(1)The Legislature finds that:
(a)Title XXI
of the federal Social Security Act, as amended, and the rules and regulations
promulgated pursuant thereto, authorize the State Children's Health Insurance
Program to assist state efforts to initiate and expand provisions of child
health assistance to uninsured, low-income children;
(b)As defined in Title
XXI of the federal Social Security Act, as amended, and the rules and regulations
promulgated pursuant thereto, child means an individual under the age of nineteen
years, including any period of time from conception to birth, up to age nineteen
years;
(c)Pursuant to Title XXI of the federal Social Security Act, as
amended, and the rules and regulations promulgated pursuant thereto, eligibility
can only be conferred to a targeted low-income c
Free access — add to your briefcase to read the full text and ask questions with AI
(1) The Legislature finds that:
(a) Title XXI
of the federal Social Security Act, as amended, and the rules and regulations
promulgated pursuant thereto, authorize the State Children's Health Insurance
Program to assist state efforts to initiate and expand provisions of child
health assistance to uninsured, low-income children;
(b) As defined in Title
XXI of the federal Social Security Act, as amended, and the rules and regulations
promulgated pursuant thereto, child means an individual under the age of nineteen
years, including any period of time from conception to birth, up to age nineteen
years;
(c) Pursuant to Title XXI of the federal Social Security Act, as
amended, and the rules and regulations promulgated pursuant thereto, eligibility
can only be conferred to a targeted low-income child, including an unborn
child, under a separate child health program;
(d) Under Title XXI of
the federal Social Security Act, as amended, and the rules and regulations
promulgated pursuant thereto, child health assistance is available to benefit
unborn children independent of the mother's eligibility and immigration status;
(e) Under Title
XXI of the federal Social Security Act, as amended, and the rules and regulations
promulgated pursuant thereto, child health assistance expressly includes prenatal
care that connects to the health of the unborn child;
(f) Prenatal care has
been clearly shown to reduce the likelihood of premature delivery or low birth
weight, both of which are associated with a wide range of congenital disabilities
as well as infant mortality, and such care can detect a great number of serious
and even life-threatening disabilities, many of which can now be successfully
treated in utero;
(g) Ensuring prenatal care for more children will significantly
help reduce infant mortality and morbidity rates and will spare many infants
from the burden of congenital disabilities and reduce the cost of treating
those congenital disabilities after birth;
(h) It is well established that access to
prenatal care can improve health outcomes during infancy as well as over a
child's life. Since healthy babies and children require less medical care
than babies and children with health problems, provision of prenatal care
will result in lower medical expenditures for the affected children in the
long run; and
(i) Adopting federal law to provide for medical services related
to unborn children before birth will result in healthier infants, better long-term
child growth and development, and ultimate cost savings to the state through
reduced expenditures for high cost neonatal and potential long-term medical
rehabilitation.
(2) Such coverage shall be implemented through the creation of a
separate program as allowed under Title XXI of the federal Social Security
Act, as amended, and 42 C.F.R. 457.10, solely for the unborn children of mothers
who are ineligible for coverage under Title XIX of the federal Social Security
Act. All other aspects of the medical assistance program relating to the State
Children's Health Insurance Program remain a medicaid expansion program as
defined in 42 C.F.R. 457.10.
(3) The benefits provided pursuant to this
subsection, unless the recipient qualifies for coverage under Title XIX of
the federal Social Security Act, as amended, shall be prenatal care and pregnancy-related
services connected to the health of the unborn child, including: (a) Professional
fees for labor and delivery, including live birth, fetal death, miscarriage,
and ectopic pregnancy; (b) pharmaceuticals and prescription vitamins; (c)
outpatient hospital care; (d) radiology, ultrasound, and other necessary imaging;
(e) necessary laboratory testing; (f) hospital costs related to labor and
delivery; (g) services related to conditions that could complicate the pregnancy,
including those for diagnosis or treatment of illness or medical conditions
that threaten the carrying of the unborn child to full term or the safe delivery
of the unborn child; and (h) other pregnancy-related services approved by
the department. Services not covered under this subsection include medical
issues separate to the mother and unrelated to pregnancy.
(4) The department
shall receive the state and federal funds appropriated or provided for benefits
provided pursuant to this section. Within thirty days after July 19, 2012,
the department shall submit a state plan amendment or waiver for approval
by the federal Centers for Medicare and Medicaid Services to provide coverage
under the medical assistance program to persons eligible under this section.
(5) Eligibility
shall be determined under this section using an income budgetary methodology
that determines children's eligibility at no greater than one hundred eighty-five
percent of the Office of Management and Budget income poverty guideline.