In February, 22-year-old Kenychi Badue of Laurel learned she was pregnant. Without health insurance, she struggled to afford prenatal care while awaiting her first child’s arrival. Thanks to a new Mississippi law, Badue received early prenatal care through the state’s Presumptive Eligibility for Pregnant Women program, according to the Mississippi Division of Medicaid.
The law, which took effect in July 2022, allows pregnant women to be presumed eligible for Medicaid while their applications are pending. It is expected to benefit about 300 low-income pregnant women in Mississippi, a state that has not expanded Medicaid under the Affordable Care Act. The American College of Obstetricians and Gynecologists has credited such programs with improving maternal health outcomes, especially in non-expansion states.
Eligible women must have a household income up to 194% of the federal poverty level, or roughly $31,000 annually for an individual. They do not need to provide proof of income to receive care at participating providers. The temporary coverage lasts until Medicaid approves their application, which must be submitted before the end of the second month of presumptive eligibility. Once enrolled, women are guaranteed coverage through 12 months postpartum, the state says.
Usha Ranji, associate director of women’s policy at the Kaiser Family Foundation, explained that presumptive eligibility removes bureaucratic barriers, allowing women to access prenatal care promptly. Mississippi officials declared a public health emergency last August over rising infant mortality rates. The CDC reports a significant increase in late or no prenatal care in the state between 2021 and 2024, which can lead to more complicated and costly medical interventions.
Health care providers estimate that the program costs the state about $567,000 annually. They argue that early intervention through prenatal care can reduce preterm births, which Mississippi leads the nation in. Dr. Susan Buttross, a pediatric specialist, said early care could save the state millions in neonatal intensive care costs. However, she noted that only a fraction of women are currently served by the program, with room to expand.
Most women using presumptive eligibility at present receive care at county health departments. Nurse Mia Walker of the Family Health Center in Laurel said her clinic serves about 35 women under the program, out of roughly 300 statewide. Walker emphasized that many women are unaware they qualify for Medicaid during pregnancy, which leads to missed appointments. Khaylah Scott of the Mississippi Health Advocacy Program called for increased outreach efforts, including flyers, billboards, and social media campaigns, to raise awareness.
Providers can participate by submitting an online application, with no penalty if patients are ultimately found ineligible for Medicaid. Tricia Brooks, a Medicaid expert at Georgetown University, stated that providers are reimbursed regardless of the application outcome, making participation low-risk.
While the program is a positive step, experts say more efforts are needed to ensure pregnant women across Mississippi are aware of and can access this vital health coverage.
