Sponsors (15)
Introduced November 20, 2025 by Angela Deneece Alsobrooks · Last progress November 20, 2025
The bill substantially expands and standardizes pregnancy and postpartum enrollment and benefits — improving timely access and continuity of maternal care for many low-income and uninsured people — but does so at the likely cost of higher premiums, increased state and payer spending, and additional administrative burdens with uneven state-level outcomes.
Pregnant people (including uninsured and those switching plans) can enroll immediately or via guaranteed pregnancy-related special enrollment periods across Exchanges, employer plans, and FEHBP, improving timely access to prenatal care and reducing delays in starting pregnancy care.
People on Medicaid/CHIP receive continuous postpartum coverage for 12 months after birth, ensuring ongoing access to maternal and postpartum health services during a high-risk period.
States must preserve a minimum Medicaid eligibility floor for pregnant people and retain at least 2025 eligibility percentages for infants/newborns, protecting continuity of coverage for low-income pregnant people and newborns in many states.
Many consumers, employers, and taxpayers face higher insurance costs or premiums because mandated expanded maternity and postpartum coverage and increased enrollments will raise plan utilization and insurer expenses.
Insurers, employers, Exchanges, FEHBP contractors, and states will incur substantial administrative, actuarial, and compliance costs to implement new enrollment rules, benefit mandates, and eligibility floors, creating implementation burden and transitional costs.
State Medicaid and CHIP programs may face increased spending and budget pressures to cover extended postpartum benefits and higher eligibility floors, potentially forcing trade-offs with other state programs or raising state taxes.
Based on analysis of 8 sections of legislative text.
Requires pregnancy SEPs and guaranteed maternity coverage in many plans, mandates 12‑month Medicaid/CHIP postpartum coverage, and preserves certain Medicaid eligibility thresholds.
Requires health plans and insurance marketplaces to allow pregnant people to enroll when pregnancy is reported or confirmed, requires maternity coverage for dependents in group and individual plans, and extends Medicaid/CHIP postpartum coverage to 12 months. Also directs OPM to treat pregnancy as a qualifying life event for Federal Employees Health Benefits, adjusts state Medicaid income‑eligibility references to preserve preexisting thresholds, and preserves stronger existing consumer protections.