Requires health insurance and Medicaid coverage for family planning and reproductive health care services; prohibits adverse actions by medical malpractice insurers in relation to performance of legally protected health care services.*
What changed between versions
A new definition of 'family planning and reproductive health care services' was added in section 2, covering six categories: abortion, emergency maternal/newborn services, family planning counseling (contraception, pregnancy detection, options counseling), family planning lab tests including genetic testing and genetic counselor visits, inpatient hospital/laboratory/ultrasound services for pregnancy and postpartum care and newborns, and well-baby medical care. Childbirth is explicitly excluded.
All coverage requirements (private insurance, State Health Benefits Commission, School Employees' Health Benefits Commission, and Medicaid) were expanded from requiring coverage for 'abortion' to requiring coverage for the broader 'family planning and reproductive health care services' category.
A new legislative finding (paragraph h) was added stating that individuals' ability to choose family size and timing of children leads to lower infant and child mortality rates, improved economic conditions for women and families, and enhanced maternal health.
A new cost-sharing exception was added: carriers may impose deductibles, coinsurance, or copayments for family planning lab tests (paragraph 4) and inpatient hospital/laboratory/ultrasound services (paragraph 5) if those services are provided by an out-of-network provider. This applies across all insurance tiers including Medicaid.
The religious employer exclusion provision was replaced. The original bill created a new mechanism allowing religious employers to request coverage exclusions based on bona fide religious beliefs. The reprint instead references the existing exclusion in section 3 of P.L.2021, c.375 (C.26:2S-39), and the repeal of that existing provision was struck from the bill.
For the State Health Benefits Commission and School Employees' Health Benefits Commission sections, the restriction on prior authorization and delays was shifted from applying to 'a contract' to applying directly to the commission itself. The commissions are now the entities that shall not impose restrictions or require prior authorization.
Effective date provisions were renumbered to reflect the new section structure: sections 1 through 6 (previously 1-3) take effect on the first day of the third month following enactment, and sections 7 through 9 (previously 4-9) take effect immediately.
