Watson Coleman Reintroduces the Healthy MOM Act to Add Special Enrollment Period for Pregnant Mothers
Bill would create special enrollment period for expectant mothers, ensure comprehensive coverage of maternity care for dependent children, guarantee 12-months of continuous Medicaid eligibility for postpartum women
On the heels of Mother’s Day, Representative Bonnie Watson Coleman (NJ-12) re-introduced 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 while 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.”
“No mother-to-be should ever have to worry about how she will get the healthcare she and her baby need throughout her pregnancy and post-partum,” said Brown. “Better access to care means better outcomes for moms. This legislation will help expand coverage options for pregnant mothers so that they can access the care that best meets their needs.”
According to the Centers for Disease Control and Prevention, about 700 women die each year in the United States from pregnancy-related complications. 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
- Guarantee 12-months of continuous Medicaid eligibility for postpartum women.
Rep. Watson Coleman first authored the Healthy MOM Act in 2015. House Cosponsors include Reps. Alma Adams (NC-12), Karen Bass (CA-37), Henry C. “Hank” Johnson, Jr. (GA-4), Haley Stevens (MI-11), André Carson (IN-7), Joyce Beatty (OH-3), Sanford D. Bishop, Jr. (GA-2), Suzanne Bonamici (OR-1), Judy Chu (CA-27)), Steve Cohen (TN-9), Jim Cooper (TN-5), Adriano Espaillat (NY-13), Dwight Evans (PA-3), Lois Frankel (FL-21), Jesus “Chuy” Garcia (IL-4), Lucile Roybal-Allard (CA-40), Bill Foster (IL-11), Jahana Hayes (CT-5), Derek Kilmer, (WA-6), James R. Langevin (RI-2), Donald M. Payne, Jr. (NJ-10), Carolyn B. Maloney (NY-12), Grace Meng (NY-6), Earl Blumenauer (OR-3), Eleanor Holmes Norton (DC-At Large), Terri A. Sewell (AL-7), John B. Larson (CT-1), Barbara Lee (CA-13), Mike Levin (CA-49), Gregory W. Meeks (NY-5), Mark Pocan (WI-2), Deborah K. Ross (NC-2), Adam Smith (WA-9), Mikie Sherrill (NJ-11), Eric Swalwell (CA-15), Rashida Tlaib (MI-13), Ritchie Torres (NY-15), Debbie Wasserman Shultz (FL-23), Frederica Wilson (FL-24), Gerald E. Connolly (VA-11), Brendan Boyle (PA-2), Mondaire Jones (NY-17) and Marilyn Strickland (WA-10).
The Healthy MOM Act is endorsed by Advocates for Youth, the Association of Maternal & Child Health Programs, March of Dimes, NARAL Pro-Choice America, National Birth Equity Collaborative, National Health Law Program, National Women’s Health Network, and Planned Parenthood Federation of America.