U.S. Senator Debbie Stabenow, Ranking Member of the Finance Committee’s Health Subcommittee, urged the Department of Health and Human Services to make sure pregnant women have full access to the comprehensive, affordable health coverage guaranteed by the Affordable Care Act. In a letter to HHS Secretary Sylvia Mathews Burwell, Sen. Stabenow and 36 other Democratic Senators called for an enrollment period for women who become pregnant at a time outside of open enrollment and are uninsured, or enrolled in a grandfathered plan that does not cover maternity services. Pregnancy would be a ‘qualifying life event,’ like marriage, divorce, a job change, or birth, which allow people to add or remove others from their health plans.
Sen. Stabenow is a long-time advocate of maternity care and fought to ensure that it is one of the 10 Essential Health Benefits included in all health care plans sold in the individual and small group markets. However, some women still lack access to maternity care, which can cost between $10,000-$20,000 for a pregnancy without complications.
Full text of the letter follows below. Dear Secretary Burwell,
We write to support your efforts to ensure that women have full access to the comprehensive, affordable health insurance coverage guaranteed by the Affordable Care Act (ACA).
The ACA has made historic progress towards ending discrimination against women in the health insurance market by requiring private health insurance plans to include maternity coverage as an Essential Health Benefit. This is a critical protection – good maternity care is essential for the well-being of children, and studies show that maternal mortality rates are three to four times higher for women who do not receive prenatal care. Millions of women have benefitted from this protection, and we appreciate your leadership in getting this done.
However, if a woman becomes pregnant at a time outside of the Open Enrollment period and is uninsured, or enrolled in a grandfathered plan that does not cover maternity services, then she will not be able to access coverage for maternity care. Without access to maternity care coverage, these women are forced to either forgo this critical care or face significant out of pocket costs.
We appreciate your efforts to address this problem in the recently released Final Notice of Benefit and Payment Parameters for 2016, in which you acknowledge many advocacy groups’ request for a special enrollment period in the insurance marketplaces for pregnant women and describe how the flexibility afforded by §155.420(d)(9) allows you to address the issue through sub-regulatory guidance. We encourage you to use that authority to create a special enrollment period to maximize women’s access to coverage.
We appreciate your timely attention to this matter and look forward to working with you to ensure that all women and families have access to this Essential Health Benefit.
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