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 
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. 
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(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-
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 
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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; 
(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 
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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. 
‘‘(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.’’. 
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(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. 
‘‘(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.’’. 
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(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply with respect to plan years begin-
ning on or after January 1, 2027. 
SEC. 4. COVERAGE OF MATERNITY CARE FOR DEPENDENT 
CHILDREN. 
(a) 
PUBLIC
HEALTH
SERVICE
ACT.—Section 
2799A–7 of the Public Health Service Act (42 U.S.C. 
300gg–117) is amended by adding at the end the following 
new subsection: 
‘‘(d) COVERAGE
OF MATERNITY CARE.—A group 
health plan, or health insurance issuer offering group or 
individual health insurance coverage, that provides cov-
erage for dependents shall ensure that such plan or cov-
erage includes coverage for maternity care associated with 
pregnancy, childbirth, and postpartum care for all partici-
pants, beneficiaries, and enrollees, including dependents, 
including coverage of labor and delivery. Such coverage 
shall be provided to all pregnant dependents regardless of 
age.’’. 
(b) ERISA.—Section 722 of the Employee Retire-
ment Income Security Act of 1974 (29 U.S.C. 1185k) is 
amended by adding at the end the following new sub-
section: 
‘‘(d) COVERAGE
OF MATERNITY CARE.—A group 
health plan, or health insurance issuer offering group 
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health insurance coverage, that provides coverage for de-
pendents shall ensure that such plan or coverage includes 
coverage for maternity care associated with pregnancy, 
childbirth, and postpartum care for all participants, bene-
ficiaries, and enrollees, including dependents, including 
coverage of labor and delivery. Such coverage shall be pro-
vided to all pregnant dependents regardless of age.’’. 
(c) INTERNAL REVENUE CODE.—Section 9822 of the 
Internal Revenue Code of 1986 is amended by adding at 
the end the following new subsection: 
‘‘(d) COVERAGE
OF MATERNITY CARE.—A group 
health plan that provides coverage for dependents shall en-
sure that such plan includes coverage for maternity care 
associated with pregnancy, childbirth, and postpartum 
care for all participants and beneficiaries, including de-
pendents, including coverage of labor and delivery. Such 
coverage shall be provided to all pregnant dependents re-
gardless of age.’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply with respect to plan years begin-
ning on or after January 1, 2027. 
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 
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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 
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.’’. 
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(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, 2027, is the percentage pro-
vided under clause (v).’’; and 
(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, 2027, 
with respect to individuals described in subparagraph (A) 
or (B) of paragraph (1) shall not be less than— 
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‘‘(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 (88)(B)(iii), by striking 
‘‘and’’ at the end; 
(B) in paragraph (89), by striking the pe-
riod at the end and inserting ‘‘; and’’; and 
(C) by inserting after paragraph (89) the 
following new paragraph: 
‘‘(90) provide that the State plan is in compli-
ance with subsection (e)(16).’’; and 
(2) in subsection (e)(16)— 
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(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)(K) of the 
Social Security Act (42 U.S.C. 1397gg(e)(1)(K)) is 
amended to read as follows: 
‘‘(K) 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 
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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)) 
is amended by striking ‘‘the month in which the 60- 
day period’’ and all that follows through ‘‘pursuant 
to section 2107(e)(1),’’. 
(c) EFFECTIVE DATE.— 
(1) IN GENERAL.—Subject to paragraph (2), 
the amendments made by this section shall apply 
with respect to services furnished on or after the 
date that is 1 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 (42 U.S.C. 1396 et seq.) or a State 
child health plan under title XXI of such Act (42 
U.S.C. 1397ee et seq.) that the Secretary of Health 
and Human Services determines requires State legis-
lation 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 
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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 calendar 
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 
shall be considered to be a separate regular session 
of the State legislature. 
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 
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