HB 110 — AN ACT TO AMEND TITLES 18, 29, AND 31 OF THE DELAWARE CODE RELATING TO INSURANCE COVERAGE FOR TERMINATION OF PREGNANCY.

Summary

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.

Bill Text

• Bill Text View text Current pdf

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The bill mandates insurance coverage for termination of pregnancy services across several categories, including Medicaid and state employee health plans, and outlines specific cost-sharing requirements and exemptions for religious employers.

• § 533. Services related to termination of pregnancy.

  coverage for services related to the termination of pregnancy up to a maximum of $750 per covered individual per year → Carriers shall cover services related to the termination of pregnancy up to a maximum of $750 per covered individual per year in all health benefit plans delivered or issued for delivery under § 505(3) of this title.

  This change specifies that all health benefit plans for Medicaid must cover termination of pregnancy services up to a specified annual limit.

• § 3370G. Services related to termination of pregnancy.

  coverage provided under this section may not be subject to any deductible, coinsurance, copayment, or any other cost-sharing requirement. → Except as provided in paragraphs (b)(1)b. and (b)(1)c. of this section, coverage provided under this section may not be subject to any deductible, coinsurance, copayment, or any other cost-sharing requirement.

  This change clarifies that coverage for termination of pregnancy services cannot require cost-sharing, with certain exceptions.

• § 3571AA. Services related to termination of pregnancy.

  coverage under this section may be limited to $750 per covered individual per year. → Coverage under this section may be limited to $750 per covered individual per year.

  This establishes a maximum limit on coverage for termination of pregnancy services similar to other provisions.

• Coverage provided under this section must be funded by State resources if services are not eligible for federal funds. If federal funds are permitted to be used for services under this section, then federal funds must be used.

  This addition specifies how coverage for termination of pregnancy services will be funded, depending on federal eligibility.

• § 5217. Services related to the termination of pregnancy.

  Such coverage may not be subject to any deductible, coinsurance, copayment, or any other cost-sharing requirement and must cover the full scope of services permissible under the law. → The plan shall provide coverage for services related to the termination of pregnancy. Such coverage may not be subject to any deductible, coinsurance, copayment, or any other cost-sharing requirement and must cover the full scope of services permissible under the law.

  This reaffirms that the state employee health plan must not impose cost-sharing on termination of pregnancy services.

• § 102. Definitions.

  “Religious employer” means an employer that is both of the following: a. A church, convention, association of churches, or elementary or secondary school that is controlled, operated, or principally supported by a church or convention or association of churches. b. Qualified as a tax-exempt organization under 26 U.S.C. § 501(c) (3).

  This addition establishes a definition for 'religious employer' within the insurance statutes.

• § 3571AA. Services related to termination of pregnancy.

  A religious employer may request, and the plan must grant, an exclusion from the coverage requirement if the coverage requirement conflicts with the religious organization’s bona fide religious beliefs and practices. → A religious employer may request, and the plan must grant, an exclusion from the coverage requirement if the coverage requirement conflicts with the religious organization’s bona fide religious beliefs and practices. If such employer obtains an exclusion, it must provide its employees reasonable and timely notice of the exclusion.

  This change requires employers who are religious organizations to notify employees if they are granted an exclusion from coverage for termination of pregnancy services.

Action History

1. September 09, 2024

   Signed by Governor

2. June 25, 2024

   Passed By Senate. Votes: 15 YES 6 NO

3. June 25, 2024

   Reported Out of Committee (Finance) in Senate with 4 On Its Merits

4. June 12, 2024

   Assigned to Finance Committee in Senate

5. June 12, 2024

   Reported Out of Committee (Health & Social Services) in Senate with 4 Favorable

6. May 23, 2024

   Assigned to Health & Social Services Committee in Senate

7. May 23, 2024

   Passed By House. Votes: 26 YES 11 NO 4 ABSENT

8. April 17, 2024

   Reported Out of Committee (Appropriations) in House with 4 On Its Merits

9. April 11, 2024

   Adopted in lieu of the original bill HB 110, and Assigned to Appropriations Committee in House

Sponsors

• David P. Sokola · Primary
• Cyndie Romer · Primary
• Marie Pinkney · Primary
• Eric Morrison · Primary
• Bryan Townsend · Primary
• Kendra Johnson · Primary
• William Bush · Primary
• Russell Huxtable · Primary
• Melissa Minor-Brown · Primary
• Valerie Longhurst · Primary
• Peter C. Schwartzkopf · Primary
• Sarah McBride · Primary
• Sean Matthews · Primary
• Paul S. Baumbach · Primary

Votes

Subjects