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. WIL-
SON 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, Edu-
cation and the Workforce, and Oversight and Accountability, 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 
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, 
VerDate Sep 11 2014 
22:49 Dec 28, 2023
Jkt 049200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H6716.IH
H6716
ddrumheller on DSK120RN23PROD with BILLS
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; 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-
tion 1302(b)(1) of the Patient Protection and Af-
fordable Care Act (42 U.S.C. 18022(b)(1)). 
(4) Congress has also recognized the significant 
challenge of maternal mortality and the need to 
eliminate disparities in maternal health outcomes for 
pregnancy-related and pregnancy-associated deaths, 
and to improve health outcomes for both mothers 
VerDate Sep 11 2014 
22:49 Dec 28, 2023
Jkt 049200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H6716.IH
H6716
ddrumheller on DSK120RN23PROD with BILLS
and babies through passage of the Preventing Ma-
ternal Deaths Act of 2018 (Public Law 115–344). 
(5) 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. 
(6) 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. 
(7) Employer health plans that exclude depend-
ent daughters from maternity coverage leave young 
women without coverage for their pregnancy, even 
though Federal law has long held that treating preg-
nancy differently than other conditions is sex-based 
discrimination. 
(8) 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. 
VerDate Sep 11 2014 
22:49 Dec 28, 2023
Jkt 049200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H6716.IH
H6716
ddrumheller on DSK120RN23PROD with BILLS
(9) This coverage would be an equalizer for 
communities of color. The maternal mortality rate 
varies drastically by race and ethnicity, and where a 
woman lives. The rising maternal mortality rate in 
the United States is driven predominantly by the 
disproportionately high African-American maternal 
mortality rate, which is four times more than the 
rate for White women. 
(10) According to the Centers for Disease Con-
trol and Prevention, about 700 women die each year 
in the United States from pregnancy-related com-
plications. Black and American Indian/Alaska Native 
women are about three times more likely to die from 
a pregnancy-related cause than White women. 
(11) Data demonstrates that 3 in 5 pregnancy 
related deaths could be prevented. Improving access 
to care is one way to help prevent deaths, regardless 
of race or ethnicity. 
(12) 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 
VerDate Sep 11 2014 
22:49 Dec 28, 2023
Jkt 049200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H6716.IH
H6716
ddrumheller on DSK120RN23PROD with BILLS
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. 
(13) The Centers for Disease Control and Pre-
vention reports that more than half of all maternal 
deaths occur at delivery or in the first postpartum 
year, whereas just more than one-third of preg-
nancy-related or pregnancy-associated deaths occur 
while a person is still pregnant. Yet, for women eligi-
ble for the Medicaid program on the basis of preg-
nancy, such Medicaid coverage lapses at the end of 
the month on which the 60th postpartum day lands. 
(14) Timely maternity care and adequate 
postpartum 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 com-
plications that result in health problems after birth, 
their insurer may end up paying much higher costs 
than if the insurer had covered the woman’s mater-
nity care during her pregnancy. Intensive maternity 
care can reduce hospital and neonatal intensive care 
unit admissions among infants, resulting in cost sav-
VerDate 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
ings of $1,768 to $5,560 per birth. For women with 
high-risk pregnancies, intensive maternity care saves 
$1.37 for every $1 invested 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-
lished under title I of the Patient Protection and Afford-
able Care Act (Public Law 111–148) and women eligible 
for other individual or group health plan coverage can ac-
cess affordable health coverage during their pregnancy. 
SEC. 3. PROVIDING FOR A SPECIAL ENROLLMENT PERIOD 
FOR PREGNANT INDIVIDUALS. 
(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 
special enrollment period for pregnant individuals, begin-
ning 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; 
VerDate Sep 11 2014 
22:49 Dec 28, 2023
Jkt 049200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H6716.IH
H6716
ddrumheller on DSK120RN23PROD with BILLS
(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 individuals, beginning on the date on 
which such pregnancy is reported to the Ex-
change; and’’. 
(c) SPECIAL ENROLLMENT PERIODS.— 
(1) 
INTERNAL
REVENUE
CODE.—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 INDIVIDUALS.— 
‘‘(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 or the pregnancy is confirmed by a 
health care provider. 
VerDate Sep 11 2014 
22:49 Dec 28, 2023
Jkt 049200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H6716.IH
H6716
ddrumheller on DSK120RN23PROD with BILLS
‘‘(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 individ-
uals to enroll in coverage and effective date of 
such coverage.’’. 
(2) ERISA.—Section 701(f) of the Employee 
Retirement Income Security Act of 1974 (29 U.S.C. 
1181(f)) is amended by adding at the end the fol-
lowing: 
‘‘(4) FOR PREGNANT INDIVIDUALS.— 
‘‘(A) A group health plan or health insur-
ance issuer in connection with a group health 
plan shall permit an employee who is eligible, 
but not enrolled, for coverage under the terms 
of the plan (or a dependent of such an employee 
if the dependent is eligible, but not enrolled, for 
coverage under such terms) to enroll for cov-
erage under the terms of the plan upon preg-
nancy, with the special enrollment period begin-
ning on the date on which the pregnancy is re-
ported to the group health plan or health insur-
ance issuer or the pregnancy is confirmed by a 
health care provider. 
VerDate Sep 11 2014 
22:49 Dec 28, 2023
Jkt 049200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H6716.IH
H6716
ddrumheller on DSK120RN23PROD with BILLS
‘‘(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 individ-
uals 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 on or after January 1, 2025. 
SEC. 4. COVERAGE OF MATERNITY CARE FOR DEPENDENT 
CHILDREN. 
Section 2719A of the Public Health Service Act (42 
U.S.C. 300gg–19a) is amended— 
(1) in subsection (e), by inserting ‘‘(other than 
subsection (f))’’ after ‘‘this section’’; and 
(2) by adding at the end the following: 
‘‘(f) COVERAGE OF MATERNITY CARE.—Not later 
than January 1, 2025, a group health plan, or health in-
surance issuer offering group or individual health insur-
ance coverage, that provides coverage for dependents shall 
ensure that such plan or coverage includes coverage for 
maternity care associated with pregnancy, childbirth, and 
postpartum care for all participants, beneficiaries, or en-
rollees, including dependents, including coverage of labor 
VerDate Sep 11 2014 
22:49 Dec 28, 2023
Jkt 049200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H6716.IH
H6716
ddrumheller on DSK120RN23PROD with BILLS
and delivery. Such coverage shall be provided to all preg-
nant dependents regardless of age.’’. 
SEC. 5. FEDERAL EMPLOYEE HEALTH BENEFIT PLANS. 
(a) COVERAGE OF PREGNANCY.— 
(1) IN GENERAL.—The Director of the Office of 
Personnel Management shall issue such regulations 
as are necessary to ensure that pregnancy is consid-
ered a change in family status and a qualifying life 
event for an individual who is eligible to enroll, but 
is not enrolled, in a health benefit plan under chap-
ter 89 title 5, United States Code. 
(2) EFFECTIVE
DATE.—The requirement in 
paragraph (1) shall apply with respect to any con-
tract entered into under section 8902 of such title 
beginning 12 months after the date of enactment of 
this Act. 
(b) 
DESIGNATING
CERTAIN
FEHBP-RELATED 
SERVICES AS EXCEPTED SERVICES UNDER THE ANTI- 
DEFICIENCY ACT.— 
(1) IN
GENERAL.—Section 8905 of title 5, 
United States Code, is amended by adding at the 
end the following: 
‘‘(j) Any services by an officer or employee under this 
chapter relating to enrolling individuals in a health bene-
fits plan under this chapter, or changing the enrollment 
VerDate Sep 11 2014 
22:49 Dec 28, 2023
Jkt 049200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6201
E:\BILLS\H6716.IH
H6716
ddrumheller on DSK120RN23PROD with BILLS
of an individual already so enrolled due to an event de-
scribed in section 5(a)(1) of the Healthy MOM Act, shall 
be deemed, for purposes of section 1342 of title 31, serv-
ices for emergencies involving the safety of human life or 
the protection of property.’’. 
(2) APPLICATION.—The amendment made by 
paragraph (1) shall apply to any lapse in appropria-
tions beginning on or after the date of enactment of 
this Act. 
SEC. 6. CONTINUATION OF MEDICAID INCOME ELIGIBILITY 
STANDARD 
FOR 
PREGNANT 
INDIVIDUALS 
AND INFANTS. 
Section 1902(l)(2)(A) of the Social Security Act (42 
U.S.C. 1396a(l)(2)(A)) is amended— 
(1) in clause (i), by striking ‘‘and not more 
than 185 percent’’; 
(2) in clause (ii)— 
(A) in subclause (I), by striking ‘‘and’’ 
after the comma; 
(B) in subclause (II), by striking the pe-
riod at the end and inserting ‘‘, and’’; and 
(C) by adding at the end the following: 
‘‘(III) January 1, 2025, is the percentage pro-
vided under clause (v).’’; and 
VerDate Sep 11 2014 
22:49 Dec 28, 2023
Jkt 049200
PO 00000
Frm 00011
Fmt 6652
Sfmt 6201
E:\BILLS\H6716.IH
H6716
ddrumheller on DSK120RN23PROD with BILLS
(3) by adding at the end the following new 
clause: 
‘‘(v) The percentage provided under clause (ii) for 
medical assistance provided on or after January 1, 2025, 
with respect to individuals described in subparagraph (A) 
or (B) of paragraph (1) shall not be less than— 
‘‘(I) the percentage specified for such individ-
uals by the State in an amendment to its State plan 
(whether approved or not) as of January 1, 2025; or 
‘‘(II) if no such percentage is specified as of 
January 1, 2025, the percentage established for 
such individuals under the State’s authorizing legis-
lation or provided for under the State’s appropria-
tions as of that date.’’. 
SEC. 7. REQUIRING AND MAKING PERMANENT 12-MONTH 
CONTINUOUS 
COVERAGE 
FOR 
PREGNANT 
AND 
POSTPARTUM 
INDIVIDUALS 
UNDER 
MEDICAID AND CHIP. 
(a) MEDICAID.—Section 1902 of the Social Security 
Act (42 U.S.C. 1396a) is amended— 
(1) in subsection (a)— 
(A) in paragraph (86), by striking ‘‘and’’ 
at the end; 
(B) in paragraph (87), by striking the pe-
riod at the end and inserting ‘‘; and’’; and 
VerDate Sep 11 2014 
22:49 Dec 28, 2023
Jkt 049200
PO 00000
Frm 00012
Fmt 6652
Sfmt 6201
E:\BILLS\H6716.IH
H6716
ddrumheller on DSK120RN23PROD with BILLS
(C) by inserting after paragraph (87) the 
following new paragraph: 
‘‘(88) provide that the State plan is in compli-
ance with subsection (e)(16).’’; and 
(2) in subsection (e)(16), as added by section 
9812 of the American Rescue Plan Act of 2021 
(P.L. 117–2)— 
(A) in subparagraph (A), by striking ‘‘At 
the option of the State, the State plan (or waiv-
er of such State plan) may provide’’ and insert-
ing ‘‘A State plan (or waiver of such State 
plan) shall provide’’; 
(B) in subparagraph (B), 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 of 
such State plan)’’; and 
(C) by striking subparagraph (C). 
(b) CHIP.— 
(1) IN GENERAL.—Section 2107(e)(1)(J) of the 
Social Security Act (42 U.S.C. 1397gg(e)(1)(J)), as 
inserted by section 9822 of the American Rescue 
Plan Act of 2021 (P.L. 117–2), is amended to read 
as follows: 
VerDate Sep 11 2014 
22:49 Dec 28, 2023
Jkt 049200
PO 00000
Frm 00013
Fmt 6652
Sfmt 6201
E:\BILLS\H6716.IH
H6716
ddrumheller on DSK120RN23PROD with BILLS
‘‘(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-
vided to a targeted low-income child or targeted 
low-income pregnant woman (as applicable) 
under the State child health plan or waiver).’’. 
(2) CONFORMING.—Section 2112(d)(2)(A) of 
the Social Security Act (42 U.S.C. 1397ll(d)(2)(A)), 
as inserted by section 9822 of the American Rescue 
Plan Act of 2021 (P.L. 117–2), is amended by strik-
ing ‘‘the month in which the 60-day period’’ and all 
that 
follows 
through 
‘‘pursuant 
to 
section 
2107(e)(1),’’. 
(c) CONFORMING AMENDMENTS.— 
VerDate Sep 11 2014 
22:49 Dec 28, 2023
Jkt 049200
PO 00000
Frm 00014
Fmt 6652
Sfmt 6201
E:\BILLS\H6716.IH
H6716
ddrumheller on DSK120RN23PROD with BILLS
(1) Section 9812(b) of the American Rescue 
Plan Act of 2021 (P.L. 117–2) is amended to read 
as follows: 
‘‘(b) EFFECTIVE DATE.— 
‘‘(1) IN GENERAL.—Subject to paragraph (2), 
the amendment made by subsection (a) shall apply 
with respect to services furnished on or after the 1st 
day of the 1st fiscal year quarter that begins one 
year after the date of the enactment of this Act. 
‘‘(2) EXCEPTION FOR STATE LEGISLATION.—In 
the case of a State plan under title XIX of the So-
cial Security Act that the Secretary of Health and 
Human Services determines requires State legisla-
tion in order for the respective plan to meet any re-
quirement imposed by amendments made by this 
section, the plan shall not be regarded as failing to 
comply with the requirements of such title solely on 
the basis of its failure to meet such an additional re-
quirement before the first day of the first fiscal year 
quarter beginning after the close of the first regular 
session of the State legislature that begins after the 
date of enactment of this Act. For purposes of the 
previous sentence, in the case of a State that has a 
2-year legislative session, each year of the session 
VerDate Sep 11 2014 
22:49 Dec 28, 2023
Jkt 049200
PO 00000
Frm 00015
Fmt 6652
Sfmt 6201
E:\BILLS\H6716.IH
H6716
ddrumheller on DSK120RN23PROD with BILLS
shall be considered to be a separate regular session 
of the State legislature.’’. 
(2) Section 9822(b) of the American Rescue 
Plan Act of 2021 (P.L. 117–2) is amended to read 
as follows: 
‘‘(b) EFFECTIVE DATE.— 
‘‘(1) IN GENERAL.—Subject to paragraph (2), 
the amendments made by subsection (a), shall apply 
with respect to services furnished on or after the 1st 
day of the 1st fiscal year quarter that begins one 
year after the date of the enactment of this Act. 
‘‘(2) EXCEPTION FOR STATE LEGISLATION.—In 
the case of a State child health plan under title XXI 
of the Social Security Act that the Secretary of 
Health and Human Services determines requires 
State legislation in order for the plan to meet any 
requirement imposed by amendments made by this 
section, the respective plan shall not be regarded as 
failing to comply with the requirements of such title 
solely on the basis of its failure to meet such an ad-
ditional requirement before the first day of the first 
fiscal year quarter beginning after the close of the 
first regular session of the State legislature that be-
gins after the date of enactment of this Act. For 
purposes of the previous sentence, in the case of a 
VerDate Sep 11 2014 
22:49 Dec 28, 2023
Jkt 049200
PO 00000
Frm 00016
Fmt 6652
Sfmt 6201
E:\BILLS\H6716.IH
H6716
ddrumheller on DSK120RN23PROD with BILLS
State that has a 2-year legislative session, each year 
of the session shall be considered to be a separate 
regular session of the State legislature.’’. 
(d) EFFECTIVE DATE.—The amendments made by 
subsections (a) and (c)(1) shall take effect as if included 
in the enactment of section 9812 of the American Rescue 
Plan Act of 2021 (P.L. 117–2). The amendments made 
by subsections (b) and (c)(2) shall take effect as if in-
cluded in the enactment of section 9822 of such Act. 
SEC. 8. RELATIONSHIP TO OTHER LAWS. 
Nothing in this Act (or an amendment made by this 
Act) shall be construed to invalidate or limit the remedies, 
rights, and procedures of any Federal law or the law of 
any State or political subdivision of any State or jurisdic-
tion that provides greater or equal protection for enrollees 
in a group health plan or group or individual health insur-
ance offered by a health insurance issuer. 
Æ 
VerDate Sep 11 2014 
22:49 Dec 28, 2023
Jkt 049200
PO 00000
Frm 00017
Fmt 6652
Sfmt 6301
E:\BILLS\H6716.IH
H6716
ddrumheller on DSK120RN23PROD with BILLS