Update on Pregnancy-Related Medicaid and Minimum Essential Coverage

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June 2016 | Medicaid and Other Payers

In its March 2014 report, the Commission looked in depth at the challenges resulting from overlapping Medicaid and exchange eligibility for pregnant women, in part related to variation across states in Medicaid-covered benefits.  The Commission made two recommendations focused on reducing inequities for pregnant women in Medicaid-covered benefits as well as mitigating the impact of potential churning between Medicaid and exchange plans. Federal guidance has since clarified the options available to pregnant women. As a result, the coverage options available to most women depend on a woman’s existing coverage, whether she is pregnant at the time of enrollment, and the time of year at which she seeks coverage, although additional options may be available to women in a handful of states.

This brief reviews the issues that led to the Commission’s 2014 recommendations and provides further details on the updated guidance and Secretary-approved minimum essential coverage determinations.

Publication Type: Issue Briefs

Tags: benefits, churning, eligibility, exchanges, Medicaid and other payers, pregnant women, prenatal care