Bill Summary for HB1009

• Bill Number: HB1009
• Primary Sponsor: Representative A. Collins
• Purpose: To allow pregnancy to be a qualifying event for enrollment in health benefit plans and the Arkansas Medicaid Program, enabling immediate access to healthcare services for pregnant women.

Key Provisions:

1. Pregnancy as a Qualifying Event for Health Insurance Enrollment:

• State and Public School Life and Health Insurance Program:
  • Employees or dependents who previously declined enrollment can join the program due to pregnancy.
• Private Insurance Policies (Arkansas Code Title 23, Chapters 85 and 86):
  • Insurers must treat pregnancy as a qualifying event, allowing individuals to enroll outside the usual enrollment periods.

2. Presumptive Medicaid Eligibility for Pregnant Women:

• Immediate Coverage:
  • The Arkansas Medicaid Program must determine presumptive eligibility for pregnant women applying for Medicaid. This ensures immediate access to prenatal care while their full application is processed.
• Qualified Entities:
  • Designated organizations (e.g., healthcare providers or agencies) can screen and enroll pregnant women directly into Medicaid programs.

3. Effective Date:

• The act becomes effective on January 1, 2026.

Layman’s Terms Summary:

This bill makes it easier for pregnant women to get healthcare coverage by:

1. Allowing pregnancy to qualify as a life-changing event for enrolling in health insurance plans—whether it's a public program (like Arkansas's state employee insurance) or private insurance.
2. Ensuring quick access to Medicaid coverage for pregnant women through presumptive eligibility, so they can start receiving care immediately, even while waiting for their formal application to be approved.

This policy aims to improve prenatal care access, reducing delays that could harm maternal and infant health.

National Context

House Bill 1009 (HB1009) proposes allowing pregnancy to be a qualifying event for health insurance enrollment and authorizing presumptive Medicaid eligibility for pregnant women in Arkansas. Here's how these provisions compare to laws in other states:

Pregnancy as a Qualifying Event for Health Insurance Enrollment:

• Current Federal Standard: Under the Affordable Care Act (ACA), having a baby is considered a qualifying life event, granting a Special Enrollment Period (SEP) to enroll in or modify health insurance coverage. However, becoming pregnant is not recognized as a qualifying event at the federal level. This means that in most states, pregnant women without existing coverage must wait until the annual open enrollment period or until after childbirth to obtain insurance.

• State Variations: Some states have enacted laws recognizing pregnancy as a qualifying event, allowing pregnant women to enroll in health insurance outside the standard enrollment periods. As of recent years, states including New York, Connecticut, Maine, Maryland, New Jersey, Rhode Island, Vermont, Colorado, and the District of Columbia have adopted such provisions.

Presumptive Medicaid Eligibility for Pregnant Women:

• Federal Provision: The ACA permits states to authorize qualified entities, such as hospitals and community health centers, to determine presumptive eligibility (PE) for pregnant women. This allows immediate, temporary Medicaid coverage based on preliminary information, ensuring access to prenatal care while the full application is processed.

• State Implementation: As of recent data, at least 30 states have implemented presumptive eligibility for pregnant women, facilitating quicker access to prenatal services. The specifics of PE programs, including duration and qualified entities authorized to make determinations, vary by state.

Comparison to HB1009:

• Alignment with Other States: By proposing pregnancy as a qualifying event for insurance enrollment and authorizing presumptive Medicaid eligibility, Arkansas would join a group of states enhancing access to prenatal care through these mechanisms.

• Potential Impact: Implementing HB1009 could reduce uninsured rates among pregnant women in Arkansas, improve early access to prenatal care, and contribute to better maternal and infant health outcomes, aligning with efforts observed in other states.

Previous Legislative Attempts:

House Bill 1787

• Session: 94th General Assembly, Regular Session, 2023 
• Sponsor: Representative Aaron Pilkington

Summary:

This bill aimed to authorize the Arkansas Medicaid Program to make presumptive eligibility determinations for pregnant women, facilitating immediate access to prenatal care while their full Medicaid applications were processed.

Outcome:

HB1787 was filed on March 29, 2023, and referred to the House Public Health, Welfare, and Labor Committee. However, it did not advance further and died in committee at the session's adjournment.