Sponsors (30)
Official title: To prevent cost-sharing requirements for prenatal, childbirth, neonatal, perinatal, or postpartum health care.
Introduced June 5, 2025 by Jared Golden · Last progress June 5, 2025
The bill expands and standardizes comprehensive, no‑cost maternity and newborn coverage (including one year of postpartum and behavioral health coverage) and closes plan gaps, improving maternal/infant health and financial protection — but it will raise costs for plans and employers, which may lead to higher premiums, benefit trade-offs, tighter networks, and greater administrative burdens.
Pregnant people, birthing people, and newborns gain guaranteed comprehensive maternity and newborn care (prenatal, delivery, neonatal, perinatal, and postpartum care for one year) including behavioral health for pregnancy‑exacerbated conditions, improving continuity of care and likely reducing maternal and infant morbidity.
People with employer and individual market plans get maternity and newborn services with no cost-sharing, cutting out-of-pocket expenses for childbirth and postpartum care and lowering financial barriers to needed services.
The bill standardizes minimum covered items (e.g., ultrasounds, miscarriage care, anesthesiology) and extends consistent federal protections across ERISA, the PHSA, and the tax code, reducing plan-to-plan variation and insurer discretion so benefits are more predictable.
Insurers and health plans face higher benefit costs from expanded required maternity and newborn coverage, which is likely to be passed on to consumers through higher premiums or reduced benefits elsewhere.
Employers—particularly small employers and ERISA-covered plans—may incur higher plan expenses that could lead to reduced employer contributions, changes to employer-sponsored benefit design, or downward pressure on wages.
Plans may respond to higher utilization pressure by tightening networks or imposing prior authorization and utilization controls, which can limit access to preferred providers or timely services despite elimination of cost-sharing.
Based on analysis of 3 sections of legislative text.
Requires comprehensive maternity/newborn benefits including 1‑year postpartum coverage and bans cost‑sharing, applied across ACA, PHSA, ERISA, and the tax code.
Requires private and individual health plans to treat maternity and newborn care as a comprehensive covered category and to cover a full suite of prenatal, delivery, neonatal, perinatal, and postpartum services (defined as the 1-year period after pregnancy) with specified minimum items and no cost‑sharing. The change is written into the ACA essential health benefits rules and parallel provisions are added to the Public Health Service Act, ERISA, and the Internal Revenue Code so group plans, market issuers, and tax treatment must comply for plan years beginning on or after enactment.