Eligibility Levels for Coverage of Pregnant Women in Medicaid and CHIP

This chart provides eligibility levels for states’ coverage of services for pregnant women under Medicaid (Title XIX of the Social Security Act) and the Children’s Health Insurance Program (Title XXI of the Social Security Act) in 2013 and 2014. Coverage levels for 2014 include states’ modified adjusted gross income (MAGI)-converted eligibility levels. Every state provides “pregnancy-related Medicaid” coverage to pregnant women at income levels above the historic AFDC levels in place on May 1, 1988. (Below this level states are required to provide full Medicaid benefits to pregnant women.) Pregnancy-related Medicaid coverage is mandatory up to 133 percent of the federal poverty level (FPL); some states provide optional coverage up to or exceeding 185 percent FPL. States that opt for these higher coverage levels in Medicaid are also allowed to cover pregnant women through their state Children’s Health Insurance Program (CHIP). For CHIP, states also have the option to provide services to pregnant women through the CHIP “unborn child” coverage option.

This chart is based on information collected by the National Academy for State Health Policy (NASHP) from multiple sources.[1] To learn more about some of the new challenges related to pregnant women’s coverage, check out our new blog post: Coverage for Pregnant Women Under the ACA.

Know of something we should add to this chart? Eager to update a fact we’ve included? Your feedback is central to our ongoing, real-time analytical process, so tell us in a comment below, or email the author, Jennifer Dolatshahi, with your suggestion. She can be reached at jdolatshahi@nashp.org.