Senate Bill No. 806 aims to expand Medicaid coverage for the treatment of certain emergency medical conditions, effective July 1, 2025. The bill defines "emergency medical condition" as a medical issue, including emergency labor and delivery, that presents acute symptoms severe enough to potentially jeopardize a patient's health, impair bodily functions, or cause dysfunction of any organ or body part. The bill mandates the Commissioner of Social Services to broaden emergency Medicaid coverage to include specific conditions such as high-risk pregnancies, Type 1 diabetes in individuals under 21, diabetic emergencies, renal failure requiring dialysis, and various other acute medical situations.

Additionally, the bill requires the Commissioner to establish an administrative system by July 1, 2026, allowing individuals to apply in advance for emergency Medicaid coverage for outpatient treatment of qualifying conditions. This system will include a prominent link to the application and a list of covered conditions on the Department of Social Services' website, as well as information in department forms and policy manuals. The bill is expected to incur administrative costs of at least $250,000 in FY 26, with a potential revenue gain of at least $125,000 from federal reimbursement.