[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 3509 Introduced in Senate (IS)]

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118th CONGRESS
  1st Session
                                S. 3509

To amend title XXVII of the Public Health Service Act to provide for a 
special enrollment period for pregnant persons, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           December 13, 2023

 Mr. Brown (for himself, Mr. King, Ms. Baldwin, Mr. Casey, Ms. Smith, 
Mr. Blumenthal, Mr. Van Hollen, Mr. Merkley, Mr. Whitehouse, Ms. Cortez 
    Masto, Mr. Kaine, Ms. Klobuchar, and Mr. Booker) introduced the 
 following bill; which was read twice and referred to the Committee on 
                                Finance

_______________________________________________________________________

                                 A BILL


 
To amend title XXVII of the Public Health Service Act to provide for a 
special enrollment period for pregnant persons, 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 ``Healthy Maternity and Obstetric 
Medicine Act'' or the ``Healthy MOM Act''.

SEC. 2. PROVIDING FOR A SPECIAL ENROLLMENT PERIOD FOR PREGNANT 
              INDIVIDUALS.

    (a) Special Enrollment Periods.--
            (1) 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, beginning on the date on which the 
        pregnancy is reported to the health insurance issuer'' before 
        the period at the end.
            (2) 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 amended--
                    (A) in subparagraph (C), by striking ``and'' at the 
                end;
                    (B) by redesignating subparagraph (D) as 
                subparagraph (E); and
                    (C) by inserting after subparagraph (C) the 
                following new subparagraph:
                    ``(D) a special enrollment period for pregnant 
                individuals, beginning on the date on which the 
                pregnancy is reported to the Exchange; and''.
            (3) 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) In general.--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 
                coverage under the terms of the plan upon pregnancy, 
                with the special 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) Regulations.--The Secretary shall promulgate 
                regulations with respect to the special enrollment 
                period under subparagraph (A), including establishing a 
                time period for pregnant individuals to enroll in 
                coverage and effective date of such coverage.''.
            (4) 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 following:
            ``(4) For pregnant individuals.--
                    ``(A) In general.--A group health plan or health 
                insurance 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 coverage under the terms of the 
                plan upon pregnancy, with the special enrollment period 
                beginning on the date on which the pregnancy is 
                reported to the group health plan or health insurance 
                issuer or the pregnancy is confirmed by a health care 
                provider.
                    ``(B) Regulations.--The Secretary shall promulgate 
                regulations with respect to the special enrollment 
                period under subparagraph (A), including establishing a 
                time period for pregnant individuals to enroll in 
                coverage and effective date of such coverage.''.
    (b) Effective Date.--The amendments made by this section shall 
apply with respect to plan years beginning after December 31, 2024.

SEC. 3. 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.--A group health plan, or health 
insurance issuer offering group or individual health insurance 
coverage, that provides coverage for dependants shall ensure that such 
plan or coverage includes coverage for maternity care associated with 
pregnancy, childbirth, and postpartum care for all participants, 
beneficiaries, or enrollees, including dependants, including coverage 
of labor and delivery. Such coverage shall be provided to all pregnant 
dependents regardless of age.''.

SEC. 4. FEDERAL EMPLOYEE HEALTH BENEFIT PLANS.

    (a) Coverage of Pregnancy.--The Director of the Office of Personnel 
Management shall issue such regulations as are necessary to ensure that 
pregnancy is considered 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 chapter 89 of title 5, United States 
Code.
    (b) Effective Date.--The requirement in subsection (a) shall apply 
with respect to any contract entered into under section 8902 of such 
title beginning 12 months after the date of enactment of this Act.

SEC. 5. 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 period at 
                the end and inserting ``, and''; and
                    (C) by adding at the end the following:
            ``(III) January 1, 2025, is the percentage provided 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, 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 individuals by the 
        State in an amendment to its State plan (whether approved or 
        not) as of January 1, 2014; or
            ``(II) if no such percentage is specified as of January 1, 
        2014, the percentage established for such individuals under the 
        State's authorizing legislation or provided for under the 
        State's appropriations as of that date.''.

SEC. 6. REQUIRING 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 period at 
                the end and inserting ``; and''; and
                    (C) by inserting after paragraph (87) the following 
                new paragraph:
            ``(88) provide that the State plan is in compliance with 
        subsection (e)(16).''; and
            (2) in subsection (e)(16)--
                    (A) 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'';
                    (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)) 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).''.
            (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 the period and inserting ``the 12-month period 
        beginning on the last day of the pregnancy.''.
    (c) Effective Date.--
            (1) In general.--Subject to paragraph (2), the amendments 
        made by this section shall take effect on the first day of the 
        first calendar quarter that begins on or after the date that is 
        1 year after the date of enactment of this Act.
            (2) Exception for state legislation.--In the case of a 
        State plan under title XIX or XXI of the Social Security Act 
        that the Secretary of Health and Human Services determines 
        requires State legislation in order for the respective plan to 
        meet any requirement 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 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 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. 7. 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 jurisdiction that provides greater or equal protection for 
enrollees in a group health plan or group or individual health 
insurance offered by a health insurance issuer.
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