House revises presumptive Medicaid eligibility for pregnant women to align with federal guidelines

• A 2024 Mississippi law is being revised to remove the requirement that women show proof of income, as directed by the federal government.

Last week, the Mississippi House of Representatives passed a bill to clean up language concerning presumptive Medicaid eligibility for low-income pregnant women by a vote of 115-3.

Presumptive eligibility refers to the process of granting Medicaid services to those who may qualify before their eligibility is verified by the program.

A similar bill – HB 539 – passed the Legislature in the 2024 session and was signed into law by Governor Tate Reeves (R). The 2024 legislation passed the House by a vote of 117-5 and the Senate by a vote of 48-4.

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However, due to a discrepancy lawmakers learned about over the summer, new legislation that removed language that requires women to show proof of income was needed to align with federal guidelines.

Also, the new legislation revises the 60-day presumptive eligibility for pregnant women to however long it takes for her Medicaid application to be approved, with the caveat being that application must be made by the end of the second month of presumptive eligibility coverage.

State Rep. Missy McGee (R), chair of the House Medicaid Committee, is hopeful that the updated measure – HB 662 – will receive similar support in the Senate as the issue did in 2024.

McGee told colleagues when presenting the bill on the House floor that the Division of Medicaid met with the Centers for Medicare and Medicaid Services to hold conversations about the changes.

Jonathan Bain, a Senior Research Fellow at the Foundation for Government Accountability, wrote in a column that appeared in Magnolia Tribune last year that presumptive eligibility was introduced by Congress in 1986. He noted that it was intended to be a narrow option for states to use with certain populations applying for Medicaid coverage. 

“Rather than going through the proper eligibility channels, this new wave of presumptive eligibility allowed hospitals to directly enroll people in Medicaid based on no evidence at all, and then start racking up charges,” Bain wrote. “Shockingly, the only requirement currently in place is a verbal attestation of having a low income—meaning the only ‘documentation’ needed is for the patient to say so.”

Bain went on to add that medical care is approved and provided in the meantime, tests are run, and treatment is provided, “and the bills are charged to the taxpayers.”