adding at the end the following new 
paragraph: 
‘‘(9) TREATMENT
OF
MATERNITY
HEALTH 
CARE SERVICES.—With respect to telehealth services 
that are maternal health care services, notwith-
standing any other provision of this subsection— 
‘‘(A) the requirements described in para-
graph (4)(C) shall not apply; 
‘‘(B) the term ‘originating site’ means sites 
at which the eligible telehealth individual is lo-
cated at the time the service is furnished via a 
telecommunications system; and 
‘‘(C) there shall be no restrictions on ac-
cess to such telehealth services through use of 
telephone based on the use of video capabilities 
or lack of such capabilities.’’. 
(b) MEDICAID COVERAGE.—Section 1905(a) of the 
Social Security Act (42 U.S.C. 1396d(a)) is amended— 
(1) in paragraph (5)(A), by inserting ‘‘(and in 
the case of physicians’ services that are maternal 
health care services, including via telehealth)’’ after 
‘‘or elsewhere’’; 
VerDate Sep 11 2014 
22:39 Jun 08, 2021
Jkt 019200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H2598.IH
H2598
pbinns on DSKJLVW7X2PROD with BILLS
(2) in paragraph (17), by inserting ‘‘, including 
services furnished via telehealth,’’ before ‘‘fur-
nished’’; 
(3) in paragraph (21), by inserting ‘‘, including 
services furnished via telehealth,’’ after ‘‘furnished’’; 
and 
(4) in paragraph (28), by inserting ‘‘, including 
such services furnished via telehealth to the extent 
such services may be performed under State law by 
freestanding birth centers’’ before the semicolon at 
the end. 
SEC. 4. ENSURING COVERAGE OF CERTAIN MATERNAL 
HEALTH CARE SERVICES. 
(a) MAKING CERTAIN MEDICAID COVERAGE OF CER-
TAIN PRENATAL AND POSTPARTUM SERVICES A STATE 
PLAN REQUIREMENT.— 
(1) STATE MEDICAID PLANS.— 
(A) IN GENERAL.—Section 1902 of the So-
cial Security Act (42 U.S.C. 1396a) is amend-
ed— 
(i) in subsection (a)— 
(I) in paragraph (86), by striking 
‘‘and’’ at the end; 
VerDate Sep 11 2014 
22:39 Jun 08, 2021
Jkt 019200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H2598.IH
H2598
pbinns on DSKJLVW7X2PROD with BILLS
(II) in paragraph (87), by strik-
ing at the end the period and insert-
ing ‘‘; and’’; and 
(III) by inserting after paragraph 
(87) the following new paragraph: 
‘‘(88) provide that the State plan is in compli-
ance with subsection (e)(16).’’; and 
(ii) in subsection (e)(16)— 
(I) in subparagraph (A), by strik-
ing ‘‘At the option of the State, the 
State plan (or waiver of such State 
plan) may provide’’ and inserting ‘‘A 
State plan (or waiver of such State 
plan) shall provide’’; 
(II) in subparagraph (B)— 
(aa) in the matter preceding 
clause (i), by striking ‘‘by a State 
making an election under this 
paragraph’’ and inserting ‘‘under 
a State plan (or a waiver os such 
State plan)’’; 
(bb) in clause (i), by striking 
at the end ‘‘and’’; 
VerDate Sep 11 2014 
22:39 Jun 08, 2021
Jkt 019200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H2598.IH
H2598
pbinns on DSKJLVW7X2PROD with BILLS
(cc) in clause (ii), by strik-
ing the period at the end and in-
serting ‘‘; and’’; and 
(dd) by adding at the end 
the following new clause: 
‘‘(iii) include as pregnancy-related 
medical assistance a comprehensive num-
ber 
of 
prenatal 
appointments 
and 
screenings furnished by a maternity care 
provider (as defined in section 2730(b)(1) 
of 
the 
Public 
Health 
Service 
Act), 
perinatal health worker (as defined in sec-
tion 2730(b)(2) of the Public Health Serv-
ice Act), or community-based provider and 
as postpartum-related medical assistance a 
full-spectrum of postpartum care furnished 
by such a provider.’’; and 
(III) by striking subparagraph 
(C). 
(B) NO
COST
SHARING
OR
SIMILAR 
CHARGES
FOR
CERTAIN
SERVICES.—Section 
1916(a)(2) of the Social Security Act (42 
U.S.C. 1396o(a)(2)) is amended— 
(i) in subparagraph (F), by striking at 
the end ‘‘or’’; 
VerDate Sep 11 2014 
22:39 Jun 08, 2021
Jkt 019200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H2598.IH
H2598
pbinns on DSKJLVW7X2PROD with BILLS
(ii) in subparagraph (G), by striking 
‘‘; and’’ and inserting ‘‘; or’’; and 
(iii) by adding at the end the fol-
lowing new subparagraph: 
‘‘(H) appointments, screenings, 
and care required to be included as 
pregnancy-related and postpartum-re-
lated medical assistance under section 
1902(e)(16)(B)(iii); and’’. 
(2) APPLYING REQUIREMENT UNDER CHIP.— 
Section 2107(e)(1)(J) of the Social Security Act (42 
U.S.C. 1397gg(e)(1)(J)) is amended to read as fol-
lows: 
‘‘(J) Paragraphs (5) and (16) of section 
1902(e) (relating to the requirement to provide 
medical assistance under the State plan or 
waiver consisting of full benefits during preg-
nancy 
and 
throughout 
the 
12-month 
postpartum period under title XIX) such that 
the provision of assistance under the State child 
health plan or waiver for targeted low-income 
children 
or 
targeted 
low-income 
pregnant 
women during pregnancy and the 12-month 
postpartum period shall be required and shall 
include coverage of all items or services pro-
VerDate Sep 11 2014 
22:39 Jun 08, 2021
Jkt 019200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H2598.IH
H2598
pbinns on DSKJLVW7X2PROD with BILLS
vided to a targeted low-income child or targeted 
low-income pregnant woman (as applicable) 
under the State child health plan or waiver), in-
cluding the appointments, screenings, and care 
required to be included as pregnancy-related 
and 
postpartum-related 
medical 
assistance 
under section 1902(e)(16)(B)(iii).’’. 
(3) EFFECTIVE DATE.— 
(A) IN GENERAL.—Except as provided in 
paragraph (2), the amendments made by this 
section shall take effect on the date of the en-
actment of this Act and shall apply to services 
furnished on or after the date that is 30 days 
after the date of enactment of this Act. 
(B) EXCEPTION
IF
STATE
LEGISLATION 
REQUIRED.—In the case of a State plan for 
medical assistance under title XIX of the Social 
Security Act or State child health plan for child 
health assistance under title XXI of such Act 
which the Secretary of Health and Human 
Services determines requires State legislation 
(other than legislation appropriating funds) in 
order for the plan to meet the additional re-
quirement imposed by the amendments made by 
this subsection, the State plan or State child 
VerDate Sep 11 2014 
22:39 Jun 08, 2021
Jkt 019200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H2598.IH
H2598
pbinns on DSKJLVW7X2PROD with BILLS
health plan shall not be regarded as failing to 
comply with the requirements of such title sole-
ly on the basis of its failure to meet this addi-
tional requirement before the first day of the 
first calendar quarter beginning after the close 
of the first regular session of the State legisla-
ture that begins after the date of the enactment 
of this Act. For purposes of the previous sen-
tence, in the case of a State that has a 2-year 
legislative session, each year of such session 
shall be deemed to be a separate regular session 
of the State legislature. 
(b) PRIVATE HEALTH PLANS.—Subpart II of part A 
of title XXVII of the Public Health Service Act (42 U.S.C. 
300gg–11 et seq.) is amended by adding at the end the 
following new section: 
‘‘SEC. 2730. COVERAGE OF PRENATAL AND POSTPARTUM 
SERVICES. 
‘‘(a) IN GENERAL.—Beginning 30 days after the date 
of enactment of this section, a group health plan and a 
health insurance issuer offering group or individual health 
insurance coverage shall provide coverage for and shall not 
impose any cost sharing requirements for— 
‘‘(1) a comprehensive number of prenatal ap-
pointments and screenings furnished by a maternity 
VerDate Sep 11 2014 
22:39 Jun 08, 2021
Jkt 019200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6201
E:\BILLS\H2598.IH
H2598
pbinns on DSKJLVW7X2PROD with BILLS
care provider, perinatal health worker, or commu-
nity-based provider; and 
‘‘(2) a full-spectrum of postpartum care fur-
nished by such a provider for at least a year after 
birth or the end of pregnancy. 
‘‘(b) DEFINITIONS.—For purposes of this section: 
‘‘(1) MATERNITY CARE PROVIDER.—The term 
‘maternity care provider’ means a health care pro-
vider who— 
‘‘(A) is a physician, physician assistant, or 
midwife who meets at a minimum the inter-
national definition of the midwife and global 
standards for midwifery education as estab-
lished by the International Confederation of 
Midwives, nurse practitioner, or clinical nurse 
specialist; and 
‘‘(B) has a focus on maternal or perinatal 
health. 
‘‘(2) PERINATAL HEALTH WORKER.—The term 
‘perinatal health worker’ means a doula, community 
health worker, peer supporter, breastfeeding and lac-
tation educator or counselor, nutritionist or dieti-
tian, childbirth educator, social worker, home visitor, 
language interpreter, or navigator.’’. 
VerDate Sep 11 2014 
22:39 Jun 08, 2021
Jkt 019200
PO 00000
Frm 00011
Fmt 6652
Sfmt 6201
E:\BILLS\H2598.IH
H2598
pbinns on DSKJLVW7X2PROD with BILLS
SEC. 5. ENSURING FREE TESTING, VACCINE, AND TREAT-
MENT FOR COVID–19 TO PREGNANT PERSONS 
AND TO INFANTS, REGARDLESS OF INSUR-
ANCE STATUS OR SOURCE OF INSURANCE. 
(a) EXPANSION
OF COVERAGE
OF TESTING
FOR 
COVID–19 TO OTHER PRIVATE PLANS.—Section 6001(a) 
of the Families First Coronavirus Response Act (Public 
Law 116–127) is amended by striking ‘‘A group health 
plan and a health insurance issuer offering group or indi-
vidual health insurance coverage (including a grand-
fathered health plan (as defined in section 1251(e) of the 
Patient Protection and Affordable Care Act))’’ and insert-
ing ‘‘A group health plan, a health insurance issuer offer-
ing group or individual health insurance coverage (includ-
ing a grandfathered health plan (as defined in section 
1251(e) of the Patient Protection and Affordable Care 
Act)), short-term limited duration insurance, association 
health plans and health care sharing ministries’’. 
(b) REQUIREMENT TO PROVIDE COVERAGE
FOR 
COVID–19 TREATMENT AFTER THE COVID–19 EMER-
GENCY PERIOD.— 
(1) STATE MEDICAID PLANS.— 
(A) PLANS
WITH
TRADITIONAL
COST 
SHARING.—Subsections (a)(2)(F) and (b)(2)(F) 
of section 1916 of the Social Security Act (42 
U.S.C. 1396o) are each amended by striking 
VerDate Sep 11 2014 
22:39 Jun 08, 2021
Jkt 019200
PO 00000
Frm 00012
Fmt 6652
Sfmt 6201
E:\BILLS\H2598.IH
H2598
pbinns on DSKJLVW7X2PROD with BILLS
‘‘that is administered during any portion of the 
emergency period described in such section be-
ginning on or after the date of the enactment 
of this subparagraph (and the administration of 
such product)’’. 
(B) PLANS
WITH
ALTERNATIVE
COST 
SHARING.—Section 1916A(b)(3)(B)(xi) of the 
Social 
Security 
Act 
(42 
U.S.C. 
1396o– 
1(b)(3)(B)(xi)) is amended by striking ‘‘that is 
furnished during any such portion’’. 
(2) PRIVATE PLANS.—Section 6001(a) of the 
Families First Coronavirus Response Act (Public 
Law 116–127), as amended by paragraph (1), is 
further amended by striking ‘‘furnished during any 
portion of the emergency period defined in para-
graph (1)(B) of section 1135(g) of the Social Secu-
rity Act (42 U.S.C. 1320b–5(g)) beginning on or 
after the date of the enactment of this Act’’. 
(c) STATE MEDICAID PLAN REQUIREMENT TO PRO-
VIDE COVERAGE OF TESTING FOR COVID–19 FOR UNIN-
SURED PREGNANT PERSONS.—Section 1902(a)(10) of the 
Social Security Act (42 U.S.C. 1396a(a)(10)) is amend-
ed— 
(1) in subparagraph (F), by striking at the end 
‘‘and’’; 
VerDate Sep 11 2014 
22:39 Jun 08, 2021
Jkt 019200
PO 00000
Frm 00013
Fmt 6652
Sfmt 6201
E:\BILLS\H2598.IH
H2598
pbinns on DSKJLVW7X2PROD with BILLS
(2) in subparagraph (G), by adding at the end 
‘‘and’’; and 
(3) by inserting after subparagraph (G) the fol-
lowing new subparagraph: 
‘‘(H) for making a clinical diagnostic lab-
oratory test administered for the detection of 
SARS–CoV–2 or the diagnosis of the virus that 
causes COVID–19 and the administration of 
such test available to an uninsured pregnant in-
dividual.’’. 
Æ 
VerDate Sep 11 2014 
22:39 Jun 08, 2021
Jkt 019200
PO 00000
Frm 00014
Fmt 6652
Sfmt 6301
E:\BILLS\H2598.IH
H2598
pbinns on DSKJLVW7X2PROD with BILLS