Senate provision to boot pregnant women off of Medicaid violates federal regulations

We wrote a brief, which you can read here, about a Senate budget provision that will throw thousands of pregnant women off of Medicaid. The bill moves Medicaid eligibility for pregnant women from 185 percent of federal poverty level (about $21,000 per year for a single person) to 133 percent of federal poverty level (or about $15,000 per year for a single person).

The Senate also creates a small voucher program to help some of these women purchase private insurance, but the way the provision is written means that very few women, if any, will qualify for full coverage during their entire pregnancy.

Besides violating good sense, it also turns out that this provision violates federal regulation.

The federal rule regarding Medicaid eligibility says that states can’t cut the minimum income for pregnant women to qualify below what the state had authorized by July 1, 1989. This date was chosen because many states expanded Medicaid eligibility for pregnant women in 1988 and 1989.

In its 1989 budget (which became effective on July 1, 1989) the North Carolina legislature authorized Medicaid eligibility for pregnant women to increase to 150 percent of the federal poverty level. Although the increase to 150 percent of federal poverty level did not take effect until 1990, the higher rate was authorized by July 1, 1989.

That means that the North Carolina legislature, even if it is determined to kick pregnant women out of Medicaid, can’t set eligibility below 150 percent of the federal poverty level. This is just one more reason to delay or cancel this ill conceived plan until we understand its impact.

4 Comments

  1. Doug

    June 4, 2013 at 7:41 pm

    Guess this will have to be tested via lawsuit. We’ll see how it works out.

  2. Adam Linker

    June 4, 2013 at 9:50 pm

    Or they could just take it out of the budget. But if they keep it in it will be tested and the legislature has a terrible record in the courtroom.

  3. NoGOPinNC

    June 5, 2013 at 12:08 pm

    They love wasting our money on misguided policies….the GOP used to at least pretend to care about fetuses, now not so much.

  4. Doug

    June 5, 2013 at 4:45 pm

    Probably test the legal waters. Get the right judge and you’re golden.