PRIA Logo™
Title 42, The Public Health and WelfareRelease 119-110

§300gg–51 Standards Relating to Benefits for Mothers and Newborns

Title 42 › CHAPTER 6A — PUBLIC HEALTH SERVICE › SUBCHAPTER XXV — REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE › Part B — Individual Market Rules › subpart 2 — other requirements › § 300gg–51

Last updated Sep 23, 2026|Official source

Summary

Health insurers that sell individual health plans must follow the same maternal and newborn coverage rules that apply to small and large employer group plans under federal law 2704, except for parts (d) and (f). These insurers must also give the same notice to enrollees that group plans must give under federal labor law (29 U.S.C. 1185(d)) as if the insurer were a group health plan. If a State has a law that requires at least a 48-hour hospital stay after a normal vaginal birth and at least a 96-hour stay after a cesarean, or a law that requires maternity and pediatric care follow professional guidelines (like those from the American College of Obstetricians and Gynecologists or the American Academy of Pediatrics), or a law that leaves the length of stay to the doctor and the mother, then the federal requirements above do not apply to coverage in that State. A separate federal rule about preemption (300gg–62(a)) does not override those State laws.

Full Legal Text

Title 42, §300gg–51

The Public Health and Welfare, Source: USLM XML via OLRC

(a)In general
The provisions of section 2704 (other than subsections (d) and (f)) shall apply to health insurance coverage offered by a health insurance issuer in the individual market in the same manner as it applies to health insurance coverage offered by a health insurance issuer in connection with a group health plan in the small or large group market.
(b)Notice requirement
A health insurance issuer under this part shall comply with the notice requirement under section 1185(d) of title 29 with respect to the requirements referred to in subsection (a) as if such section applied to such issuer and such issuer were a group health plan.
(c)Preemption; exception for health insurance coverage in certain States
(1)In general
The requirements of this section shall not apply with respect to health insurance coverage if there is a State law (as defined in section 300gg–23(d)(1) 1 of this title) for a State that regulates such coverage that is described in any of the following subparagraphs: (A)
(B)Such State law requires such coverage to provide for maternity and pediatric care in accordance with guidelines established by the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, or other established professional medical associations.
(C)Such State law requires, in connection with such coverage for maternity care, that the hospital length of stay for such care is left to the decision of (or required to be made by) the attending provider in consultation with the mother.
(2)Construction
section 300gg–62(a) of this title shall not be construed as superseding a State law described in paragraph (1).

Legislative History

Notes & Related Subsidiaries

Editorial Notes

References in Text

section 2704, referred to in subsec. (a), is a reference to section 2704 of act
July 1, 1944. section 2704, which was classified to section 300gg–4 of this title, was renumbered section 2725, and amended by Pub. L. 111–148, title I, §§ 1001(2), 1563(c)(3), formerly § 1562(c)(3), title X, § 10107(b)(1), Mar. 23, 2010, 124 Stat. 130, 265, 911, and was transferred to section 300gg–25 of this title. A new section 2704 of act
July 1, 1944, related to prohibition of preexisting condition exclusions or other discrimination based on health status, was added, effective for plan years beginning on or after Jan. 1, 2014, with certain exceptions, and amended, by Pub. L. 111–148, title I, §§ 1201(2), 1563(c)(1), formerly § 1562(c)(1), title X, § 10107(b)(1), Mar. 23, 2010, 124 Stat. 154, 264, 911, and is classified to section 300gg–3 of this title. section 300gg–23(d)(1) of this title, referred to in subsec. (c)(1), was in the original “section 2723(d)(1)”, and was translated as meaning section 2724(d)(1) of act
July 1, 1944, to reflect the probable intent of Congress and the renumbering of section 2723 as 2724 by Pub. L. 111–148, title I, §§ 1001(4), 1563(c)(14)(B), formerly § 1562(c)(14)(B), title X, § 10107(b)(1), Mar. 23, 2010, 124 Stat. 130, 269, 911.

Statutory Notes and Related Subsidiaries

Effective Date

Section applicable to health insurance coverage offered, sold, issued, renewed, in effect, or operated in the individual market on or after Jan. 1, 1998, see section 605(c) of Pub. L. 104–204, set out as an

Effective Date

of 1996 Amendment note under section 300gg–44 of this title.

Reference

Citations & Metadata

Citation

42 U.S.C. § 300gg–51

Title 42, The Public Health and Welfare

Last Updated

Sep 23, 2026

Release point: 119-110