A group of 55 House Democrats is endorsing an effort to add pregnancy to the list of qualifying life events that allow individuals to select or change their health coverage outside of the annual open enrollment period.
In a March 12 letter to Health and Human Services Secretary Sylvia Burwell, the lawmakers called on the agency to “exercise its authority” and, through subregulatory guidance, create a special enrollment period triggered by pregnancy for health plans that participate in the Affordable Care Act’s insurance marketplaces.
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“This is a critical protection – good maternity care is essential for the well-being of women and children,” the lawmakers wrote, noting that women who do not receive prenatal are more likely to have an infant die in the first month, and that maternal mortality rates are up to four times higher for women who do not receive prenatal care.
Although the Affordable Care Act requires coverage of maternity care as an essential health benefit, women are not eligible for this coverage if they are uninsured and become pregnant outside of the open enrollment period, or if they are enrolled in an older health plan that is exempt from offering the ACA’s essential health benefits.
Special enrollment periods already exist under the ACA for the birth of a child but not for pregnancy.
A separate letter sent the same day and signed by 32 organizations, including the American Congress of Obstetricians and Gynecologists and the Association of Reproductive Health Professionals, also calls on HHS to make the regulatory change.