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

2023-2024 Regular Session Introduced by Stephanie Chang

Requires Michigan private health plans to cover group prenatal care services.

placed on second reading

#insurance:healthbenefits #insurance:healthinsurers

Purpose

SB 1128 would require health insurers that deliver, issue for delivery, or renew health insurance policies in Michigan to provide coverage for "group prenatal care services." The intent is to expand insurance coverage for group-based prenatal models (e.g., CenteringPregnancy) that combine clinical assessments, education, and peer support to improve maternal and infant health outcomes.

Key provisions

Adds a new section to the Insurance Code (proposed MCL 500.3406jj) within Chapter 34 (Disability Insurance Policies) of 1956 PA 218.

Requires any insurer that delivers, issues for delivery, or renews a health insurance policy in Michigan to cover group prenatal care services.

Defines "group prenatal care services" as a series of prenatal visits provided in a group setting based on an evidence‑based model that includes (or, in the committee substitute, may include) health assessments, social and clinical support, and educational activities in a family‑centered environment with peer‑to‑peer interaction to help pregnant individuals support one another during pregnancy and into early childhood.

Who would be affected

Insurers: All issuers of health insurance policies in Michigan (policies delivered, issued for delivery, or renewed in the state) would be required to cover group prenatal care services.

Pregnant individuals and families: Insured Michigan residents seeking prenatal care could gain access to group prenatal care covered by their health plans.

Providers and programs: Clinics, hospitals, community health centers, and other providers offering evidence‑based group prenatal models (e.g., CenteringPregnancy) would potentially see increased enrollment and reimbursement opportunities.

Fiscal and enforcement notes

Nonpartisan legislative analyses (Senate and House staff) find no direct fiscal impact on state or local government from SB 1128; Medicaid impacts are addressed separately in companion SB 1127.

The Insurance Code contains enforcement provisions (MCL section 150 equivalents) allowing administrative fines for violations; House fiscal staff noted potential general‑fund receipts if fines are assessed for noncompliance.

Analysts expect fiscal impact to be minimal if group prenatal services align with existing Medicaid/state programs and available provider capacity.

Procedural status (selected)

Introduced in the Michigan Senate by Sen. Stephanie Chang (Senate Bill 1128).

Substitute S‑1 was adopted and the Senate passed the bill (Senate passage reported 12/12/2024).

Transmitted to the House; referred to House committees. (Documents indicate the bill was placed on the House second reading calendar in early 2025 — check the legislative website for the current live status.)

Companion/related bill: SB 1127 (would require Medicaid to cover group prenatal care services); HB 3221 is a House companion.

Practical effect

If enacted, SB 1128 would make group prenatal care a mandatory covered benefit under private health insurance policies in Michigan, potentially increasing access to group prenatal programs shown in some studies to reduce preterm birth, gestational diabetes, and postpartum depression. The requirement could modestly affect insurer benefit design and provider billing, but legislative analyses project minimal state fiscal impact.

Bill