An Act To Provide Women Access to Affordable Postpartum Care
Maine Legislature, Session 130, LD 0265
Committee: Health and Human Services
Sponsors: CARNEY, TALBOT ROSS, BREEN, BRENNER, CLAXTON, MOORE, MEYER, PERRY, WHITE
Amends: 22 MRSA §3174-G

Legislative Document
No. 265
S.P. 114
In Senate, February 1, 2021
An Act To Provide Women Access to Affordable Postpartum Care
Received by the Secretary of the Senate on January 28, 2021.  Referred to the Committee 
on Health and Human Services pursuant to Joint Rule 308.2 and ordered printed.
DAREK M. GRANT
Secretary of the Senate
Presented by Senator CARNEY of Cumberland.
Cosponsored by Representative TALBOT ROSS of Portland and
Senators: BREEN of Cumberland, BRENNER of Cumberland, CLAXTON of Androscoggin, 
MOORE of Washington, Representatives: MEYER of Eliot, PERRY of Calais, WHITE of 
Waterville.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  22 MRSA §3174-G, sub-§1, ¶A, as enacted by PL 1999, c. 731, Pt. OO, 
§1, is amended to read:
A.  A qualified woman during her pregnancy and up to 60 days 12 months following 
delivery when the woman's family income is equal to or below 200% of the nonfarm 
income official poverty line;
Sec. 2.  22 MRSA §3174-G, sub-§1, ¶G, as amended by IB 2017, c. 1, Pt. A, §2, 
is further amended to read:
G.  A person who is a noncitizen legally admitted to the United States to the extent that 
coverage is allowable by federal law if the person is:
(1)  A woman during her pregnancy and up to 60 days 12 months following 
delivery; or
(2)  A child under 21 years of age; and
Sec. 3.  Federal Medicaid waivers or state plan amendments; cost 
neutrality.  The Department of Health and Human Services shall, no later than January 
1, 2022, submit requests for any waivers or state plan amendments to the United States 
Department of Health and Human Services, Centers for Medicare and Medicaid Services 
determined necessary in order to accomplish the purposes of this Act.  The department shall 
take all reasonable and necessary steps to seek approval of the waiver or state plan 
amendment.  The department shall demonstrate cost neutrality in the waiver or state plan 
amendment, including, but not limited to, using savings from premium tax credits on health 
insurance obtained through the health insurance marketplace for which MaineCare 
members receiving services under this Act would be eligible, savings on limited family 
planning coverage and any other source of savings.
Sec. 4.  Funding.  In order to implement those sections of this Act that amend the 
Maine Revised Statutes, Title 22, section 3174-G, subsection 1, paragraphs A and G, if the 
United States Department of Health and Human Services, Centers for Medicare and 
Medicaid Services does not grant a waiver or state plan amendment under section 3, the 
Department of Health and Human Services shall use federal funds first, if allowable under 
federal law, and then shall use the General Fund.
Sec. 5.  Rulemaking.  Within 180 days after receiving a decision regarding coverage 
by the United States Department of Health and Human Services, Centers for Medicare and 
Medicaid Services pursuant to a request in accordance with section 3, the Department of 
Health and Human Services shall adopt rules to implement the Maine Revised Statutes, 
Title 22, section 3174-G, subsection 1, paragraphs A and G.  Rules adopted pursuant to this 
section are routine technical rules as defined in Title 5, chapter 375, subchapter 2-A.  Upon 
adoption of the rules, the Commissioner of Health and Human Services shall notify the 
Secretary of State, the Secretary of the Senate, the Clerk of the House of Representatives 
and the Revisor of Statutes.
Sec. 6.  Report.  The Department of Health and Human Services shall report quarterly 
to the joint standing committee of the Legislature having jurisdiction over health and 
human services matters, beginning April 1, 2022, on the department's progress in seeking 
a waiver or state plan amendment under section 3 until the process is complete.  The joint 
standing committee of the Legislature having jurisdiction over health and human services 
matters is authorized to report out a bill to the Legislature regarding each report.
Sec. 7.  Contingent effective date.  Those sections of this Act that amend the Maine 
Revised Statutes, Title 22, section 3174-G, subsection 1, paragraphs A and G do not take 
effect until the adoption of rules pursuant to section 5.
SUMMARY
This bill extends from 60 days to 12 months the period of time following delivery of a 
baby that a woman may be eligible for services under MaineCare.  The bill directs the 
Department of Health and Human Services to submit a waiver or state plan amendment 
request no later than January 1, 2022 to the United States Department of Health and Human 
Services, Centers for Medicare and Medicaid Services to implement the provisions of this 
legislation that extend MaineCare coverage to a woman following delivery of a baby from 
days to 12 months.  The department is required to take all reasonable and necessary 
steps to seek approval of the waiver or state plan amendment.  In the event the waiver or 
state plan amendment is not granted, the department is directed to implement the coverage 
provisions using federal funds, if allowable, and then using the General Fund.  The 
department is directed to adopt rules no later than 180 days after receiving a decision from 
the United States Department of Health and Human Services, Centers for Medicare and 
Medicaid Services to approve or deny the waiver or state plan amendment.  The department 
is required to report on a quarterly basis beginning April 1, 2022 to the joint standing 
committee of the Legislature having jurisdiction over health and human services matters 
its progress in seeking a waiver or state plan amendment until the process is complete.  The 
committee is authorized to report out legislation related to each report.