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HB 4703

Insurance: health insurers; coverage for group prenatal care services; require. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406ss.

2025-2026 Regular Session Introduced by Timmy Beson and 20 co-sponsors

The bills require private insurance and Medicaid in Michigan to cover group prenatal care services under an evidence-based, group-based model.

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Bill Summary · HB 4703

Summary: HB 4703 (and companion HB 4704) – Coverage for Group Prenatal Care Services

What the bill would do

  • HB 4703 would amend the Insurance Code (1956 PA 218) to require that any health insurance policy delivered, issued for delivery, or renewed in Michigan on or after January 1, 2026 must provide coverage for group prenatal care services.
  • HB 4704 would amend the Social Welfare Act to require Michigan’s Medicaid program to cover group prenatal care services under the same model of care.

Key concept: group prenatal care services

  • Defined as a series of prenatal care visits provided in a group setting based on an evidence-based model.
  • Included services may comprise health assessments by a qualified provider, social and clinical support, educational activities in a family-centered environment, and opportunities for peer-to-peer interaction among pregnant individuals.

Why this bill is proposed

  • Current law requires standard prenatal and maternity coverage but does not mandate coverage for prenatal care provided in a group setting.
  • The bills aim to expand access to a collaborative, community-based model of prenatal care that can accompany traditional medical care.

Major provisions

HB 4703 (Insurance Code amendment)

  • Effective for policies delivered, issued, or renewed on/after January 1, 2026.
  • Requires coverage for group prenatal care services.
  • Defines group prenatal care services as described above.
  • Enforcement and penalties: violations subject to the Insurance Code’s enforcement framework.
    • Administrative hearings before the Director of the Department of Insurance and Financial Services (DIFS).
    • Civil fines: $1,000 per violation; $5,000 if the violator knew or reasonably should have known of the violation.
    • Civil fines capped at $50,000; fine revenue deposited to the state general fund.
  • Fiscal note highlights:
    • No direct state/local government cost anticipated.
    • Potential general fund revenue from fines if violations occur.
    • Definition of group prenatal care services as a group-based, evidence-based model.

HB 4704 (Social Welfare Act amendment)

  • Applies to Michigan’s Medicaid program.
  • Requires Medicaid to cover group prenatal care services using the same model described above.
  • Potential impact on Medicaid costs will depend on provider participation, scope of services, and utilization.
  • Administrative costs for the Department of Health and Human Services (DHHS) are not expected to be substantial; costs to Medicaid could be indeterminate but non-substantive.
  • Current Medicaid context:
    • Group-based prenatal services are reimbursable under Medicaid but via hospital-based direct contracts.
    • The annual appropriations act includes a $5.0 million gross allocation for this purpose.
    • Expanded codification could affect provider participation, caseloads, and utilization.
    • Federal match (FMAP) is applicable; for FY 2025-26, Michigan’s FMAP is 65.30%.

Who would be affected

  • Private health insurance policyholders in Michigan (policies delivered/issued/renewed on or after Jan 1, 2026) would gain coverage for group prenatal care services.
  • Medicaid enrollees would gain access to group prenatal care covered under the state program, potentially expanding the range of providers and settings offering these services.
  • Health insurers, health care providers, and the Department of Insurance and Financial Services (DIFS) would administer and enforce the new requirements.

Timeline and status

  • Introduced: March 12, 2025.
  • Version: House Bill 4703 electronically reproduced June 26, 2025; introduced and referred to the Committee on Insurance.
  • Related actions: Companion bill HB 4704 considered as introduced; legislative actions show public hearing activity on or around April 17, 2025, with ongoing committee work.
  • The document notes completion to Oct 21, 2025 for Committee analysis, with an analysis available from the House Fiscal Agency.

Notes

  • HB 4703 and HB 4704 are companion measures addressing private insurance coverage and public Medicaid coverage, respectively, for a unified model of group prenatal care.
  • The legislative analysis was prepared by the nonpartisan House Fiscal Agency and outlines potential fiscal implications, including enforcement costs and Medicaid-related expenditures.

If you’d like, I can extract specific proposed amendments to MCL 500.3406ss and MCL 400.109t or convert this into a one-page brief for a particular audience (e.g., policymakers, insurers, or providers).

Compiled from official sources — confirm details with the bill’s official record.

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