State Options to Provide Pregnancy-Related Coverage in CHIP

States may elect to offer full-benefit CHIP coverage for pregnant individuals once they raise pregnancy Medicaid income eligibility to at least 185% FPL.

States can also use the CHIP-funded "unborn child" option to offer limited benefits from conception to birth when the mother is not eligible for Medicaid. States may finance a postpartum coverage period for this population using a CHIP Health Services Initiative.¹

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Updated March 2023
¹ The State Children’s Health Insurance Program (CHIP) allows states to use a limited amount of CHIP funding to implement health services initiatives (HSIs) focused on improving the health of eligible children. Permissible activities include public health programs or the provision of certain services, including preventive care and other interventions, to improve the health of low-income children eligible for CHIP or Medicaid, and other low-income children.
² Colorado enacted the Health Benefits For Colorado Children And Pregnant Persons in 2022 to cover prenatal and postpartum care for all children, pregnant, and postpartum people regardless of immigration status.
³ Maryland enacted the Healthy Babies Equity Act in 2022 to cover prenatal and postpartum care for undocumented immigrants.
⁴ Massachusetts uses state-only funds to cover 12 months of postpartum coverage for people in the unborn child category.
⁵ In 2022, New Jersey and Vermont began using state-only funds to provide pregnancy coverage or some pregnancy-related services for individuals who are not otherwise eligible for coverage.

Notes: January 2023 income limits reflect Modified Adjusted Gross Income (MAGI)-converted income standards and include a disregard equal to five percentage points of the federal poverty level (FPL). The FPL for a family of three is $24,860 as of January 2023.

Source:
Brooks, T., et. al. “Medicaid and CHIP Eligibility, Enrollment, and Renewal Policies as States Prepare for the Unwinding of the Pandemic-Era Continuous Enrollment Provision” (Washington DC: Georgetown University Center for Children and Families and Henry J. Kaiser Family Foundation, March 2023), Table 2, available at https://www.kff.org/medicaid/report/medicaid-and-chip-eligibility-enrollment-and-renewal-policies-as-states-prepare-for-the-unwinding-of-the-pandemic-era-continuous-enrollment-provision/