03.03.15

Murray, Democrats: Additional Measures Needed to Help Pregnant Women Get Health Care Coverage

Led by Murray, Democratic Senators call on HHS to build on progress made in Affordable Care Act for women and expectant mothers, institute special enrollment period for pregnancy

(Washington, D.C.) – Today, Senate Health, Education, Labor, and Pensions (HELP) Committee Ranking Member Patty Murray (D-WA) and 36 Democratic Senators wrote a letter to Department of Health and Human Services Secretary Sylvia Mathews Burwell, encouraging her to further improve women’s access to health care under the Affordable Care Act by instituting a special open enrollment period for women to enroll in health coverage when they find out they are pregnant.

In the letter, Murray and Senators Ron Wyden (D-OR), Kirsten Gillibrand (D-NY), Barbara Mikulski (D-MD), Tammy Baldwin (D-WI), Michael Bennet (D-CO), Richard Blumenthal (D-CT), Sherrod Brown (D-OH), Maria Cantwell (D-WA), Bob Casey (D-PA), Dianne Feinstein (D-CA), Tim Kaine (D-VA), Claire McCaskill (D-MO), Chris Murphy (D-CT), Bernie Sanders (I-VT), Chuck Schumer (D-NY), Jeanne Shaheen (D-NH), Sheldon Whitehouse (D-RI), Debbie Stabenow (D-MI), Barbara Boxer (D-CA), Patrick Leahy (D-VT), Ben Cardin (D-MD), Chris Coons (D-DE), Joe Donnelly (D-IN), Mazie Hirono (D-HI), Ed Markey (D-MA), Gary Peters (D-MI), Elizabeth Warren (D-MA), Jon Tester (D-MT), Al Franken (D-MN), Dick Durbin (D-IL), Amy Klobuchar (D-MN), Jeff Merkley (D-OR), Heidi Heitkamp (D-ND), Cory Booker (D-NJ), Jack Reed (D-RI), and Martin Heinrich (D-NM) urged Secretary Burwell to address a gap in coverage that could leave a woman uninsured and without access to maternity care if she becomes pregnant at a time outside of the Open Enrollment period. Pregnancy is an important time in a woman’s life, and maternal mortality rates are three to four times higher for women who receive no prenatal care compared to women that do, which makes health coverage critical during this time.

“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,” the Senators wrote in the letter. 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 encourage you to….create a special enrollment period to maximize women’s access to coverage.”

The text of the letter is available below and posted here.

Full text of the letter:

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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