Supporting Premature Infant Nutrition Act of 2025
Summary
The "Supporting Premature Infant Nutrition Act of 2025" aims to amend the Social Security Act and the Public Health Service Act to mandate no-cost coverage of human milk fortifier under Medicaid, the Children's Health Insurance Program (CHIP), and group health plans. This bill ensures that premature infants and those with specific medical needs have access to essential nutritional support. The Act defines 'human milk fortifier' and sets criteria for its medical necessity, including gestational age, birth weight, and specific medical conditions.
Expected Effects
The Act will likely increase healthcare costs for states, insurers, and employers, but it will also improve health outcomes for vulnerable infants. It mandates coverage without cost-sharing, potentially increasing demand for human milk fortifier. The changes are set to take effect on January 1, 2026, with exceptions for states requiring legislative changes to comply with CHIP amendments.
Potential Benefits
- Improved health outcomes for premature infants and infants with specific medical needs.
- Increased access to specialized nutritional support.
- Reduced financial burden on families with premature or medically fragile infants.
- Consistent coverage standards across Medicaid, CHIP, and group health plans.
- Potential for long-term cost savings due to improved infant health and reduced hospital readmissions.
Potential Disadvantages
- Increased healthcare costs for states, insurers, and employers.
- Potential administrative burden for healthcare providers and insurers to implement the new coverage requirements.
- Possible increase in demand for human milk fortifier, potentially straining supply chains.
- The definition of 'medical necessity' may lead to interpretation challenges and potential disputes.
- Potential for increased premiums for health insurance plans due to the expanded coverage mandate.
Most Disadvantaged Areas:
Constitutional Alignment
The bill aligns with the "general Welfare" clause of the Preamble of the US Constitution, as it seeks to promote the health and well-being of vulnerable infants. Congress has the power to legislate on matters related to healthcare and social welfare programs under Article I, Section 8, which grants them the power to collect taxes and provide for the general welfare of the United States. The amendments to the Social Security Act and the Public Health Service Act fall under this purview.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).