Referred to the House Committee on Energy and Commerce.
The bill adds a new section to the Public Health Service Act that limits cost sharing for prenatal services when a health plan uses a bundled payment that includes prenatal care and payment for the birth. If an individual experiences a miscarriage or stillbirth and the bundled payment for the birth is not made, the plan may not charge more cost sharing (deductibles, coinsurance, copayments) for prenatal services already furnished than would have applied under the bundled payment had the birth occurred.
Scope and role of federal regulation: liberals see necessary consumer protection; conservatives see federal overreach.
Relative to its intended legislative type, this bill is a narrowly focused substantive policy change that clearly states a prohibition on certain cost sharing for prenatal services in the event of miscarriage or stillbirth when a bundled payment is not made.
The bill adds a new section to the Public Health Service Act that limits cost sharing for prenatal services when a health plan uses a bundled payment that includes prenatal care and payment for the birth.
If an individual experiences a miscarriage or stillbirth and the bundled payment for the birth is not made, the plan may not charge more cost sharing (deductibles, coinsurance, copayments) for prenatal services already furnished than would have applied under the bundled payment had the birth occurred.
The rule applies to group health plans and group or individual health insurance coverage and takes effect for plan years beginning on or after January 1, 2027.
On content alone this is a narrowly targeted, administratively implementable consumer-protection tweak rather than a sweeping policy change, which improves its prospects. However, it creates a new restriction on private plan cost-sharing without built-in exemptions or detailed implementation guidance, which can provoke insurer, employer, and jurisdictional (ERISA/state) concerns. Those factors, plus the typical difficulty of advancing standalone statutory changes through both chambers and obtaining final enactment, reduce its overall likelihood unless it is adopted as part of a larger, bipartisan package.
Relative to its intended legislative type, this bill is a narrowly focused substantive policy change that clearly states a prohibition on certain cost sharing for prenatal services in the event of miscarriage or stillbirth when a bundled payment is not made. The statutory text establishes the core rule and an effective date but provides limited operational detail.
Scope and role of federal regulation: liberals see necessary consumer protection; conservatives see federal overreach.
These are examples from the analysis, not a ranked list of the most-affected groups.
Scope and role of federal regulation: liberals see necessary consumer protection; conservatives see federal overreach.
This persona would likely view the bill positively as a targeted consumer-protection measure that prevents grieving people from facing unexpectedly high out-of-pocket bills after a miscarriage or stillbirth.
It is seen as compassionate policy that reduces financial harm during an emotionally difficult event and closes a specific coverage gap that can arise when insurers use bundled maternity payments.
They may wish the protection were broader (e.g., include additional services or guaranteed reimbursement) but would generally welcome the statutory protection.
A centrist would see this as a narrowly targeted consumer-protection measure with a sympathetic purpose that addresses a specific gap created by bundled payment arrangements.
They would generally favor the intent but want clarity on implementation details, administrative burden, and the size of any insurer or premium impacts.
They are inclined to support the bill if regulators provide clear rules and if the fiscal or market impacts are shown to be limited or offset.
A mainstream conservative would be sympathetic to the bill's intent to protect grieving families but is likely skeptical of adding federal regulatory constraints on insurers and plan design.
They would raise concerns about government intrusion into private insurance contracts, potential unintended cost-shifting, and added administrative complexity.
Some conservatives might accept this narrowly tailored protection as reasonable; others would prefer market or state-level solutions rather than a federal mandate.
Reached or meaningfully advanced
Reached or meaningfully advanced
Still ahead
Still ahead
Still ahead
On content alone this is a narrowly targeted, administratively implementable consumer-protection tweak rather than a sweeping policy change, which improves its prospects. However, it creates a new restriction on private plan cost-sharing without built-in exemptions or detailed implementation guidance, which can provoke insurer, employer, and jurisdictional (ERISA/state) concerns. Those factors, plus the typical difficulty of advancing standalone statutory changes through both chambers and obtaining final enactment, reduce its overall likelihood unless it is adopted as part of a larger, bipartisan package.
The bill has not accumulated any surfaced votes yet.
Scope and role of federal regulation: liberals see necessary consumer protection; conservatives see federal overreach.
On content alone this is a narrowly targeted, administratively implementable consumer-protection tweak rather than a sweeping policy change…
Relative to its intended legislative type, this bill is a narrowly focused substantive policy change that clearly states a prohibition on certain cost sharing for prenatal services in the event of miscarriage or stillbi…
Go beyond the headline summary with full stakeholder mapping, legislative design analysis, passage barriers, and lens-by-lens tradeoff breakdowns.