Presumptive Eligibility for Pregnant Women
States can adopt a policy that makes a pregnant woman “presumptively” eligible for Medicaid once she submits preliminary income information.1
States have new opportunities to use presumptive eligibility to provide health services through Medicaid. States that adopt the Medicaid family planning expansion can take advantage of presumptive eligibility for women who need family planning services (effective immediately). Starting in 2014, states can choose to allow qualified hospital to use presumptive eligibility to provide services to all potential Medicaid enrollees.
Does the state provide presumptive Medicaid eligibility for pregnant women?
States receive a "meets policy" if they allow a pregnant woman to receive Medicaid coverage while her application is being approved. States that do not consider a pregnant woman to be presumptively eligible for Medicaid receive a "no policy."
| State | Strength of Policy | Change from 2007 |
|---|---|---|
| Alabama | No Policy | Same |
| Alaska | No Policy | Same |
| Arizona | No Policy | Same |
| Arkansas | Meets Policy | Same |
| California | Meets Policy | Same |
| Colorado | Meets Policy | Same |
| Connecticut 2 | Meets Policy | Same |
| Delaware | Meets Policy | Same |
| District of Columbia | Meets Policy | Same |
| Florida | Meets Policy | Same |
| Georgia | Meets Policy | Same |
| Hawaii | No Policy | Same |
| Idaho | Meets Policy | Same |
| Illinois | Meets Policy | Same |
| Indiana | Meets Policy | Better |
| Iowa | Meets Policy | Same |
| Kansas | No Policy | Same |
| Kentucky | Meets Policy | Same |
| Louisiana 3 | Meets Policy | Same |
| Maine | Meets Policy | Same |
| Maryland 4 | Meets Policy | Better |
| Massachusetts | Meets Policy | Same |
| Michigan | Meets Policy | Same |
| Minnesota | No Policy | Same |
| Mississippi | No Policy | Same |
| Missouri | Meets Policy | Same |
| Montana | Meets Policy | Same |
| Nebraska | Meets Policy | Same |
| Nevada | No Policy | Same |
| New Hampshire | Meets Policy | Same |
| New Jersey | Meets Policy | Same |
| New Mexico | Meets Policy | Same |
| New York | Meets Policy | Same |
| North Carolina | Meets Policy | Same |
| North Dakota | No Policy | Same |
| Ohio 5 | Meets Policy | Same |
| Oklahoma | Meets Policy | Same |
| Oregon | No Policy | Same |
| Pennsylvania | Meets Policy | Same |
| Rhode Island | No Policy | Same |
| South Carolina 6 | Meets Policy | Same |
| South Dakota | No Policy | Same |
| Tennessee | Meets Policy | Same |
| Texas | Meets Policy | Same |
| Utah | Meets Policy | Same |
| Vermont | No Policy | Same |
| Virginia | No Policy | Same |
| Washington | No Policy | Same |
| West Virginia | No Policy | Same |
| Wisconsin | Meets Policy | Same |
| Wyoming | Meets Policy | Same |
Data Source: The Henry J. Kaiser Family Foundation, "Has Presumptive Eligibility Under Medicaid for Pregnant Women," December 2009, available at http://www.statehealthfacts.org/comparetable.jsp?ind=225&cat=4, accessed September 7, 2010.
Footnotes
1 States may provide for making ambulatory prenatal care available to a pregnant woman during a presumptive eligibility period. 42 U.S.C. § 1396r-1 (2009).
2 Connecticut has an alternative, presumptive eligibility-like process in place. The 2010 health report card gives full credit to Connecticut for this alternative process; the 2007 health report card did not give the state credit though the process was in place at that time. This represents a change in the way Connecticut is graded and not an actual change in policy, thus no change is reported from 2007 to 2010.
3 Louisiana has an alternative, presumptive eligibility-like process in place.
4 Maryland has an alternative, presumptive eligibility-like process in place.
5 Ohio has an alternative, presumptive eligibility-like process in place. The 2010 health report card gives full credit to Ohio for this alternative process; the 2007 health report card did not give the state credit though the process was in place at that time. This represents a change in the way Ohio is graded and not an actual change in policy, thus no change is reported from 2007 to 2010.
6 South Carolina has an alternative, presumptive eligibility-like process in place. The 2010 health report card gives full credit to South Carolina for this alternative process; the 2007 health report card did not give the state credit though the process was in place at that time. This represents a change in the way South Carolina is graded and not an actual change in policy, thus no change is reported from 2007 to 2010.
