Bill
S 823
Expands explicit coverage of post-pregnancy mental health care across major MA health plans, with no cost-sharing for state employees.
Status snapshot
- Bill number: S 823 (Massachusetts)
- Introduced/Filed: January 17, 2025; reported as introduced March 3, 2025
- Sponsor / Petitioner (Senate): Rebecca L. Rausch (with Patricia D. Jehlen; James B. Eldridge listed on cover)
- Current procedural note in file: Substituted by A2249 (companion/house version). Hearing activity and referrals are recorded in 2025 legislative actions.
- Effective date (if enacted): 6 months after passage
Purpose / intent
- To expand statutory health insurance coverage language in Massachusetts to explicitly include “post-pregnancy mental health care” — defined in the bill to include postpartum mental health care and post-miscarriage mental health care — and to strengthen access and parity protections for those services across multiple types of public and private health plans.
Key provisions and changes
- Inserts “including post-pregnancy mental health care” (or “post-pregnancy or postpartum”) into multiple existing insurance and public-health statutes so that post-pregnancy mental health care is explicitly within mandated coverage. Affected statutory sections include:
- Chapter 32A §17C (state employee benefits)
- Chapter 118E §§10A, 10E, 10S (MassHealth/Medicaid-related provisions)
- Chapter 175 §§47F, 47WW (commercial insurance)
- Chapter 176A §§8H, 8XX (HMOs)
- Chapter 176B §§4H, 4XX (health insurers)
- Chapter 176G §§4I, 4PP (other plan types created/regulated by 176G)
- For state employee plans (chapter 32A §17C), the bill adds explicit consumer protections:
- Coverage for post-pregnancy mental health care shall not be subject to any deductible, coinsurance, copayment, or any other cost-sharing requirement.
- Coverage shall not impose unreasonable restrictions or delays.
- Benefits under this section shall be the same for an enrollee’s covered spouse and dependents.
- The relevant commission (state plan administrator) shall ensure plan compliance.
- For MassHealth/Medicaid-related statutes, the bill requires parity of benefits for spouses/dependents and affirms the division’s authority to enforce compliance by contracted insurers, plans, behavioral health management firms, and third-party administrators.
- Similar language additions across other insurance chapters ensure consistency of terminology and coverage expectations (e.g., replacing or supplementing the term “postpartum” with “post-pregnancy or postpartum”).
Who would be affected
- Insured individuals in Massachusetts experiencing post-pregnancy mental health conditions, including postpartum depression/anxiety and post-miscarriage mental health needs.
- Coverage populations across statutes: state employees and retirees (chapter 32A), MassHealth enrollees (chapter 118E), commercial insurance policyholders, HMO members, and dependents/spouses covered under these plans.
- Health insurers, HMOs, behavioral health management firms, Medicaid managed care contractors, and third-party administrators — who would be required to comply with clarified coverage expectations and enforcement.
Procedural / timeline notes
- The bill text provides an effective date of six months after enactment.
- Legislative action records indicate the bill was referred to committee(s), had scheduled hearings, and was substituted by companion bill A2249 — readers should consult the Legislature’s docket for up-to-date status and any text changes in the substituted version.
Potential impacts (practical effect)
- Expands explicit legal recognition of post-pregnancy mental health care across Massachusetts health statutes, likely increasing access and clarifying insurer obligations.
- Eliminates cost-sharing for post-pregnancy mental health services in state employee plans (per §2), reducing financial barriers for that population; cost-sharing impacts for other plan types depend on existing statutory/regulatory frameworks and enforcement by regulators under the amended sections.
- May increase utilization of mental health services after pregnancy or miscarriage and could raise costs for payers; regulators will be charged with ensuring compliance and preventing unreasonable restrictions or delays.
Compiled from official sources — confirm details with the bill’s official record.
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