COVID–19 Safe Birthing Act
Bill: H.R.2598 | Sponsor: Rep. Pressley, Ayanna (D-MA)
Policy area: Health

Summary:
COVID-19 Safe Birthing Act
This bill expands coverage of maternal health care under Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and private health insurance.
The bill specifically provides for Medicare and Medicaid coverage of maternal health services that are furnished via telehealth. It also requires Medicaid, CHIP, and private health insurance to cover prenatal services and one year of postpartum care without cost-sharing.
The bill also requires short-term, limited-duration health insurance plans, association health plans, and health care sharing ministries to cover COVID-19 testing without cost-sharing. It also requires state Medicaid programs to provide coverage of COVID-19 testing for pregnant individuals who are uninsured.
Additionally, as a condition of Medicare participation, hospitals must permit pregnant individuals to be accompanied by someone of their choosing (in addition to a doula or other health care worker) during labor, delivery, and recovery, and may not implement any discriminatory policies that restrict hospital access or birthing options for pregnant individuals.

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 Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``COVID-19 Safe Birthing Act''.

SEC. 2. EXPANDING ACCESS TO MATERNAL CARE IN HOSPITALS.

    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 permits 
                        a pregnant or birthing person to be accompanied 
                        by an individual of the pregnant or birthing 
                        person's choosing (in addition to a doula or 
                        other perinatal health worker) during labor, 
                        delivery, and recovery; 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, 
                        communicated to the patient without threat or 
                        intimidation, and applied without 
                        discrimination on the basis of race, gender 
                        identity, 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 implementation 
                        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 MATERNAL HEALTH CARE SERVICES.

    (a) Removal of Certain Medicare Requirements for Maternal Health 
Care Services.--Section 1834(m) of the Social Security Act (42 U.S.C. 
1395m(m)) is amended--
            (1) in paragraph (4)(C)(i), by striking ``paragraphs (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, notwithstanding any other provision of this 
        subsection--
                    ``(A) the requirements described in paragraph 
                (4)(C) shall not apply;
                    ``(B) the term `originating site' means sites at 
                which the eligible telehealth individual is located at 
                the time the service is furnished via a 
                telecommunications system; and
                    ``(C) there shall be no restrictions on access 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'';
            (2) in paragraph (17), by inserting ``, including services 
        furnished via telehealth,'' before ``furnished'';
            (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 Certain Prenatal and 
Postpartum Services a State Plan Requirement.--
            (1) State medicaid plans.--
                    (A) In general.--Section 1902 of the Social 
                Security Act (42 U.S.C. 1396a) is amended--
                            (i) in subsection (a)--
                                    (I) in paragraph (86), by striking 
                                ``and'' at the end;
                                    (II) in paragraph (87), by striking 
                                at the end the period and inserting ``; 
                                and''; and
                                    (III) by inserting after paragraph 
                                (87) the following new paragraph:
            ``(88) provide that the State plan is in compliance with 
        subsection (e)(16).''; and
                            (ii) in subsection (e)(16)--
                                    (I) in subparagraph (A), by 
                                striking ``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'';
                                            (cc) in clause (ii), by 
                                        striking the period at the end 
                                        and inserting ``; and''; and
                                            (dd) by adding at the end 
                                        the following new clause:
                            ``(iii) include as pregnancy-related 
                        medical assistance a comprehensive number 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 
                        section 2730(b)(2) of the Public Health Service 
                        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'';
                            (ii) in subparagraph (G), by striking ``; 
                        and'' and inserting ``; or''; and
                            (iii) by adding at the end the following 
                        new subparagraph:
                                    ``(H) appointments, screenings, and 
                                care required to be included as 
                                pregnancy-related and postpartum-
                                related 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 follows:
                    ``(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 pregnancy 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 
                provided to a targeted low-income child or targeted 
                low-income pregnant woman (as applicable) under the 
                State child health plan or waiver), including 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 enactment 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 requirement imposed by the 
                amendments made by this subsection, the State plan or 
                State child health plan shall not be regarded as 
                failing to comply with the requirements of such title 
                solely on the basis of its failure to meet this 
                additional requirement 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 the 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 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 appointments and 
        screenings furnished by a maternity care provider, perinatal 
        health worker, or community-based provider; and
            ``(2) a full-spectrum of postpartum care furnished 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 provider who--
                    ``(A) is a physician, physician assistant, or 
                midwife who meets at a minimum the international 
                definition of the midwife and global standards for 
                midwifery education as established 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 lactation educator or counselor, nutritionist 
        or dietitian, childbirth educator, social worker, home visitor, 
        language interpreter, or navigator.''.

SEC. 5. ENSURING FREE TESTING, VACCINE, AND TREATMENT FOR COVID-19 TO 
              PREGNANT PERSONS AND TO INFANTS, REGARDLESS OF INSURANCE 
              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 individual health insurance 
coverage (including a grandfathered health plan (as defined in section 
1251(e) of the Patient Protection and Affordable Care Act))'' and 
inserting ``A group health plan, a health insurance issuer offering 
group or individual health insurance coverage (including 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 Emergency 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 ``that is administered during any 
                portion of the emergency period described in such 
                section beginning 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 paragraph 
        (1)(B) of section 1135(g) of the Social Security 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 Provide Coverage of Testing 
for COVID-19 for Uninsured Pregnant Persons.--Section 1902(a)(10) of 
the Social Security Act (42 U.S.C. 1396a(a)(10)) is amended--
            (1) in subparagraph (F), by striking at the end ``and'';
            (2) in subparagraph (G), by adding at the end ``and''; and
            (3) by inserting after subparagraph (G) the following new 
        subparagraph:
                    ``(H) for making a clinical diagnostic laboratory 
                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 individual.''.
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