A07836 Summary:

BILL NO    A07836 

SAME AS    SAME AS S05548-A

SPONSOR    Simotas (MS)

COSPNSR    Buchwald, Colton, Titone, Sepulveda, Mayer, Seawright, Titus,
           Lupardo, Miller, Hevesi, Rozic, Solages, Persaud, Abinanti, Skoufis,
           Linares, Woerner, Braunstein, Wozniak, Clark, Gunther

MLTSPNSR   Glick, Markey, Simon, Thiele

Add S2507, Pub Health L

Makes the commencement of pregnancy a triggering event for purposes of
eligibility to enroll in a qualified health plan in the state health insurance
exchange.
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A07836 Actions:

BILL NO    A07836 

05/28/2015 referred to health
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A07836 Votes:

There are no votes for this bill in this legislative session.
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A07836 Memo:

BILL NUMBER:A7836

TITLE OF BILL:

An act to amend the public health law, in relation to making pregnancy
a triggering event for purposes of enrollment in a qualified health
plan

PURPOSE:

Establishes pregnancy as a qualifying event making one eligible for a
special enrollment period under the New York State of Health
Marketplace.

SUMMARY OF PROVISIONS:

Section one adds a new Public Health Law S 2507 to require that, in
addition to any qualifying event under federal law, rule or
regulation, that makes one eligible for a special enrollment period,
the New York insurance exchange, known as the New York State of
Health, shall allow for the enrollment of a pregnant individual at any
time after the commencement of her pregnancy.

Section two provides the effect date.

JUSTIFICATION:

Under the federal Patient Protection and Affordable Care Act (Pl.
111-148) generally individuals must enroll in qualified health plans
offered on health insurance exchanges during open enrollment periods.
Federal law provides exceptions to this rule if you have certain life
events that qualify you for a special enrollment. period. Life events
such as getting married, having a baby, losing other coverage or
gaining citizenship are several examples of qualifying event under
federal law.

Under current federal provisions, a pregnant woman is not eligible for
a special enrollment period until she gives birth, after which she and
her baby can enroll in coverage with a qualified health plan on the
exchange. This bill would permit New York women to enroll when become
pregnant, rather than having to wait until their baby is born.  This
would enable women who become pregnant outside the three-month open
enrollment period to enroll in coverage, thus ensuring they seek
appropriate prenatal care and are not stuck with thousands of dollars
in bills for prenatal care and delivery. Without access to coverage,
women are more likely to forgo prenatal care which puts them at higher
risk for conditions that affect their own health as well as that of
the child, such as pregnancy related diabetes and high blood pressure.
While ideally most individuals will enroll in coverage prior to a life
event such as a pregnancy, the federal government already acknowledges
the need for a special enrollment period for women who have given
birth, this legislation will just allow for said enrollment upon
pregnancy.

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.
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A07836 Text:

                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________

                                         7836

                              2015-2016 Regular Sessions

                                 I N  A S S E M B L Y

                                     May 28, 2015
                                      ___________

       Introduced  by  M.  of  A. SIMOTAS, BUCHWALD, COLTON, TITONE, SEPULVEDA,
         MAYER, SEAWRIGHT, TITUS,  LUPARDO,  MILLER,  HEVESI,  ROZIC,  SOLAGES,
         PERSAUD,   ABINANTI,  SKOUFIS  --  Multi-Sponsored  by  --  M.  of  A.
         BROOK-KRASNY, MARKEY, SIMON, THIELE -- read once and referred  to  the
         Committee on Health

       AN ACT to amend the public health law, in relation to making pregnancy a
         triggering event for purposes of enrollment in a qualified health plan

         THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
       BLY, DO ENACT AS FOLLOWS:

    1    Section 1. The public health law is amended by adding  a  new  section
    2  2507 to read as follows:
    3    S  2507.  SPECIAL ENROLLMENT; PREGNANCY. IN ADDITION TO ANY QUALIFYING
    4  EVENT UNDER FEDERAL LAW, RULE OR REGULATION THAT MAKES ONE ELIGIBLE  FOR
    5  A SPECIAL ENROLLMENT PERIOD FOR ENROLLMENT IN A QUALIFIED HEALTH PLAN IN
    6  THE  STATE HEALTH INSURANCE EXCHANGE ESTABLISHED PURSUANT TO THE FEDERAL
    7  PATIENT PROTECTION AND AFFORDABLE CARE ACT (P.L.   111-148),  THE  STATE
    8  HEALTH  INSURANCE  EXCHANGE SHALL ALLOW FOR THE ENROLLMENT OF A PREGNANT
    9  INDIVIDUAL AT ANY TIME AFTER THE COMMENCEMENT OF THE  PREGNANCY.    UPON
   10  SUCH ENROLLMENT, ANY QUALIFIED HEALTH PLAN IN THE STATE HEALTH INSURANCE
   11  EXCHANGE SHALL ENSURE THAT COVERAGE IS EFFECTIVE ON THE DATE OF APPLICA-
   12  TION.
   13    S  2. This act shall take effect on the first of January next succeed-
   14  ing the date on which it shall have become a law and shall apply to  all
   15  qualified  health plans issued, renewed, modified, altered or amended on
   16  or after such effective date; provided, however,  that  effective  imme-
   17  diately, the addition, amendment and/or repeal of any rule or regulation
   18  necessary  for  the implementation of this act on its effective date are
   19  authorized and directed to be made  and  completed  on  or  before  such
   20  effective date.

        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD11190-02-5
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