SF 2251 (LSB 5156SV (1) 90)

SENATE FILE 2251

BY  COMMITTEE ON HEALTH AND HUMAN SERVICES

(SUCCESSOR TO SSB 3140)

A BILL FOR

An Act relating to eligibility for pregnant women and infants under the Medicaid program, and including effective date provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  Section 249A.3, subsection 1, paragraphs h and l, Code 2024, are amended to read as follows:
   h.  Is a woman who, while pregnant, meets eligibility requirements for assistance under the federal Social Security Act, section 1902(l), and continues to meet the requirements except for income. The woman is eligible to receive assistance until sixty days twelve months after the date pregnancy ends.
   l.  (1)  Is an infant whose family income is not more than two hundred fifteen percent of the federal poverty level, as defined by the most recently revised income guidelines published by the United States department of health and human services.
   (2)  Is a pregnant woman or infant whose family income while pregnant is at or below three two hundred fifteen percent of the federal poverty level, as defined by the most recently revised poverty income guidelines published by the United States department of health and human services, if otherwise eligible.
    Sec. 2.  MEDICAID —— PREGNANT WOMEN —— CONTINUOUS POSTPARTUM COVERAGE —— STATE PLAN AMENDMENTS.  The department of health and human services shall submit a Medicaid state plan amendment to the centers for Medicare and Medicaid services of the United States department of health and human services for approval in accordance with sections 9812 and 9822 of the federal American Rescue Plan Act of 2021, Pub. L. No. 117-2, as amended by section 5113 of the federal Consolidated Appropriations Act of 2023, to provide twelve months of continuous postpartum eligibility under the Medicaid program to a pregnant woman whose family income while pregnant is at or below two hundred fifteen percent of the federal poverty level for the household size, beginning January 1, 2025. The department of health and human services shall also submit a children’s health insurance program state plan amendment to the centers for Medicare and Medicaid services of the United States department of health and human services to update infant eligibility consistent with the provisions of this Act, beginning January 1, 2025.
    Sec. 3.  EFFECTIVE DATE.  The following, being deemed of immediate importance, takes effect upon enactment:
   The section of this Act directing the department of health and human services to submit state plan amendments to the centers for Medicare and Medicaid services of the United States department of health and human services.
    Sec. 4.  EFFECTIVE DATE.  The following takes effect January 1, 2025:
   The section of this Act amending section 249A.3, subsection 1, paragraphs “h” and “l”.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
   This bill amends provisions relating to income eligibility levels for pregnant women and infants under the Medicaid program and provides for the extension of postpartum coverage from 60 days to 12 months.
   Code section 249A.3(1)(h) provides Medicaid eligibility for a woman who while pregnant meets federally required eligibility requirements and continues to meet those requirements, except for income, to receive assistance until 60 days after the pregnancy ends. Provisions of the federal American Rescue Plan Act of 2021 (H.R. 1319) provide the option to states to submit a state plan amendment, effective for a five-year period, to provide postpartum Medicaid coverage for 12 months after pregnancy ends. A provision under the federal Consolidated Appropriations Act of 2023 removed the five-year limitation period for the state plan amendment. The bill amends Code section 249A.3(1)(h) to extend postpartum coverage from 60 days to 12 months after pregnancy ends.
   Code section 249A.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.
   Under Code section 249A.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 12 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.