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A07836 Summary:

A07836 Actions:

A07836 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
 submitted in accordance with Assembly Rule III, Sec 1(f)



 
BILL NUMBER: A7836
 
SPONSOR: Simotas (MS)

 
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 Market-
place.
 
 
SUMMARY OF PROVISIONS:
 
Section one adds a new Public Health Law § 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 appro-
priate 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.

A07836 Text:

 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          7836
 
                               2015-2016 Regular Sessions
 
                   IN ASSEMBLY
 
                                      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    §  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    §  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