HB 89 and SB 102 would improve maternal health, save money and save lives in Alabama

Presumptive eligibility allows doctors and other providers to determine Medicaid eligibility for expectant mothers who are likely to be eligible. This allows women to begin receiving Medicaid coverage in the first trimester without having to wait for the agency’s official eligibility decision.

More than 50% of expectant mothers in Alabama are eligible for Medicaid coverage for prenatal medical care crucial for the health of both mother and child. Yet that care is regularly delayed because Alabama doesn’t have a timely procedure to allow many mothers to get prenatal care.

HB 89 by Rep. Marilyn Lands, D-Huntsville, and SB 102 by Sen. Linda Coleman-Madison, D-Birmingham, would allow expectant mothers to receive Medicaid coverage earlier in the pregnancy, when health care is essential for the mother and child. These bills would expand presumptive eligibility and reduce red-tape barriers to coverage.

Why do we need presumptive eligibility?

The wait for Medicaid’s official eligibility approval can prevent mothers from receiving care earlier in their pregnancy. Areas with a lack of maternal health care access compound this issue, increasing the cost of higher-risk pregnancies and deliveries.

Presumptive eligibility allows up to 60 days of Medicaid coverage for women who have not yet been formally approved for coverage but who submit proof of pregnancy and household income information to their maternity care provider. This would allow mothers to see a doctor, receive pregnancy verification and begin prenatal care while the Medicaid approval process is ongoing.

What are the benefits of presumptive eligibility?

Alabama has some of the nation’s highest rates of infant mortality, maternal death and low birth weight. Maternal mortality is higher among patients with late or no prenatal care.
More than 1 in 4 pregnant women (27%) do not receive prenatal care until the second trimester, according to the March of Dimes. This can lead to costlier care later in pregnancy or postpartum.
Receiving prenatal care in the first trimester can improve outcomes and save millions of dollars by diagnosing and treating conditions that may worsen over time without medical attention, thereby reducing risk for maternal and infant death or severe complications.
The state cost for presumptive eligibility – just $273,700, according to the fiscal note – is small compared to the potential savings, both in dollars and especially in lives.