December 12, 2023

Watson Coleman, Brown Reintroduce the Healthy MOM Act to Add Special Enrollment Period for Pregnant Mothers

Bill would also ensure comprehensive coverage of maternity care for dependent children and guarantee 12-months of continuous medicaid eligibility for postpartum women

Today, Congresswoman Bonnie Watson Coleman (NJ-12) announced the reintroduction of legislation to expand healthcare options for expectant mothers. The bill, the Healthy Maternal and Obstetric Medicine (Healthy MOM) Act, would ensure that all women eligible for coverage through the Affordable Care Act (ACA) insurance marketplaces, as well as women eligible for other individual or group health plan coverage, can access affordable health coverage throughout their pregnancies. The bill would do this by establishing a special enrollment period (SEP) for expectant mothers. Right now, marriage, divorce, having a baby, adoption, and changing jobs are considered qualifying life events that trigger a special enrollment period. However, becoming pregnant is not considered a qualifying event.

U.S. Senator Sherrod Brown (D-OH) will be introducing a companion bill in the U.S. Senate.

Research has widely shown that prenatal care leads to healthier mothers and babies, and such care comes with the burden of high out-of-pocket costs without access to the appropriate health insurance. The maternal mortality rate in the United States is the worst among comparable industrialized countries. The Healthy MOM Act will allow women to sign up for or change their coverage when they become pregnant, rather than needing to wait for the birth of their child or the annual enrollment period. The bill would also guarantee 12 months of continuous Medicaid eligibility for postpartum women, thus removing key barriers that often prevent mothers from getting the care they need after birth.

“Events like the birth or adoption of a child, marriage, divorce, or even moving to a new state all trigger a special window to get or change your health insurance. Meanwhile, pregnancy, one of the most life-altering events a woman can experience, doesn’t,” said Watson Coleman. “We’re dealing with maternal mortality rates that are, in some places and among some groups, worse than developing nations. It is inexcusable that the United States, the wealthiest nation on Earth, has such a high maternal mortality rate. Ensuring every woman can access the care she needs during pregnancy and after giving birth is a critical part of ending this crisis. This is a simple, logical way to make sure that happens.”

“Any mother knows that your health care needs change when you become pregnant – you should be able to change your insurance to meet those needs. It’s absurd that right now, becoming pregnant isn’t considered a ‘qualifying life event’ for insurance purposes. This legislation will fix that. Expectant and new moms should not have to worry about how they will get the healthcare they need to keep themselves and their baby healthy during pregnancy and post-partum,” said Senator Brown.

According to the Centers for Disease Control and Prevention, 1205 women died in the United States from pregnancy-related complications in 2021, up from 861 in 2020 and 754 in 2019. Black and American Indian/Alaska Native women are about three times more likely to die from a pregnancy-related cause than White women. The Healthy MOM Act will work to improve these outcomes by expanding quality access to care, which data demonstrates could help prevent three-in-five pregnancy-related deaths.

Specifically, the Healthy MOM Act would:

  • Create a special enrollment period (SEP) in the ACA marketplaces and other commercial insurance plans for pregnant individuals once pregnancy is reported, so that they can enroll in or change their healthcare plan;

  • Enable the Director of the Office of Personnel Management to establish a special enrollment period for pregnancy, for those eligible to receive coverage through the Federal Employees Health Benefits Program and clarify that the enrollment shall be available for families even during a lapse in appropriation or government shutdown; 

  • Ensure comprehensive coverage of maternity care – including labor and delivery – for dependent children covered by group health plans and other forms of employer-sponsored coverage;

  • Protect against threats to Medicaid income eligibility and maintain the highest standard of care for low-income pregnant individuals and infants, and

  • Guarantee12-months of continuous Medicaid eligibility for postpartum women.

Rep. Watson Coleman first authored the Healthy MOM Act in 2015. House Cosponsors include Reps. Brendan Boyle (PA-2), Frederica Wilson (FL-24), Donald M. Payne, Jr. (NJ-10), Raúl M. Grijalva (AZ-07), Henry C. "Hank" Johnson, Jr. (GA-04), Dwight Evans (PA-03), Gerald E. Connolly (VA-11), Judy Chu (CA-28), Ritchie Torres (NY-15), Mark Pocan (WI-02), Barbara Lee (CA-12), Steve Cohen (TN-09), Eleanor Holmes Norton (DC-At Large), André Carson (IN-12), Jahana Hayes (CT-05), Jasmine Crockett (TX-30), Gregory Meeks (NY-05), Troy A. Carter, Sr. (LA-02), Jonathan L. Jackson (IL-01), Haley Stevens (MI-11), Suzanne Bonamici (OR-01), Eric Swalwell (CA-14), Grace Meng (NY-06), and Lois Frankel (FL-22).

The Healthy MOM Act is endorsed by Reproductive Freedom For All, National Women's Health Network, American College of Obstetricians and Gynecologists, MomsRising, March of Dimes, and Planned Parenthood Federation of America.