Sponsors (4)
This is not an official government website.
Copyright © 2026 PLEJ LC. All rights reserved.
The bill expands and standardizes no-cost coverage of medically necessary human milk fortifiers—improving access and likely infant health outcomes while reducing out-of-pocket newborn care costs—at the expense of higher public and private program costs and increased administrative and safety oversight burdens.
Infants under 1 with qualifying conditions (including those on Medicaid/CHIP and in private plans) will receive medically necessary human milk fortifier with no out-of-pocket costs beginning Jan 1, 2026, expanding immediate access to needed nutrition.
Medically at-risk infants (preterm or low birthweight) may experience improved nutrition and health outcomes due to increased access to donor human milk–derived fortifiers.
Families, including low-income parents, will face lower newborn care costs because Medicaid, CHIP, and private plans are prohibited from imposing cost sharing for human milk fortifier.
State Medicaid and CHIP programs may incur higher program costs to cover donor human milk–derived fortifiers, creating additional state budget pressure and potential taxpayer impacts.
Private insurers and employers will face added benefit costs beginning in plan years on/after Jan 1, 2026, which could contribute to higher premiums or cost-shifting to employers or employees.
Requiring coverage of donor human milk–derived products raises supply, screening, and safety oversight needs, increasing provider administrative burden and complicating procurement.
Requires Medicaid, CHIP, and private group and individual health plans to cover donor human milk–derived human milk fortifier for medically eligible infants under 1 year with no cost sharing, effective January 1, 2026. It defines eligible infants by gestational age, birth weight, current weight status, or specific congenital/acquired conditions and requires a licensed clinician to determine medical necessity. The bill makes human milk fortifier a mandatory category of medical assistance under Medicaid and CHIP and adds a parallel coverage requirement for private market and employer plans. CHIP state plans that need state legislation get extra time to comply; the legislation does not provide new appropriations, so implementation affects payer benefits, state program administration, and supply chain actors like milk banks and neonatal units.
Introduced July 21, 2025 by Morgan McGarvey · Last progress July 21, 2025