HB414 would create a new state policy framework for perinatal palliative care in Kentucky. The bill defines perinatal palliative care broadly as coordinated medical, emotional, counseling, spiritual, and bereavement support for pregnant women, birth fathers, babies, and family members when a prenatal diagnosis suggests the baby may die before or shortly after birth, when fetal anomalies make long-term survival uncertain or minimal, or when a newborn is diagnosed with a potentially life-limiting illness. Hospitals, alternative birthing centers, maternal-fetal medicine providers, and midwives would be required to provide the care directly or make referrals, and the Cabinet for Health and Family Services would have to maintain a public list of providers and programs.
The bill also requires health benefit plans to cover these perinatal palliative care services, subject to federal rules for qualified health plans and possible waiver or cost-defrayal issues. It amends several existing statutes governing state employee health insurance, Medicaid, KCHIP, and public postsecondary institution health plans so that those programs must comply with the new coverage mandate. In addition, it adds special enrollment protections for pregnant women in state and public employee health plans. The bill takes effect in stages, with most coverage-related provisions beginning January 1, 2026.
Beyond insurance coverage, HB414 includes a broader policy statement that the state should support families facing life-limiting prenatal or newborn diagnoses with dignity and compassion. The bill cites medical organizations such as the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, and the Society for Maternal-Fetal Medicine in support of perinatal palliative care as a coordinated care strategy focused on comfort and quality of life. It also states that nothing in the new section may be interpreted to permit any violation of Kentucky’s abortion law, and it expressly allows the act’s first section to be cited as the “Love Them Both Act of 2025.”
The bill’s impact on state law would be significant because it creates a new statutory requirement for providers and insurers to offer or cover perinatal palliative care, and it inserts that requirement into multiple public coverage systems, including Medicaid, KCHIP, state employee plans, and university-sponsored plans. It would also require the state to publish provider information and, where necessary, seek federal approvals or waivers to implement the coverage mandate without jeopardizing federal funding. Affected parties would include hospitals, birthing centers, midwives, insurers, Medicaid managed care organizations, state agencies, and families receiving high-risk prenatal or neonatal diagnoses.
Because there are no committee transcripts or votes provided, there is no recorded legislative debate or vote history to gauge support or opposition. Based on the bill text alone, the measure appears designed to appeal to supporters of expanded family-centered care and opponents of abortion by framing perinatal palliative care as an alternative supportive pathway. The most likely points of contention are the insurance mandate, the administrative and fiscal burden on public programs and insurers, and the bill’s explicit anti-abortion framing and interaction with Kentucky abortion law.
HB414 would add a new statutory requirement in KRS Chapter 216 for hospitals, alternative birthing centers, maternal-fetal medicine providers, and midwives to provide or refer for perinatal palliative care, and it would require the Cabinet for Health and Family Services to maintain a public list of providers. It would also amend Kentucky insurance and public-benefit statutes to require coverage of those services in private health plans, state employee plans, public postsecondary employee plans, Medicaid, and KCHIP, while directing state agencies to seek any needed federal approvals or waivers. The bill would therefore affect insurers, public health programs, health care providers, and families facing life-limiting prenatal or newborn diagnoses.
No committee discussion or vote record was provided, so there is no documented legislative sentiment from hearings or roll calls. From the bill text, the measure is presented in strongly supportive and compassionate terms, emphasizing dignity, family support, and medical consensus. Its framing suggests likely support from advocates of perinatal hospice/palliative care and from lawmakers seeking to pair that support with an anti-abortion policy message.
The main likely points of contention are whether the state should mandate coverage for perinatal palliative care across private and public plans, the cost and administrative burden of implementing those mandates, and whether the bill’s references to abortion law and its “Love Them Both” framing are appropriate or politically motivated. Another possible issue is federal compliance, since the bill anticipates that some qualified health plans may require cost-defrayal payments or waivers before the new coverage can apply. No specific objections or supporters are identified in the provided materials.