NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A2656REVISED 1/11/24
SPONSOR: Walker TITLE OF BILL:
An act to amend the insurance law, in relation to permitting pregnant
women to enroll in health insurance during a special enrollment period
without penalty
PURPOSE OR GENERAL IDEA OF BILL:
Amends the insurance law to permit pregnant individuals to enroll in the
state health insurance exchange during a special enrollment period with-
out incurring fees or penalties.
SUMMARY OF PROVISIONS:
Section 1 amends Section 4328(b)(4)(B) of the Insurance law to permit
pregnant individuals to enroll in the state health insurance exchange
during a special enrollment period without incurring fees or penalties.
Section 3 provides the effective date.
JUSTIFICATION:
In New York State we must improve access to adequate and early prenatal
care. Decisions about pregnancy are time sensitive whether or not the
pregnant individual chooses to continue the pregnancy. Having prenatal
care is critical for pregnant women's health and to ensure positive
pregnancy outcomes. The federal Centers for Disease Control and
Prevention urges that comprehensive prenatal care begin as soon as a
woman decides to become pregnant. Prenatal care is crucial in decreasing
the risk of complications, maternal morbidity, and Sudden Infant Death
Syndrome (SIDS). Babies of mothers who do not, get prenatal care are
three times more likely to have a low birth weight and five times more
likely to die than those born to mothers who do get care. Doctors can
spot health problems early when they see mothers regularly. Early treat-
ment can cure many problems and prevent others. To that end, identifying
and closing gaps in health care and pregnancy-support needs, in partic-
ular the gap insurance coverage for hard working women, are important to
achieve optimal health outcomes for women who are pregnant.
This bill would improve access to healthcare for pregnant women by
making it clear in state law that health insurers shall not impose fees
or other penalties for the special enrollment of a pregnant individual
into the state health insurance exchange.
PRIOR LEGISLATIVE HISTORY:
2019-2020: A8684 - Referred to Insurance
2021-2022: A6007 - Referred to Insurance
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:
None.
EFFECTIVE DATE:
This act shall take effect on the first of January next succeeding the
date on which it shall have become a law
STATE OF NEW YORK
________________________________________________________________________
2656
2023-2024 Regular Sessions
IN ASSEMBLY
January 26, 2023
___________
Introduced by M. of A. WALKER, CLARK -- read once and referred to the
Committee on Insurance
AN ACT to amend the insurance law, in relation to permitting pregnant
women to enroll in health insurance during a special enrollment period
without penalty
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subparagraph (B) of paragraph 4 of subsection (b) of
2 section 4328 of the insurance law, as amended by chapter 11 of the laws
3 of 2016, is amended to read as follows:
4 (B) In addition to the enrollment periods required in subparagraph (A)
5 of this paragraph, an individual enrollee direct payment contract
6 offered pursuant to this section shall allow for the enrollment of a
7 pregnant individual. Such individual may enroll at any time after a
8 health care professional licensed pursuant to title eight of the educa-
9 tion law and acting within the scope of his or her practice certifies
10 that the individual is pregnant. Such health insurance policy or
11 contract shall not impose a fee or other penalty for special enrollment
12 of the pregnant individual. Upon enrollment, coverage shall be effec-
13 tive as of the first day of the month in which the health care profes-
14 sional certifies that the individual is pregnant, unless the individual
15 elects to have coverage effective on the first day of the month follow-
16 ing the date that the individual received certification of the pregnan-
17 cy.
18 § 2. This act shall take effect on the first of January next succeed-
19 ing the date on which it shall have become a law and shall apply to all
20 policies or contracts issued, renewed, modified, altered or amended on
21 or after such effective date. Effective immediately, the addition,
22 amendment and/or repeal of any rule or regulation necessary for the
23 implementation of this act on its effective date are authorized to be
24 made and completed on or before such effective date.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD02059-01-3
