Supporting Healthy Moms and Babies Act

This bill amends Section 1302(b) of the Patient Protection and Affordable Care Act (42 U.S.C. 18022(b)) to include comprehensive prenatal, labor and delivery, neonatal, perinatal, and postpartum care and screenings as essential health benefits. This means health plans must cover these services without cost-sharing requirements. The bill specifically mandates coverage for ultrasounds, services for spontaneous pregnancy loss, delivery services including anesthesiology and specialist consultations, and non-preventive postpartum care for conditions exacerbated by pregnancy, as well as behavioral health services for new parents for one year. This directly expands the services that must be covered by all ACA-compliant health insurance plans. The money trail for this legislation flows from health insurers to healthcare providers and diagnostic companies. Insurers will bear the increased cost of covering these services without deductibles, co-pays, or co-insurance. Healthcare providers, including hospitals, obstetricians, neonatologists, and mental health professionals, will see an increase in guaranteed payments for a broader range of services. Diagnostic companies providing ultrasounds and other screenings will also experience increased demand and revenue. The mechanism is a regulatory mandate, not direct appropriation, shifting costs within the existing healthcare payment system. Historically, expansions of mandated health benefits under the ACA have led to increased revenue for providers and increased costs for insurers. For example, when the ACA's essential health benefits were fully implemented in 2014, healthcare providers saw a sustained increase in utilization and reimbursement for previously underinsured services. While specific market reactions to individual benefit expansions are difficult to isolate, the broader trend shows that mandates increase the total addressable market for covered services. Insurers typically adjust premiums in subsequent years to account for increased claims costs, but in the short term, their medical loss ratios increase. There is no direct historical precedent for this exact combination of mandated services, but the principle of expanding essential health benefits has a clear track record. Specific winners include large hospital systems and healthcare providers, as well as diagnostic companies. Companies like LabCorp ($LH) and Quest Diagnostics ($DGX) will benefit from increased demand for screenings and tests. Medical device companies providing ultrasound equipment, such as GE HealthCare Technologies Inc. ($GEHC) and Teleflex Incorporated ($TFX), will also see increased utilization. Health insurers such as UnitedHealth Group ($UNH), Elevance Health, Cigna ($CI), and Humana ($HUM) will face increased claims costs due to the elimination of cost-sharing for these services. CVS Health ($CVS), through its Aetna subsidiary, also faces increased costs. These companies will likely absorb these costs in the short term, potentially impacting their medical loss ratios, before adjusting future premium structures. This bill has been introduced in the House and referred to three committees. The next step is committee consideration. Given the bipartisan sponsorship (20 cosponsors including members from both parties), it has moderate legislative momentum. If it passes committee, it moves to a floor vote in the House, then to the Senate for a similar process. The timeline for passage is uncertain but could extend through the current legislative session. If enacted, the amendment would take effect immediately upon becoming law, impacting health plans in the next enrollment cycle.