Relating to eligibility for pregnant women and infants under the Medicaid program, and including effective date provisions

A provision under the federal Consolidated Appropriations Act of 2023 removed the five-year limitation period for the state plan amendment.3(1)(h) to extend postpartum coverage from days to months after pregnancy ends.3(1)(l)(1) provides a separate basis for Medicaid eligibility for an infant whose income is not more than 200 percent of the federal poverty level (FPL). The bill amends this provision to provide eligibility for an infant whose family income is not more than 215 percent of the FPL.3(1)(l)(2), a pregnant woman or infant whose family income is at or below 300 percent of the FPL, if otherwise eligible, is eligible for Medicaid. The bill amends this provision to provide eligibility for a pregnant woman whose family income while pregnant is at or below 215 percent of the FPL, if otherwise eligible. The bill requires HHS to submit a Medicaid state plan amendment to the centers for Medicare and Medicaid services of the United States department of health and human services (CMS) for approval in accordance with the provisions in federal law to provide months of continuous postpartum eligibility under the Medicaid program to a pregnant woman whose family income while pregnant is at or below 215 percent of the federal poverty level for the household size, beginning January 1, 2025. The bill also requires HHS to submit a children’s health insurance program state plan amendment to CMS to update infant eligibility consistent with the provisions of the bill, beginning January 1, 2025. The section of the bill directing HHS to submit state plan amendments to the federal government for approval takes effect upon enactment; and the section of the bill amending Code provisions relating to Medicaid eligibility for pregnant women and infants takes effect January 1, 2025.