text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Healthy Maternity and Obstetric 
  Medicine Act'' or the ``Healthy MOM Act''.
  
  SEC. 2. FINDINGS AND PURPOSE.
  
      (a) Findings.--Congress finds the following:
              (1) Pregnancy is a significant life event for millions of 
          women in the United States each year.
              (2) For more than 30 years, our Nation, through the 
          Medicaid program, has recognized that pregnant women need 
          immediate access to affordable care, and has allowed women who 
          meet income-eligibility requirements to enroll in Medicaid 
          coverage when they become pregnant.
              (3) Congress recognized the central importance of maternity 
          coverage by classifying maternity and newborn care as one of 
          the ten essential health benefits that must now be covered on 
          most individual and small group health insurance plans under 
          section 1302(b)(1) of the Patient Protection and Affordable 
          Care Act (42 U.S.C. 18022(b)(1)).
              (4) Access to comprehensive maternity coverage allows women 
          to access important pregnancy-related care, which is 
          demonstrated to improve health outcomes for women and newborns 
          and reduce financial costs for both consumers and insurers.
              (5) Uninsured women, women with grandfathered and 
          transitional health plans, self-funded student health plans, 
          and catastrophic and high-deductible health plans may lack 
          access to comprehensive and affordable maternity coverage.
              (6) A special enrollment period is especially important for 
          young adults, who are at high risk for unintended pregnancies, 
          yet young adults are frequently enrolled in catastrophic 
          coverage, which often has fewer benefits, more restrictions, 
          and higher deductibles.
              (7) Timely maternity care improves the health of pregnant 
          women, as well as birth outcomes and the health of babies 
          throughout their lifetimes. Pregnancy-related maternal 
          mortality is three to four times higher among women who receive 
          no maternity care compared to women who do. Regular maternity 
          care can detect or mitigate serious pregnancy-related health 
          complications, including preeclampsia, placental abruption, 
          complications from diabetes, complications from heart disease, 
          and Graves' disease, all of which can result in morbidity or 
          mortality for the mother or newborn.
              (8) Regular maternity care can reduce preterm births and 
          the health complications associated with preterm births.
              (9) Timely maternity care can reduce short- and long-term 
          health care costs. If a woman does not have access to 
          affordable maternity care during her pregnancy, and she or her 
          newborn experiences pregnancy complications that result in 
          health problems after birth, their insurer may end up paying 
          much higher costs than if the insurer had covered the woman's 
          maternity care during her pregnancy. Intensive maternity care 
          can reduce hospital and neonatal intensive care unit admissions 
          among infants, resulting in cost savings of $1,768 to $5,560 
          per birth. For women with high-risk pregnancies, intensive 
          maternity care saves $1.37 for every $1 invested in maternity 
          care.
      (b) Purpose.--The purpose of this Act is to protect the health of 
  women and newborns by ensuring that all women eligible for coverage 
  through the Exchanges established under title I of the Patient 
  Protection and Affordable Care Act (Public Law 111-148) can access 
  affordable health coverage during their pregnancy.
  
  SEC. 3. PROVIDING FOR A SPECIAL ENROLLMENT PERIOD FOR PREGNANT WOMEN.
  
      (a) Public Health Service Act.--Section 2702(b)(2) of the Public 
  Health Service Act (42 U.S.C. 300gg-1(b)(2)) is amended by inserting 
  ``including a special enrollment period for pregnant women, beginning 
  on the date on which the pregnancy is reported to the health insurance 
  issuer'' before the period at the end.
      (b) Patient Protection and Affordable Care Act.--Section 1311(c)(6) 
  of the Patient Protection and Affordable Care Act (42 U.S.C. 
  18031(c)(6)) is amended--
              (1) in subparagraph (C), by striking ``and'' at the end;
              (2) by redesignating subparagraph (D) as subparagraph (E); 
          and
              (3) by inserting after subparagraph (C) the following new 
          subparagraph:
                      ``(D) a special enrollment period for pregnant 
                  women, beginning on the date on which the pregnancy is 
                  reported to the Exchange; and''.
      (c) Special Enrollment Periods.--Section 9801(f) of the Internal 
  Revenue Code of 1986 (26 U.S.C. 9801(f)) is amended by adding at the 
  end the following new paragraph:
              ``(4) For pregnant women.--
                      ``(A) A group health plan shall permit an employee 
                  who is eligible, but not enrolled, for coverage under 
                  the terms of the plan (or a dependent of such an 
                  employee if the dependent is eligible, but not 
                  enrolled, for coverage under such terms) to enroll for 
                  coverage under the terms of the plan upon pregnancy, 
                  with the special enrollment period beginning on the 
                  date on which the pregnancy is reported to the group 
                  health plan.
                      ``(B) The Secretary shall promulgate regulations 
                  with respect to the special enrollment period under 
                  subparagraph (A), including establishing a time period 
                  for pregnant women to enroll in coverage and effective 
                  date of such coverage.''.
      (d) Effective Date.--The amendments made by this section shall 
  apply with respect to plan years beginning after the 2016 plan year.
  
  SEC. 4. FEDERAL EMPLOYEE HEALTH BENEFIT PLANS.
  
      (a) In General.--The Director of the Office of Personnel Management 
  shall issue such regulations as are necessary to ensure that pregnancy 
  is considered a change in family status and a qualifying life event for 
  an individual who is eligible to enroll, but is not enrolled, in a 
  health benefit plan under chapter 89 title 5, United States Code.
      (b) Effective Date.--The requirement in subsection (a) shall apply 
  with respect to any contract entered into under section 8902 of such 
  title beginning 12 months after the date of enactment of this Act.
target: Healthy Maternity and Obstetric Medicine Act or the Healthy MOM Act This bill amends the Public Health Service Act and Internal Revenue Code to require health insurers, health insurance exchanges, and group health plans to offer a special enrollment period to pregnant women beginning when the pregnancy is reported to the issuer, exchange, or plan. The Office of Personnel Management must ensure that eligible pregnant women are allowed to enroll in federal employee health benefit plans outside of the open enrollment period.
feat_title: Healthy MOM Act