Washington—In advance of the Health Insurance Marketplace’s open enrollment period starting next week, U.S. Sen. Dianne Feinstein (D-Calif.) joined 22 of her Senate colleagues today introduced legislation that would increase access to prenatal and maternity care. This bill, the Healthy Maternity and Obstetric Medicine Act (Healthy MOM Act) would create a special enrollment period (SEP) so pregnant individuals can enroll in or change their healthcare plans once they become pregnant.
Individuals who become pregnant during the Health Insurance Marketplace’s open enrollment period – which begins on Nov. 1, 2015 – can change their plans or enroll in a new plan, but an individual who becomes pregnant outside that period cannot because pregnancy is not considered a “qualifying life event.” Some major life changes – like getting married, giving birth, or adopting a child – are considered “qualifying life events” that make individuals eligible for an SEP, allowing them to enroll in or change their health care plans through HealthCare.gov. Because pregnancy is not currently classified as a “qualifying life event” under law, some mothers who become pregnant and are unable to change their insurance status may forgo critical prenatal care or pay significant out-of-pocket medical costs – risking the health and safety of both mother and baby.
The Healthy MOM Act would address this coverage gap by creating an SEP for pregnant women, ensuring mothers have access to the health care options that best fit their maternity and prenatal needs. Specifically, the Healthy MOM Act would:
- Create an SEP in the Health Insurance Marketplace for pregnant individuals so that they can enroll in or change their healthcare plan;
- Enable the Director of the Office of Personnel Management to establish an SEP for pregnancy for those eligible to receive coverage, but who do not currently receive coverage, through the Federal Employees Health Benefits Program;
- Ensure comprehensive coverage of maternity care – including labor and delivery – for dependent children covered by group health plans and other forms of employer-sponsored coverage; and
- Protect existing income eligibility levels for pregnant women and infants covered by Medicaid.
According to the U.S. Health Resources and Services Administration (HRSA), more than one million babies are born to mothers that did not receive adequate prenatal care each year. Nationwide, maternal mortality rates are three to four times higher for mothers who do not receive prenatal care compared with mothers who do, and babies of mothers who do not receive prenatal care are five times more likely to die and three times as likely to be born prematurely compared with mothers who receive adequate care.
The legislation was introduced by Senator Sherrod Brown and is also cosponsored by U.S. Sens. Patty Murray (D-Wash.), Barbara Mikulski (D-Md.), Ed Markey (D-Mass.), Jon Tester (D-Mont.), Martin Heinrich (D-N.M.), Tammy Baldwin (D-Wis.), Sheldon Whitehouse (D-R.I.), Robert P. Casey, Jr. (D-Pa.), Charles Schumer (D-N.Y.), Tim Kaine (D-VA), Chris Coons (D-DE), Patrick Leahy (D-VT), Kirsten Gillibrand (D-NY), Richard Blumenthal (D-CT), Cory Booker (D-NJ), Gary Peters (D-MI), Ben Cardin (D-MD), Michael Bennet (D-CO), Jeff Merkley (D-OR), Barbara Boxer (D-CA), and Christopher Murphy (D-CT). A similar bill was introduced in the U.S. House of Representatives by Rep. Bonnie Watson Coleman (D-NJ-12) earlier this year and has 97 cosponsors.
The Healthy MOM Act is endorsed by the following organizations: American College of Nurse-Midwives; American Congress of Obstetricians and Gynecologists; Association of Women's Health, Obstetric and Neonatal Nurses; EverThrive Illinois; Families USA; March of Dimes; NARAL Pro Choice Oregon; National Health Law Program; National Patient Advocate Foundation; National Women’s Law Center; Maryland Women's Coalition for Health Care Reform; MomsRising; Ohio Hospital Association; Ohio MetroHealth System; Ohio Public Health Association; URGE: Unite for Reproductive & Gender Equity; and Young Invincibles.