Many of the Affordable Care Act’s major reforms are set to go into effect in the upcoming year. The expansion of Medicaid, in particular, will have a significant affect on the lower- and moderate-income pregnant women, although Florida has still opted not to expand Medicaid coverage.
Under ACA, eligibility for Medicaid will change. A pregnant woman’s type and the extent of her Medicaid coverage will depend on:
- The timing of her pregnancy
- Her state’s Medicaid policies
By federal law, the state must offer Medicaid coverage of pregnancy-related services to pregnant women who have incomes at or below 133 percent of the Federal Poverty Level. The state can decide if they will allow pregnant women with incomes above the FPL to be eligible for Medicaid coverage.
In Florida, women with a family income of 185 percent of the FPL or less will still qualify for Medicaid for Pregnancy coverage.
Lower- and moderate-income pregnant women who are not eligible for Medicaid may be eligible for premium tax credits to reduce their monthly premium costs from their subsidized private insurance company. Maternity and newborn care is listed as an essential health benefit that all subsidized private insurance companies must provide their consumers, however, states have the option to determine what services are covered as part of the mandatory maternity benefit.
For more information about ACA and its affect on pregnant women, visit the following resources from maternal and child health organizations:
- The National Partnership for Women and Families: Why the Affordable Care Act Matters for Women: Health Insurance Coverage for Lower- and Moderate-Income Pregnant Women and Frequently Asked Questions: Health Insurance Coverage for Low- and Moderate-Income Pregnant Women
- The National Health Law Program: Q&A on Pregnant Women’s Coverage under Medicaid and the ACA
- Association of Maternal & Child Health Programs: Who Will be Covered for What in 2014?
- Family-Related Medicaid Fact Sheet — Florida