House Study Bill 643 - Introduced
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BY (PROPOSED GOVERNOR BILL)
A BILL FOR
1 An Act relating to eligibility for pregnant women and infants
2 under the Medicaid program, and including effective date
3 provisions.
4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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1 Section 1. Section 249A.3, subsection 1, paragraphs h and l,
2 Code 2024, are amended to read as follows:
3 h. Is a woman who, while pregnant, meets eligibility
4 requirements for assistance under the federal Social Security
5 Act, section 1902(l), and continues to meet the requirements
6 except for income. The woman is eligible to receive assistance
7 until sixty days twelve months after the date pregnancy ends.
8 l. (1) Is an infant whose family income is not more than
9 two hundred fifteen percent of the federal poverty level,
10 as defined by the most recently revised income guidelines
11 published by the United States department of health and human
12 services.
13 (2) Is a pregnant woman or infant whose family income while
14 pregnant is at or below three two hundred fifteen percent of
15 the federal poverty level, as defined by the most recently
16 revised poverty income guidelines published by the United
17 States department of health and human services, if otherwise
18 eligible.
19 Sec. 2. MEDICAID —— PREGNANT WOMEN —— CONTINUOUS POSTPARTUM
20 COVERAGE —— STATE PLAN AMENDMENTS. The department of health
21 and human services shall submit a Medicaid state plan amendment
22 to the centers for Medicare and Medicaid services of the United
23 States department of health and human services for approval in
24 accordance with sections 9812 and 9822 of the federal American
25 Rescue Plan Act of 2021, Pub. L. No. 117-2, as amended by
26 section 5113 of the federal Consolidated Appropriations Act
27 of 2023, to provide twelve months of continuous postpartum
28 eligibility under the Medicaid program to a pregnant woman
29 whose family income while pregnant is at or below two hundred
30 fifteen percent of the federal poverty level for the household
31 size, beginning January 1, 2025. The department of health and
32 human services shall also submit a children’s health insurance
33 program state plan amendment to the centers for Medicare and
34 Medicaid services of the United States department of health and
35 human services to update infant eligibility consistent with the
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1 provisions of this Act, beginning January 1, 2025.
2 Sec. 3. EFFECTIVE DATE. The following, being deemed of
3 immediate importance, takes effect upon enactment:
4 The section of this Act directing the department of health
5 and human services to submit state plan amendments to the
6 centers for Medicare and Medicaid services of the United States
7 department of health and human services.
8 Sec. 4. EFFECTIVE DATE. The following takes effect January
9 1, 2025:
10 The section of this Act amending section 249A.3, subsection
11 1, paragraphs “h” and “l”.
12 EXPLANATION
13 The inclusion of this explanation does not constitute agreement with
14 the explanation’s substance by the members of the general assembly.
15 This bill amends provisions relating to income eligibility
16 levels for pregnant women and infants under the Medicaid
17 program and provides for the extension of postpartum coverage
18 from 60 days to 12 months.
19 Code section 249A.3(1)(h) provides Medicaid eligibility for
20 a woman who while pregnant meets federally required eligibility
21 requirements and continues to meet those requirements, except
22 for income, to receive assistance until 60 days after the
23 pregnancy ends. Provisions of the federal American Rescue Plan
24 Act of 2021 (H.R. 1319) provide the option to states to submit
25 a state plan amendment, effective for a five-year period,
26 to provide postpartum Medicaid coverage for 12 months after
27 pregnancy ends. A provision under the federal Consolidated
28 Appropriations Act of 2023 removed the five-year limitation
29 period for the state plan amendment. The bill amends Code
30 section 249A.3(1)(h) to extend postpartum coverage from 60 days
31 to 12 months after pregnancy ends.
32 Code section 249A.3(1)(l)(1) provides a separate basis for
33 Medicaid eligibility for an infant whose income is not more
34 than 200 percent of the federal poverty level (FPL). The bill
35 amends this provision to provide eligibility for an infant
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1 whose family income is not more than 215 percent of the FPL.
2 Under Code section 249A.3(1)(l)(2), a pregnant woman or
3 infant whose family income is at or below 300 percent of the
4 FPL, if otherwise eligible, is eligible for Medicaid. The bill
5 amends this provision to provide eligibility for a pregnant
6 woman whose family income while pregnant is at or below 215
7 percent of the FPL, if otherwise eligible.
8 The bill requires HHS to submit a Medicaid state plan
9 amendment to the centers for Medicare and Medicaid services
10 of the United States department of health and human services
11 (CMS) for approval in accordance with the provisions in federal
12 law to provide 12 months of continuous postpartum eligibility
13 under the Medicaid program to a pregnant woman whose family
14 income while pregnant is at or below 215 percent of the federal
15 poverty level for the household size, beginning January 1,
16 2025. The bill also requires HHS to submit a children’s
17 health insurance program state plan amendment to CMS to update
18 infant eligibility consistent with the provisions of the bill,
19 beginning January 1, 2025.
20 The section of the bill directing HHS to submit state plan
21 amendments to the federal government for approval takes effect
22 upon enactment; and the section of the bill amending Code
23 provisions relating to Medicaid eligibility for pregnant women
24 and infants takes effect January 1, 2025.
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