2025-02938NoticeWallet

Idaho moms lose Medicaid coverage fight over abortion clause drama

Published Date: 2/24/2025

Notice

Summary

Idaho wants to give pregnant Medicaid moms continuous health coverage for a full year after their pregnancy ends, but CMS said no because Idaho wants to exclude some cases involving certain abortions. Now, there’s a hearing on April 2, 2025, to rethink that decision. This affects pregnant Medicaid beneficiaries in Idaho and could impact how long they get coverage and state Medicaid costs.

Analyzed Economic Effects

2 provisions identified: 1 benefits, 1 costs, 0 mixed.

Proposed 12‑Month Postpartum Medicaid Coverage

Idaho submitted State Plan Amendment (SPA) 24-0015 on October 11, 2024 to give Medicaid-enrolled pregnant people continuous coverage from pregnancy through the last day of the month in which the 12-month period after their pregnancy ends. CMS disapproved that SPA on January 6, 2025 and has scheduled a hearing to reconsider the disapproval on April 2, 2025.

Proposed Exclusion for Certain Abortions

Idaho's SPA 24-0015 proposed to exclude from the extended postpartum coverage people whose pregnancies end due to abortions “that are not in accordance with Idaho Code 18-622.” CMS disapproved the SPA on January 6, 2025, stating that section 1902(e)(16) requires coverage regardless of the reason a pregnancy ends; the disapproval is being reconsidered at the April 2, 2025 hearing.

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Key Dates

Published Date
Effective Date
2/24/2025
4/2/2025

Department and Agencies

Department
Independent Agency
Agency
Health and Human Services Department
Centers for Medicare & Medicaid Services
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