Sponsors (20)
Official title: To amend title XXVII of the Public Health Service Act to provide for a special enrollment period for pregnant women, and for other purposes.
Introduced November 20, 2025 by Bonnie Watson Coleman · Last progress November 20, 2025
The bill expands and standardizes pregnancy and postpartum coverage—improving access and likely reducing maternal harms—at the cost of higher premiums and public spending, plus administrative and legal complexity that could shift costs or delay benefits.
Low-income pregnant and postpartum people on Medicaid/CHIP keep continuous, full-benefit coverage for 12 months after birth, reducing gaps in postpartum care and likely improving maternal outcomes.
People who become pregnant can enroll immediately through special enrollment periods (Exchanges, group plans, and FEHBP), ensuring earlier access to prenatal care and lowering out-of-pocket pregnancy costs.
States must preserve or may maintain pre-2025 Medicaid income eligibility floors for pregnant people and (in many cases) infants, preventing planned eligibility rollbacks and protecting coverage access.
Workers, families, and other enrollees could face higher premiums or employer contribution costs because insurers and employers may spread added maternity-related claims and benefit costs across all enrollees.
States and taxpayers may incur materially higher Medicaid/CHIP costs from preserving eligibility floors and adding 12 months of postpartum full benefits, putting pressure on state budgets and potentially requiring tradeoffs.
Insurers, Exchanges, employers, FEHBP carriers, and state agencies will face nontrivial administrative and compliance burdens to update systems, plan documents, and operations to implement SEPs, new benefit mandates, and eligibility rules.
Based on analysis of 8 sections of legislative text.
Creates pregnancy-triggered enrollment rights, mandates dependent maternity coverage, and requires 12-month postpartum Medicaid/CHIP coverage while locking certain state Medicaid eligibility levels.
Provides new enrollment rights and coverage mandates so pregnant people can get and keep maternity and postpartum health coverage. It creates special enrollment periods for pregnancy across Exchanges, individual and group plans, requires dependent coverage include maternity care regardless of age, makes 12-month postpartum Medicaid and CHIP coverage mandatory, locks in each State’s Medicaid eligibility level for pregnant people as of early 2025/2027 benchmarks, and directs FEHBP to treat pregnancy as a qualifying life event.