AN ACT TO AMEND TITLES 18, 29, AND 31 OF THE DELAWARE CODE RELATING TO INSURANCE COVERAGE FOR TERMINATION OF PREGNANCY.

Section 1 amends Title 31 to require all health benefit plans delivered or issued for Medicaid to cover services related to the termination of pregnancy. Coverage provided under this section is not subject to any deductible, coinsurance, copayment, or any other cost-sharing requirement and must cover the full scope of services permissible under the law. It also moves the definition of “carrier” out of individual provisions and into the general definition section for the chapter. Section 2 adds a definition of “religious employer” to Title 18. Sections 3 and 4 amend Title 18 to require both individual and group health carriers to cover services related to the termination of pregnancy with identical cost-sharing prohibitions. Certain types of limited coverage plans are exempt from the requirement, and HDHP and catastrophic plans are exempt from the cost-sharing prohibitions if such requirements would cause them to lose their status and treatment under federal law. A religious employer may obtain an exclusion from the carrier if the requirements conflict with the organization’s bona fide religious beliefs and practices. Section 5 amends Title 29 to require coverage for services related to the termination of pregnancy under the state employee health plan. Coverage shall not be subject to any deductible, coinsurance, copayment, or any other cost-sharing requirement and shall apply to the full scope of services permissible under the law. The changes to Medicaid and the state employee health plan are effective January 1 of the year following enactment. The changes to insurance requirements for private group, blanket, and individual coverage are effective for policies issued, renewed, or altered after December 31, 2025. This substitute differs from the original bill as follows: (1) It makes several technical corrections; (2) It limits the permissible applications of referral, prior authorization, and in-network requirements to ensure full and timely access to covered services; (3) It requires federal funds to be used for Medicaid services wherever the use of federal funds is allowed and specifies State funds will otherwise be used for covered services; (4) It adds a definition of religious employer and requires a religious employer to cover services when the life or health of the covered individual is at risk; (5) It changes the effective and application dates of the coverage requirements; (6) It caps the benefit at $750 per year per covered individual for Medicaid; and for private insurance it allows the benefit to be limited to $750 per covered individual per year. The bill also makes a technical change by moving the definition of “carrier” out of individual sections of Chapter 5 of Title 29 and into the general definitions section for that chapter.