House File 2583 - Introduced HOUSE FILE 2583 BY COMMITTEE ON HEALTH AND HUMAN SERVICES (SUCCESSOR TO HSB 643) A BILL FOR An Act relating to eligibility for pregnant women and infants 1 under the Medicaid program, and including effective date 2 provisions. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 5156HV (1) 90 pf/ko

H.F. 2583 Section 1. Section 249A.3, subsection 1, paragraphs h and l, 1 Code 2024, are amended to read as follows: 2 h. Is a woman who, while pregnant, meets eligibility 3 requirements for assistance under the federal Social Security 4 Act, section 1902(l), and continues to meet the requirements 5 except for income. The woman is eligible to receive assistance 6 until sixty days twelve months after the date pregnancy ends. 7 l. (1) Is an infant whose family income is not more than 8 two hundred fifteen percent of the federal poverty level, 9 as defined by the most recently revised income guidelines 10 published by the United States department of health and human 11 services. 12 (2) Is a pregnant woman or infant whose family income while 13 pregnant is at or below three two hundred fifteen percent of 14 the federal poverty level, as defined by the most recently 15 revised poverty income guidelines published by the United 16 States department of health and human services, if otherwise 17 eligible. 18 Sec. 2. MEDICAID —— PREGNANT WOMEN —— CONTINUOUS POSTPARTUM 19 COVERAGE —— STATE PLAN AMENDMENTS. The department of health 20 and human services shall submit a Medicaid state plan amendment 21 to the centers for Medicare and Medicaid services of the United 22 States department of health and human services for approval in 23 accordance with sections 9812 and 9822 of the federal American 24 Rescue Plan Act of 2021, Pub. L. No. 117-2, as amended by 25 section 5113 of the federal Consolidated Appropriations Act 26 of 2023, to provide twelve months of continuous postpartum 27 eligibility under the Medicaid program to a pregnant woman 28 whose family income while pregnant is at or below two hundred 29 fifteen percent of the federal poverty level for the household 30 size, beginning January 1, 2025. The department of health and 31 human services shall also submit a children’s health insurance 32 program state plan amendment to the centers for Medicare and 33 Medicaid services of the United States department of health and 34 human services to update infant eligibility consistent with the 35 -1- LSB 5156HV (1) 90 pf/ko 1/ 3

H.F. 2583 provisions of this Act, beginning January 1, 2025. 1 Sec. 3. EFFECTIVE DATE. The following, being deemed of 2 immediate importance, takes effect upon enactment: 3 The section of this Act directing the department of health 4 and human services to submit state plan amendments to the 5 centers for Medicare and Medicaid services of the United States 6 department of health and human services. 7 Sec. 4. EFFECTIVE DATE. The following takes effect January 8 1, 2025: 9 The section of this Act amending section 249A.3, subsection 10 1, paragraphs “h” and “l”. 11 EXPLANATION 12 The inclusion of this explanation does not constitute agreement with 13 the explanation’s substance by the members of the general assembly. 14 This bill amends provisions relating to income eligibility 15 levels for pregnant women and infants under the Medicaid 16 program and provides for the extension of postpartum coverage 17 from 60 days to 12 months. 18 Code section 249A.3(1)(h) provides Medicaid eligibility for 19 a woman who while pregnant meets federally required eligibility 20 requirements and continues to meet those requirements, except 21 for income, to receive assistance until 60 days after the 22 pregnancy ends. Provisions of the federal American Rescue Plan 23 Act of 2021 (H.R. 1319) provide the option to states to submit 24 a state plan amendment, effective for a five-year period, 25 to provide postpartum Medicaid coverage for 12 months after 26 pregnancy ends. A provision under the federal Consolidated 27 Appropriations Act of 2023 removed the five-year limitation 28 period for the state plan amendment. The bill amends Code 29 section 249A.3(1)(h) to extend postpartum coverage from 60 days 30 to 12 months after pregnancy ends. 31 Code section 249A.3(1)(l)(1) provides a separate basis for 32 Medicaid eligibility for an infant whose income is not more 33 than 200 percent of the federal poverty level (FPL). The bill 34 amends this provision to provide eligibility for an infant 35 -2- LSB 5156HV (1) 90 pf/ko 2/ 3

H.F. 2583 whose family income is not more than 215 percent of the FPL. 1 Under Code section 249A.3(1)(l)(2), a pregnant woman or 2 infant whose family income is at or below 300 percent of the 3 FPL, if otherwise eligible, is eligible for Medicaid. The bill 4 amends this provision to provide eligibility for a pregnant 5 woman whose family income while pregnant is at or below 215 6 percent of the FPL, if otherwise eligible. 7 The bill requires HHS to submit a Medicaid state plan 8 amendment to the centers for Medicare and Medicaid services 9 of the United States department of health and human services 10 (CMS) for approval in accordance with the provisions in federal 11 law to provide 12 months of continuous postpartum eligibility 12 under the Medicaid program to a pregnant woman whose family 13 income while pregnant is at or below 215 percent of the federal 14 poverty level for the household size, beginning January 1, 15 2025. The bill also requires HHS to submit a children’s 16 health insurance program state plan amendment to CMS to update 17 infant eligibility consistent with the provisions of the bill, 18 beginning January 1, 2025. 19 The section of the bill directing HHS to submit state plan 20 amendments to the federal government for approval takes effect 21 upon enactment; and the section of the bill amending Code 22 provisions relating to Medicaid eligibility for pregnant women 23 and infants takes effect January 1, 2025. 24 -3- LSB 5156HV (1) 90 pf/ko 3/ 3