House approves presumptive Medicaid eligibility for expectant mothers

House Bill 539, introducing presumptive eligibility for pregnant women, passed the full House 117-5 on Wednesday and now advances to the Senate. 

The bill, authored by House Medicaid Committee Chairwoman Missy McGee, R-Hattiesburg, allows pregnant women whose net family income is 194% or less of the federal poverty level to be presumed eligible for Medicaid. They could receive medical services before their Medicaid application is officially approved by the Mississippi division of Medicaid. 

For an individual, an income up to 194% of the federal poverty level would be an income up to about $29,000 a year.

The bill does not introduce an additional eligibility category or expand coverage, McGee explained. Rather, it simply allows pregnant women eligible for Medicaid to get into a doctor’s office earlier. 

“So, what the bill proposes,” McGee said, “is that a qualified provider – whether that be (from) the health department, (a Federally Qualified Health Center) or a doctor’s office, who has been trained and approved through Medicaid – would have the ability to presumptively designate a woman eligible for Medicaid when she presents pregnant and presents proof of income … and therefore allow her to get into the doctor’s office early while the division of Medicaid is making that final and official determination that she is eligible.”

Presumptive eligibility would cost the state roughly $560,000, McGee said, compared to the $1 million it can cost the state to care for just one extremely premature baby receiving care in a neonatal intensive care unit – “a minimal investment for a tremendous benefit to women in our state,” McGee said.

The bill allows pregnant women to receive care under presumed Medicaid eligibility for 60 days after their first doctor’s visit. The hope is that by the end of the 60-day window, they will have submitted their paperwork and been fully determined as eligible for Medicaid – since a regular Medicaid application only takes 45 days to process. 

Medicaid application processing times have increased over the last few months due to people being kicked off coverage after the pandemic – the percentage of applications taking longer than 45 days to process was 10.79% last July. By the time this bill would go into effect next July, “unwinding” from the pandemic is expected to be over. 

One of the five representatives who voted no on the bill, Dan Eubanks, R-DeSoto, raised a question on the floor about women who are deemed ineligible during that 60-day period. 

“If Medicaid pays a doctor bill, and then a woman is found to be ineligible in the end, then that is a part of the cost to the state estimated to be, in total, about $567,000 a year,” McGee replied. 

The bill still needs to be passed on the Senate side before it is signed into law, but its rapid passage this early in the legislative session shows promise that it will advance.

Though it’s only a piece of the puzzle, the bill would go a long way in addressing pregnancy outcomes in Mississippi, said Dr. Anita Henderson, pediatrician and former president of the state pediatric association. 

“We are thrilled that the House Medicaid Committee and then the full House passed presumptive eligibility for pregnant women,” Henderson said. “It will really help moms get that first OB visit sooner to start working on their high blood pressure, diabetes, or any chronic medical conditions, infections. The more we can get our moms seen, the more we can help, the more likely we’re going to reduce our premature birth rates, our fetal mortality rates, our infant mortality rates and our maternal mortality rates.”