SCHIP Coverage for Pregnant Women and Unborn Children

SCHIP Coverage for Pregnant Women and
Unborn Children
Evelyne P. Baumrucker
Analyst in Health Care Financing
Domestic Social Policy Division
Summary
The State Children’s Health Insurance Program (SCHIP) does not include
pregnancy status among its eligibility criteria and does not cover individuals over age
18. Under SCHIP, states can cover pregnant women aged 19 and older in one of three
ways: (1) states may apply for waivers of program rules to extend coverage to adults
such as pregnant women (§1115 waiver authority); (2) states may provide health benefits
coverage, including prenatal care and delivery services, to unborn children through an
SCHIP state plan amendment (SPA) as permitted through regulation;¹ or (3) states may
offer a “family coverage option” that allows them to provide coverage under a group
health plan that may include maternity care to adult females in eligible families.² As of
October 2007, 17 states offered pregnancy-related services using SCHIP funds. Of those,
6 states used the §1115 waiver authority and 12 states extended coverage through
unborn child SPAs (Rhode Island extends coverage to pregnant women through both
authorities). This report summarizes the variation in pregnancy coverage and the
financing streams associated with such coverage among these states. This report will
be updated as state activity warrants.
Background
States that choose to cover pregnant women through the §1115 waiver authority must
submit a proposal to the Centers for Medicare and Medicaid Services (CMS) for approval.

¹ Federal Register, vol. 67, no. 191, Wednesday, October 2, 2002, Rules and Regulations.
² Section 2105(c)(3) of the Social Security Act allows states to cover entire families including
parents if the purchase of family coverage is cost-effective when compared with the cost of
covering only the targeted low-income children in the families involved, and would not substitute
for other health insurance coverage. E-mail correspondence (from June 7, 2007) with Kathleen
Farrell, the CMS Director of the SCHIP program, indicates that New Jersey and Massachusetts
are the only states with operational family coverage variance programs.

States with approved §1115 demonstration programs define the available pregnancy-
related services in their waiver terms and conditions agreements.
States that opt to extend SCHIP coverage to unborn children must submit an SPA
to CMS for approval specifying the pregnancy-related services. Under the SCHIP SPA
option, covered services must be related to the pregnancy or to conditions that could
complicate the pregnancy, including those for diagnosis or treatment of illnesses or
medical conditions that might threaten the health of the unborn child. Care after delivery
for the mother, such as postpartum services, is generally not covered as part of the title
XXI SPA option. Although CMS requires the care to be directed at the unborn child, the
SCHIP unborn child SPA option effectively enables states to provide prenatal care to
pregnant women including those with incomes at or above the Medicaid income eligibility
thresholds and for individuals who do not qualify for Medicaid (or SCHIP) for other
reasons, such as immigration status³ or incarceration.⁴ Finally, for the family coverage
option, pregnancy-related benefits are those offered by participating private health plans.
Summary of State Variation in Pregnancy Coverage Under SCHIP
Table 1 summarizes the variation in pregnancy coverage among states with §1115
waivers and those using the SCHIP unborn child SPA option. As of October 2007, 17
states offered pregnancy-related services using SCHIP funds. Of those, 12 states extended
coverage through unborn child SCHIP SPAs and 6 states used the §1115 waiver authority
(Rhode Island extends coverage to pregnant women through both authorities). The
highest upper-income eligibility thresholds for pregnant women and/or unborn children
under SCHIP was 300% FPL in California. Seven states established upper-income limits
at 200% FPL. Four states exceeded 200% FPL, and six states set maximum income levels
below 200% FPL.
Of the 12 states that offer pregnancy-related services to unborn children under the
SCHIP SPAs, all but Tennessee extended coverage to the unborn children of
undocumented aliens who otherwise would not have access to federally funded⁵
pregnancy-related services, except through emergency Medicaid. Two states used
SCHIP SPAs to extend coverage to the unborn children of incarcerated women who are
otherwise ineligible for SCHIP coverage.
Covered services under the §1115 waiver programs and the SCHIP SPAs generally
consisted of comprehensive pregnancy-related services including prenatal care, labor and
delivery services, and access to some form of coverage during the postpartum period.
However, the length of coverage (e.g., prenatal period through labor and delivery, or
prenatal period through 60 days postpartum period) and financing streams for the care

³ Section 1903(v) of the Social Security Act.
⁴ Section 2110(b)(2)(A) of the Social Security Act.
⁵ Illegal immigrants are barred from Medicaid and SCHIP eligibility; legal immigrants who have
not been granted lawful permanent residency status are ineligible for Medicaid or SCHIP for five
years. Such women who otherwise qualify but for their documentation status have access to
emergency care under Medicaid, which includes labor and delivery costs (Section 1903(v) of the
Social Security Act).

associated with each of these pregnancy phases varied across states. For example, some
states offered coverage from conception through 60 days postpartum care (financed with
SCHIP funds), whereas others segmented the coverage to include prenatal care (financed
with SCHIP funds), labor and delivery (financed with emergency Medicaid funds), and
postpartum care (financed with state-only funds). In these states, program specialists
pointed out that the pregnancy-related care is seamless to the mother despite the
administrative complexities required of the state to submit claims under multiple funding
streams. Three states indicated that the coverage offered to pregnant women and/or
unborn children was comprehensive and not limited to pregnancy-related services. An
additional four states specified that the available care included pregnancy-related care and
associated health services including, for example, medically necessary dental or mental
health benefits as long as the care was necessary to promote the health of the unborn
child.
Postpartum care differs among states that chose to extend pregnancy coverage under
the §1115 waiver authority as compared with those that offered coverage to unborn
children under the SCHIP unborn child SPAs. There were 15 states that offered 60 days
of postpartum care to at least some of their eligible populations, including each of the 6
states that offered pregnancy coverage under the §1115 waiver authority. Among the
SCHIP SPA states, five states financed 60 days of postpartum care with state-only funds.
Four SCHIP SPA states extended 60 days of postpartum care using SCHIP funds. CMS
permitted this financing arrangement despite the fact that the unborn child regulation
clearly states that federal SCHIP-financed care ends with the birth of the child. The
reason CMS permits this is because the state has a global rate for their pregnancy services
that includes the cost of prenatal care, labor and delivery, and 60 days of postpartum care.
One SCHIP SPA state provided SCHIP-financed postpartum care through the end of the
month that the child was delivered because those services have already been paid for
under the monthly managed care capitation payment. Two SCHIP SPA states did not
offer any form of care for the mother after the birth of the child except in the case of an
emergency during which the mother would have access to emergency Medicaid services.
Finally, two states (one §1115 waiver state and one SCHIP SPA state) provided access
to extended family planning services and supplies as a part of their postnatal care benefit.

CRS-4
Table1. SCHIP Pregnancy Coverage for States with Section 1115 Waivers and SCHIP Unborn Child State Plan
Amendments (as of October 2007)
^Upper-
^Inc^o^m^e^Ben^e^fi^{t C}^overage
^St^a^t^e^T^h^res^hold^Le^ng^t^h^o^f^Fⁱ^na^ncing
^w^a^{rd Da}^t^e⁾^A^ut^ho^rit^y^{(% FPL}⁾^M^o^ther’s^{Coverage After}^Deliv^ery^Fⁱ^na^ncing^St^rea^m^{Covered Services}^C^overage^Stream
^nsa^s^Uⁿ^born^200%^F^P^L^Sep^a^r^a^{te SCHI}^P^p^r^o^g^r^a^m⁽^SSP⁾^Coⁿ^cep^tioⁿ^to^bⁱ^r^t^h^S^CHI^P^{No cov}^e^rag^e^ex^{cept u}ⁿ^d^er^E^m^e^r^ge^nc^y
^30/⁰⁴⁾^Ch^ild^SP^A^und^o^c^.^a^lⁱ^e^nsⁱⁿ^clu^d^es^pren^{atal care, an}^{d deliv}^ery^em^erg^eⁿ^c^y^Medicaid^Medicaid
^s^e^rv^ices
^lo^r^a^d^o^SCHI^P^200%^F^P^L^P^ren^a^t^a^l^{care, l}^a^{bor an}^{d del}ⁱ^v^ery^,^an^d^{Date o}^f^ap^p^licatioⁿ^S^C^H^I^P^{60 day}^s^pos^t^p^art^u^m^care^S^C^H^I^P
^27/⁰²⁾^§1115^{60 day}^s^pos^t^p^art^u^m^{care (ex}^c^l^u^des^t^h^r^o^{ugh 6}⁰^d^a^y^s
^HIFA^den^t^{al care)}^p^o^s^tp^ar^tu^m
^o^rⁿⁱ^a^Uⁿ^born^0%^-^200%^P^r^en^{atal care, labor an}^{d deliv}^ery^,^an^d^C^oⁿ^ception^SC^HIP^{60 day}^s^pos^tpartu^m^care^SC^HIP^{(treated as}^a
ⁱ^{ki/CRS-RS22785}^28/⁰⁶⁾^Ch^ild^SP^A^und^o^c^.^a^lⁱ^e^ns^{60 day}^s^pos^t^p^art^u^m^care^t^h^r^o^{ugh 6}⁰^d^a^y^s^b^und^l^e^d^se^r^vⁱ^c^e⁾
^g/w^p^o^s^tp^ar^tu^m
^s^.or^300%^A^I^{M prog}^ram^of^f^e^rs^com^p^reh^eⁿ^sⁱ^v^e^C^oⁿ^ception^SCHI^P
^le^ak^uni^nsur^e^d^{care n}^o^{t j}^u^s^t^pregⁿ^aⁿ^c^y^{related care}^t^h^r^o^{ugh 6}⁰^d^a^y^s
^p^o^s^tp^ar^tu^m
^://wiki^oⁱ^s^Uⁿ^born^0%^-^200%^S^S^P^Medi^cai^{d l}^ook^alⁱ^k^{e ben}^e^fⁱ^t^s^Co^nfir^m^e^d^S^C^H^I^P^{60 day}^s^pos^t^p^art^u^m^care^S^t^a^t^e^-^oⁿ^l^y^f^uⁿ^d^s
^h^ttp^11/⁰³⁾^Ch^ild^SP^A^und^o^c^.^a^lⁱ^e^nsⁱⁿ^clu^d^es^pren^{atal care an}^{d as}^s^o^ciated^p^r^e^gna^nc^y^aⁿ^d
^an^d^h^ealth^ser^v^{ices (}^e^x^c^lu^d^e^{s HCB}^S^t^h^r^o^{ugh st}^a^r^t^o^f
ⁱⁿ^carcerated^w^a^iv^{er s}^e^rv^ices^an^{d abortion}^l^a^bor
^wo^meⁿ^s^e^rv^ices⁾
^L^a^{bor an}^{d del}ⁱ^v^ery^s^e^rvⁱ^ces^L^a^{bor t}^h^rou^g^h^E^m^e^r^ge^nc^y
^d^e^liv^er^y^Medicaid
^o^SCHI^P^u^p^t^o^185%^P^r^em^iu^m^as^sⁱ^s^t^an^{ce f}^o^{r priv}^ate^Co^nfir^m^e^d^SCHI^P^p^a^y^s^Defⁱⁿ^e^dⁱⁿ^p^a^r^ticip^atin^g^p^r^iv^ate^SCHI^P^p^a^y^s^f^o^r
^21/⁰⁵⁾^§1115^wo^r^k^e^r^sⁱⁿⁱⁿ^su^r^aⁿ^{ce (}^m^u^s^{t co}^v^e^r^p^o^s^tp^ar^tu^m^p^r^e^gna^nc^y^t^h^r^o^ugh^fo^r^c^o^ve^r^a^ge^p^l^aⁿ^s^premⁱ^u^m^s^on^l^y
^HIFA^sm^a^l^l^care)^{60 day}^s^pos^t^p^art^u^m^premⁱ^u^m^s
^b^u^sine^sse^s^on^l^y
^sⁱ^aⁿ^a^Uⁿ^born^0%^-^200%^SSP^{to prov}^{ide pren}^{atal care, care}^Co^nfir^m^e^d^SC^HIP^N^{o cov}^e^rag^e^ex^{cept em}^erg^eⁿ^c^y^Medi^cai^d

^/0⁷⁾^Ch^ild^SP^A^und^o^c^.^a^lⁱ^e^ns^r^e^lated^to^th^{e p}^r^egⁿ^aⁿ^c^y^,^an^d^p^r^e^gna^nc^y^t^h^r^o^ugh^s^e^rv^ices^uⁿ^d^{er Medicaid}
^deliv^ery^s^e^rv^ices^d^e^liv^er^y

CRS-5
^Upper-
^Inc^o^m^e^Ben^e^fi^{t C}^overage
^St^a^t^e^T^h^res^hold^Le^ng^t^h^o^f^Fⁱ^na^ncing
^w^a^{rd Da}^t^e⁾^A^ut^ho^rit^y^{(% FPL}⁾^M^o^ther’s^{Coverage After}^Deliv^ery^Fⁱ^na^ncing^St^rea^m^{Covered Services}^C^overage^Stream
^ssa^c^huse^t^t^s^Uⁿ^born^200%^SSP^pren^{atal care, as}^s^o^{ciated h}^ealth^C^oⁿ^ception^S^C^H^I^P^{60 day}^s^pos^t^p^art^u^m^care^S^t^a^t^e^f^uⁿ^d^ed
^15/⁰³⁾^Ch^ild^SP^A^und^o^c^.^a^lⁱ^e^ns^s^e^rvⁱ^ces^{, l}^a^{bor an}^{d del}ⁱ^v^ery^t^h^r^o^{ugh b}ⁱ^r^t^h^prog^ram^an^{d f}^r^ee
^{care pool}
^ig^an^Uⁿ^born^185%^F^P^L^SSPⁱⁿ^clu^d^es^pren^{atal care,}^C^oⁿ^ception^S^C^H^I^P^L^{abor an}^{d del}ⁱ^v^ery^an^{d 60 day}^s^SC^HIP^{(treated as}^a
^17/⁰³⁾^Ch^ild^SP^A^und^o^c^.^a^lⁱ^e^ns^p^r^e^gna^nc^y^-^r^e^l^a^t^e^d^c^a^r^e^,^aⁿ^d^no^n-^t^h^r^o^{ugh 6}⁰^d^a^y^s^pos^tpartu^m^care^b^und^l^e^d^se^r^vⁱ^c^e⁾
^pregⁿ^aⁿ^c^y^rel^a^t^e^{d care (u}^{p t}^o^bi^rt^h^of^p^o^s^tp^ar^tu^m^O^t^he^r^he^a^l^t^h^c^o^ve^r^a^ge⁽^e^.^g^.^,^b^r^o^k^eⁿ^E^m^e^r^ge^nc^y
^chⁱ^l^d^{) l}^a^{bor an}^{d del}ⁱ^v^ery^,^an^{d 60}^arm^s⁾^Medicaid
^day^s^pos^tpartu^m^care
^nne^so^t^a^Uⁿ^born^275%^S^S^P^Medi^cai^{d l}^ook^-^a^-^lⁱ^k^{e prog}^ram^C^oⁿ^ception^S^C^H^I^P^{60 day}^s^pos^t^p^art^u^m^care^S^t^a^t^e^-^f^uⁿ^d^ed
^/0³⁾^Ch^ild^SP^A^und^o^c^.^a^lⁱ^e^ns^c^o^ve^r^s^p^r^e^gna^nc^y^-^r^e^l^a^t^e^d^se^r^vⁱ^c^e^s^,^t^h^r^o^{ugh e}ⁿ^d^o^f^t^h^e
^pren^{atal care, labor an}^{d deliv}^ery^,^an^d^m^o^nt^{h i}ⁿ^w^hⁱ^c^{h t}^h^e
ⁱ^{ki/CRS-RS22785}^lim^ited^p^o^s^tp^ar^tu^m^car^e^ch^ild^w^a^{s b}^o^rⁿ
^g/w^a^d^a^SCHI^P^133%^-^185%^Medi^cai^{d preg}ⁿ^aⁿ^c^y^-^r^el^at^{ed ben}^e^fⁱ^t^s^C^oⁿ^ception^S^C^H^I^P^{60 day}^s^pos^t^p^art^u^m^care^S^C^H^IP
^s^.or^2/⁰⁶⁾^§1115ⁱⁿ^clu^dⁱⁿ^g^pren^{atal care, related}^t^h^r^o^{ugh 6}⁰^d^a^y^s
^le^ak^HIFA^h^ealth^{care, labor an}^{d deliv}^ery^,^an^d^p^o^s^tp^ar^tu^m
^{60 day}^s^pos^t^p^art^u^m^care
^://wiki^J^e^rsey^Medicaid^0%-^200%^P^r^es^u^m^ptiv^{e elig}^ibility^prog^ram^T^e^m^porary^Medicaid^E^m^e^rg^en^cy^{Medicaid f}^o^{r labor an}^d^E^m^e^r^ge^nc^y
^h^ttp^18/⁰¹⁾^an^{d SC}^HIPⁱⁿ^clu^d^es^pren^{atal care, labor, an}^d^elig^ib^ility^uⁿ^til^d^e^liv^er^y^ser^v^{ices o}ⁿ^ly^Medicaid
^§1115^d^e^liv^er^y^d^e^ter^mⁱⁿ^ed^elig^ib^le
^HIFA^f^o^{r Medi}^cai^d
^0%^-^185%^N^e^w^Jers^ey^Medi^cai^{d pack}^ag^e^C^oⁿ^ception^Medi^cai^d^{60 day}^s^f^u^l^l^com^p^reh^eⁿ^sⁱ^v^e^Medicaid
ⁱⁿ^clu^d^es^pren^{atal care, labor an}^d^t^h^r^o^{ugh 6}⁰^d^a^y^s^Medi^cai^d
^delⁱ^v^ery^,^an^{d 60 day}^s^of^f^u^l^l^p^o^s^tp^ar^tu^m
^{Medicaid cov}^e^rag^e^186%^-^200%^C^oⁿ^ceptⁱ^oⁿ^SCHI^P^S^CHI^P
^t^h^r^o^{ugh 6}⁰^d^a^y^s
^p^o^s^tp^ar^tu^m
^{ode Is}^l^aⁿ^d^Uⁿ^born^185%^-^250%^{Medicaid ben}^e^f^{it pack}^ag^{e in}^clu^d^es^C^oⁿ^ception^SCH^I^P^E^xt^eⁿ^d^e^d^fa^mⁱ^l^y^p^l^aⁿⁿⁱ^{ng fa}^mⁱ^l^y^SCHI^P
^17/⁰³⁾^Ch^ild^SP^A^und^o^c^.^a^lⁱ^e^ns^pren^{atal care, labor an}^{d deliv}^ery^t^h^r^o^{ugh l}^a^b^o^r^aⁿ^d^s^e^rvⁱ^ces^an^{d s}^u^pplⁱ^e^s^f^o^{r 24 m}^oⁿ^t^h^s
^d^e^liv^er^y^{60 day}^s^pos^tpartu^m^care^State-^on^ly^f^uⁿ^d^s

CRS-6
^Upper-
^Inc^o^m^e^Ben^e^fi^{t C}^overage
^St^a^t^e^T^h^res^hold^Le^ng^t^h^o^f^Fⁱ^na^ncing
^w^a^{rd Da}^t^e⁾^A^ut^ho^rit^y^{(% FPL}⁾^M^o^ther’s^{Coverage After}^Deliv^ery^Fⁱ^na^ncing^St^rea^m^{Covered Services}^C^overage^Stream
^{ode Is}^l^aⁿ^d^SCHI^P^185%^-^250%^Medi^cai^{d ben}^e^fⁱ^t^pack^ag^{e (i}^.e.,^C^oⁿ^ception^SC^HIP^{60 day}^s^pos^tpartu^m^{care an}^d^SCHI^P
^18/⁰¹⁾^§1115^pren^{atal care, labor an}^{d deliv}^ery^,^an^d^t^h^r^o^{ugh 6}⁰^d^a^y^s^e^x^t^e^nd^e^d^fa^mⁱ^l^y^p^l^aⁿⁿⁱ^{ng fa}^mⁱ^l^y
^{60 day}^s^pos^t^p^art^u^m^care)^p^o^s^tp^ar^tu^m^s^e^rvⁱ^ces^an^{d s}^u^pplⁱ^e^s^f^o^{r 24 m}^oⁿ^t^h^s
^gⁱⁿ^ia^SCHI^P^133%^-^185%^F^u^l^l^Medi^cai^{d ben}^e^fⁱ^t^s⁽ⁿ^ot^C^oⁿ^ception^SC^HIP^C^ov^erag^{e f}^o^{r th}^{e rem}^aⁱⁿ^{der of}^th^e^SCHI^P
^21/⁰⁵⁾^§1115^(approv^{ed u}^p^p^r^e^gna^nc^y^oⁿ^l^y^b^e^ne^fi^t^s⁾^t^h^r^o^{ugh l}^a^b^o^r^aⁿ^d^bi^rt^h^m^oⁿ^t^h^pl^u^s^{60 day}^s^pos^t^p^art^u^m
^HIFA^t^o^200%⁾^d^e^liv^er^y^c^o^ve^r^a^ge^.
^sse^e^Uⁿ^born^185%^-^250%^S^S^P^Pregⁿ^aⁿ^c^y^-^rel^a^t^e^{d s}^e^rvⁱ^ces^C^oⁿ^ception^SCH^I^P^C^o^v^e^r^a^g^e^t^h^r^o^{ugh t}^h^e^l^a^st^d^a^y^o^f^t^h^e^SC^HIP^{(treated as}^a
^3/⁰⁷⁾^Ch^ild^Stateⁱⁿ^clu^dⁱⁿ^g^pren^{atal care, labor an}^d^t^h^r^o^{ugh 6}⁰^d^a^y^s^m^oⁿ^t^h^t^h^at^{60 day}^pos^t^part^u^m^b^und^l^e^d^se^r^vⁱ^c^e⁾
^P^l^an^Op^tioⁿ^delⁱ^v^ery^,^an^{d 60 day}^s^pos^t^p^art^u^m^pos^t^part^u^m^peri^{od occu}^rs
^care
ⁱ^{ki/CRS-RS22785}^a^s^/0⁶⁾^Uⁿ^born^Ch^ild^SP^A^200%^und^o^c^.^a^lⁱ^e^ns^SSP^{to prov}^{ide pren}^{atal care, labor an}^{d deliv}^ery^,^an^{d 2}^pos^tpartu^m^vⁱ^s^its^C^a^{re en}^ds^{at th}^{e en}^{d of}^th^{e m}^oⁿ^t^h^d^u^rⁱⁿ^g^w^h^ich^th^{e ch}^ild^{is b}^o^rⁿ^.^SCHI^P
^g/w^T^h^{ere are n}^o^pu^{blic ben}^e^f^its^af^ter
^s^.or^th^{at ex}^cep^{t if}^th^{e m}^o^th^er^q^u^alif^{ies f}^o^r
^le^ak^em^erg^eⁿ^c^y^{Medicaid s}^e^rv^ices^.
^://wiki^shi^ngt^oⁿ^22/⁰³⁾^Uⁿ^born^Ch^ild^SP^A^185%^und^o^c^.^a^lⁱ^e^ns^SSP^{, B}^eⁿ^e^f^itsⁱⁿ^clu^d^es^pren^{atal care}^an^{d as}^s^o^{ciated h}^ealth^s^e^rv^ices^C^oⁿ^ception^an^d^t^h^r^o^{ugh st}^a^r^t^o^f^SC^HIP^{60 day}^s^pos^tpartu^m^care^s^t^ate-^on^ly^f^uⁿ^d^s
^h^ttp^l^a^{bor an}^{d del}ⁱ^v^ery
^L^a^{bor an}^{d del}ⁱ^v^ery^L^a^{bor an}^{d del}ⁱ^v^ery^E^m^e^rg^en^cy
^Medicaid
^sc^oⁿ^sin^Uⁿ^born^185%^SSP^B^a^dg^{er C}^a^{re pren}^{atal prog}^ram^C^oⁿ^ception^S^C^H^I^P^{60 day}^s^pos^t^p^art^u^m^{care al}^l^o^w^e^{d f}^o^r^SC^HIP^{(treated as}^a
^/0⁷⁾^Ch^ild^SP^A^uⁿ^doc.^prov^ides^f^o^{r pren}^{atal cov}^e^rag^e^t^h^r^o^{ugh 6}⁰^d^a^y^s^{all b}^u^{t u}ⁿ^d^o^c^u^m^en^ted^alien^s^b^und^l^e^d^se^r^vⁱ^c^e⁾
^alien^s^{, an}^dⁱⁿ^cl^u^dⁱⁿ^g^cos^t^of^l^a^{bor an}^{d del}ⁱ^v^ery^p^o^s^tp^ar^tu^m
^uni^nsur^e^d^an^{d 60 day}^s^pos^t^p^art^u^m^care^Uⁿ^d^o^c^um^eⁿ^t^e^d^a^lⁱ^e^{ns e}^m^e^r^ge^nc^y^E^m^e^r^ge^nc^y
^an^d/^or^Medi^cai^{d on}^l^y^Medicaid
ⁱⁿ^carcerated
^wo^meⁿ
^:^Section^{1115 w}^a^iv^{er term}^s^an^{d con}^d^ition^s^docu^m^en^ts^{, SC}^HIP^uⁿ^born^ch^{ild s}^t^{ate plan}^am^en^dm^en^ts^{, an}^{d con}^v^e^rs^ation^s^w^ith^s^t^{ate of}^f^icials.
^SP^A^m^ean^s^{State P}^l^an^A^m^en^dm^en^{t, HIFA}^m^ean^s^Section^{1115 Health}^In^s^u^ran^{ce Flex}^ibility^an^{d A}^ccouⁿ^t^ability^W^a^iv^{er, A}^I^{M s}^t^an^ds^f^o^r^A^cces^s^f^o^{r In}^f^aⁿ^t^s^an^d^Moth^ers^prog^ram^,
^s^t^an^ds^f^o^{r Medi}^cai^{d S}^ectⁱ^oⁿ^{1915(c) H}^o^m^e^an^{d C}^o^m^m^uⁿⁱ^t^y^-^B^as^{ed Wai}^v^{er, S}^S^P^m^ean^s^S^C^H^I^{P S}^e^parat^e^S^t^at^e^Prog^ram^,^an^d^a^Medi^cai^{d l}^ook^-^a^-^lⁱ^k^{e prog}^ramⁱ^s^a^S^e^parat^e^S^C^H^I^P
^ram^w^ith^{a ben}^e^f^{it pack}^ag^{e th}^{at look}^s^lik^{e Medicai}^{d, bu}^{t m}^a^y^ex^clu^d^{e, f}^o^{r ex}^am^{ple, certain}^s^e^rv^ices^.