“To prevent cost-sharing requirements for prenatal, childbirth, neonatal, perinatal, or postpartum health care.”
No CRS summary available for this bill.
This section requires the maternity and newborn care category of essential health benefits—required for qualified health plans in the individual and small group markets under the ACA—to include comprehensive prenatal, labor and delivery, neonatal, perinatal, and postpartum care and screenings. At a minimum, such care must include (1) ultrasounds by a licensed provider; (2) services related to spontaneous pregnancy loss or miscarriage; (3) delivery services, including anesthesiology, fetal monitoring, specialist consultations, and postpartum health services; (4) services required under specified public health, ERISA, and tax laws; (5) non-preventive postpartum care, including behavioral health services for pregnancy-exacerbated or -related conditions such as diabetes, hypertension, and obesity; and (6) behavioral health services relating to new parenthood for legal parents who did not give birth, for the 1-year period beginning on the day of the child's birth. (Postpartum is defined as the 1-year period beginning immediately after pregnancy ends; the requirements apply to plan years beginning on or after the date of enactment.)
This section establishes, for plan years beginning on or after enactment, a requirement under the Public Health Service Act, ERISA, and the Internal Revenue Code for group health plans and health insurance issuers offering group or individual health insurance coverage to provide maternity and newborn care benefits (as described in ACA §1302(b)(1)(D)) without any cost-sharing requirements (i.e., no deductibles, copays, or coinsurance). (Thus, the requirement applies uniformly to insured and self-insured plans, as if included in the ACA.)