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Status of State Actions to Extend Postpartum Medicaid Coverage

See which states are beginning to take action to extend postpartum Medicaid coverage.

States have started to take action to extend postpartum Medicaid coverage! Most states are choosing to provide full Medicaid benefits for 12 months after the end pregnancy using what's known as the State Plan Amendment (SPA) pathway. Other states are selecting the Medicaid Section 1115 Waiver, which grants states flexibility to achieve identified goals and target specific populations through pilot or demonstration projects. Because states can choose how to design their waiver request, there is an option to limit services and provide coverage for less than 12 months. Learn about these pathways.

The map and accompanying chart below detail the status of state action to extend postpartum Medicaid coverage.*

Status of State Actions (Map)

 

*It is important to note that a federal law passed in 2020 prohibits states from ending coverage for Medicaid enrollees for the duration of the COVID-19 public health emergency declaration.

Status of State Actions (Table)
State Legislation Passed (Yes/No) Selected Pathway Details about 1115 Waiver (If applicable) Waiver or SPA Approved by CMS Elected to Extend Coverage to Undocumented People Medicaid Expansion State

Alabama

Yes

SPA

N/A

Yes

No

No

Alaska

Yes

SPA

N/A

N/A

N/A

Yes

Arizona

Yes

SPA

N/A

Yes

N/A

Yes

Arkansas

No

N/A

N/A

N/A

N/A

Yes

California

Yes

SPA

N/A

Yes

Yes

Yes

Colorado

Yes

 SPA

N/A

Yes

Yes

Yes

Connecticut

Yes

 SPA

N/A

Yes

Yes

Yes

Delaware

Yes

SPA

N/A

Yes

No

Yes

District of Columbia

Yes

SPA

N/A

Yes

No

Yes

Florida

Yes

1115 Waiver

Eligibility: All Medicaid eligible pregnant persons

Scope of Services: Full services

Coverage Extension: 12 months

Waiver Period: May 2022–June 2030

Yes

No

No

Georgia

Yes

SPA

N/A

Yes

No

No

Hawaii

Yes

SPA

N/A

Yes

No

Yes

Idaho

No

N/A

N/A

N/A

N/A

Yes

Illinois

Yes

1115 Waiver

Eligibility: All Medicaid eligible pregnant persons

Scope of Services: Full services

Coverage Extension: 12 months

Waiver Period: January 2021–January 2026

Yes

Yes

Yes

Indiana

Yes

SPA

N/A

Yes

No

Yes

Iowa

No

N/A

N/A

N/A

N/A

Yes

Kansas

Yes

SPA

N/A

Yes

N/A

No

Kentucky

No

SPA

N/A

Yes

No

Yes

Louisiana

Yes

SPA

N/A

Yes

No

Yes

Maine

Yes

SPA

N/A

Yes

Yes

Yes

Maryland

Yes

SPA

N/A

Yes

Yes

 Yes

Massachusetts

Yes

SPA

 --

Yes

Yes

Yes

Michigan

Yes

SPA

 N/A

Yes

No

Yes

Minnesota

Yes

SPA

N/A

Yes

Yes

Yes

Mississippi

Yes

TBD

N/A

N/A

N/A

No

Missouri

Yes

 SPA

N/A

Yes

No

Yes

Montana

No

N/A

N/A

N/A

N/A

Yes

Nebraska

No

N/A

N/A

N/A

N/A

Yes

Nevada

No

N/A

N/A

N/A

N/A

Yes

New Hampshire

No

N/A

N/A

N/A

N/A

Yes

New Jersey

Yes

1115 Waiver

Eligibility: All Medicaid eligible pregnant persons

Scope of Services: Full services

Coverage Extension: 12 months

Waiver Period: Expires June 2022

Additional Information: Renewal of waiver pending

Yes

No

Yes

New Mexico

Yes

SPA

N/A

Yes

No

Yes

New York

Yes

TBD

--

--

Yes

Yes

North Carolina

Yes

SPA

N/A

Yes

No

Yes

North Dakota

No

SPA

N/A

Yes

No

Yes

Ohio

Yes

SPA

 N/A             

Yes

No

Yes

Oklahoma

No

SPA

N/A

Yes

No

Yes

Oregon

Yes

SPA

 N/A

Yes

No

Yes

Pennsylvania

Yes

SPA

 N/A

Yes

No

Yes

Rhode Island

No

SPA

N/A

Yes

Yes

Yes

South Carolina

Yes

SPA

N/A

Yes

No

No

South Dakota

No

SPA

N/A

N/A

N/A

Yes

Tennessee

Yes

1115 Waiver (Medicaid)

SPA (CHIP)

Eligibility: All Medicaid eligible pregnant persons

Scope of Services: Full services

Coverage Extension: 12 months

Waiver Period: January 2022–December 2030

Additional Information: Extended postpartum coverage for CHIP eligible beneficiaries via a SPA

Yes (Waiver)

Yes (CHIP SPA)

No

No

Texas

Yes

1115 Waiver

Eligibility: All Medicaid eligible pregnant persons

Scope of Services: Services related to behavioral health conditions, cardiovascular conditions, diabetes, and asthma

Coverage Extension: 6 months

Waiver Period: December 2020–December 2024

Additional information: CMS approval pending

TBD

No

No

Utah

Yes

TBD

N/A

N/A

N/A

Yes

Vermont

No

SPA

N/A

N/A

N/A

Yes

Virginia

Yes

1115 Waiver

Eligibility: All Medicaid eligible pregnant persons

Scope of Services: Full services

Coverage Extension: 12 months

Waiver Period: Expires June 2029

Yes

Yes

Yes

Washington

Yes

SPA and 1115 Waiver

Eligibility: People who apply for Medicaid or CHIP during their postpartum period, but who were not previously enrolled in Medicaid or CHIP during their pregnancy and individuals who receive pregnancy-related services under the CHIP "unborn child" option.

Scope of services: Full services

Coverage Extension: 12 months

Waiver Period: N/A

Additional information: Pending CMS approval

Y (SPA)

Yes

Yes

West Virginia

Yes

SPA

N/A

Yes

No

Yes

Wisconsin

Yes

1115 Waiver

Eligibility: All Medicaid eligible pregnant persons

Scope of Services: Full services

Coverage Extension: 90 days

Waiver Period: N/A

Additional Information: Draft waiver pending CMS approval

TBD

No

No

Wyoming

Yes

SPA

N/A

N/A

N/A

No

State Totals

Yes: 37
No: 14

SPA: 36
1115 Waiver: 8
TBD: 3

9

Yes: 35

Yes: 11

Yes: 40
No: 11