Sponsors (29)
The bill extends standardized, no-cost comprehensive maternity and newborn coverage across plan types to improve maternal and infant health, but that expansion is likely to raise costs for insurers and employers—raising premiums or prompting plan design changes—and will bring added administrative and compliance burdens.
Pregnant people and newborns across plan types gain guaranteed, comprehensive maternity and newborn coverage (prenatal, delivery, neonatal/perinatal, and one year of postpartum care including behavioral health) with no cost-sharing, reducing out-of-pocket costs and likely improving maternal and infant health outcomes.
People with employer and individual market plans receive consistent federal protections (ERISA, PHSA, and tax code alignment), reducing coverage gaps and variation between plan types.
The law specifies minimum covered items (e.g., ultrasounds, miscarriage care, anesthesiology), standardizing benefits and reducing insurer discretion so covered services are more predictable across plans.
Insurers' higher benefit costs are likely to translate into higher premiums or cost-sharing for enrollees and taxpayers.
Employers and ERISA plans will face increased plan expenses, which could lead to reduced wages, altered employer contributions, or changes in employer-sponsored benefits.
Plans may respond to higher costs by narrowing networks, tightening prior authorization, or imposing other utilization controls, which could limit timely access to some providers or services despite nominal coverage.
Based on analysis of 3 sections of legislative text.
Requires health plans and insurers to cover comprehensive maternity and newborn care (prenatal through 1-year postpartum, including behavioral health) and bans cost-sharing for those benefits.
Requires private and marketplace health plans to cover a broad set of maternity and newborn services and screenings, and bars cost-sharing for those services. It makes the maternity and newborn essential health benefit more specific by listing minimum covered items (ultrasounds, miscarriage care, delivery services including anesthesia and fetal monitoring, certain federal maternity-related services, extended postpartum medical and behavioral health care, and behavioral health for legal parents who did not give birth). It defines "postpartum" as the 1-year period after pregnancy. Applies the same coverage and no-cost-sharing rules across the Public Health Service Act, ERISA, and the Internal Revenue Code so group health plans, employers, and issuers must follow the same standards; changes take effect for plan years beginning on or after enactment.
Introduced June 5, 2025 by Jared Golden · Last progress June 5, 2025