Relates to enrollment of a pregnant individual in a health insurance plan

8 Co-sponsors

• Kemp Hannon
• Liz Krueger
• Tony Avella
• John J. Bonacic
• Jesse Hamilton
• William J. Larkin Jr.
• Marc Panepinto
• Kevin S. Parker

Title of bill

An act to amend the insurance law and the public health law, in relation to enrollment during pregnancy

Purpose

To allow a pregnant individual to enroll in any health plan at any time.

Summary of provisions

Section one adds a new subsection (d) to Section 3217-c of the Insurance Law to provide that a health insurance plan shall allow for the enrollment of a pregnant individual, whose pregnancy has been certified by a health care practitioner, at any time, and that such coverage shall be in effect as of the date of application.

Section 2 adds a new Public Health Law § 2507 to provide that a health insurance plan shall allow for the enrollment of a pregnant individual, whose pregnancy has been certified by a health care practitioner, at any time, and that such coverage shall be in effect as of the date of application.

Section 3 provides the effective date.

Justification

Studies show that infants born to mothers who have had little or no prenatal care have a lower birth rate and a higher rate of infant mortality. Maternal mortality is also higher among women who do not receive prenatal care, as is the rate of other health risks for pregnant women, including preeclampsia, placental abruption, and diabetes.

This bill would allow women to enroll for health insurance when she becomes pregnant, regardless of the open enrollment period on the exchange or any other restrictions in seeking coverage off the exchange. By enabling women to receive covered comprehensive prenatal care, women are not faced with the choice between high out-of-pocket health care expenditures or forgoing prenatal care. Not only does coverage of prenatal care offer health benefits to pregnant women and their newborns, but such coverage offers preventative care which could provide long-term cost savings to the state's health care system. Although the best case scenario would be individuals seeking coverage before they need it, there is cost savings potential in allowing a woman to sign up during pregnancy, rather than waiting until having given birth-a qualifying even that triggers special enrollment under the exchange. The concern that this will establish a precedent for creating new qualifying events, such as cancer, is misplaced. Pregnancy is not an illness, and should not be likened to one.

Legislative history

New bill.

Fiscal implications

None.

Effective date

January 1st succeeding enactment and shall apply to all qualified health plans issued, renewed or amended after such date; provided, effective immediately the commissioner may adopt regulations to implement.