At the end of August, the U.S. Department of Health and Human Services (HHS) blocked recipients of Deferred Action for Childhood Arrivals (DACA) from participating in healthcare coverage options under the Patient Protection and Affordable Care Act (ACA). Additionally, HHS’s Centers for Medicare & Medicaid Services (CMS) blocked DACA recipients from receiving federally-funded prenatal and pediatric care, which about half of the states have affirmatively opted to provide to all “lawfully residing” pregnant women and children through Medicaid and the Children’s Health Insurance Plan (CHIP).
In 2012, Nebraska extended prenatal care coverage to all women regardless of immigration status. It did so by using what is called the “unborn child option” in the federal Children’s Health Insurance Program (CHIP). In 2002, the U.S. Department of Health and Human Services (HHS) revised the definition of the term “child” in the CHIP program (then called the State Children’s Health Insurance Program, or SCHIP) to include the period from conception to birth (see the federal rule change here). Since that change, states have been able to elect this option to cover certain prenatal and postpartum care for women in need who are otherwise ineligible for Medicaid. The federal Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) continued this “unborn child option” (see the explanatory memorandum from HHS here). The 2012 Nebraska bill is LB599.
CHIP is a federally-created program that provides health coverage for children in families that have incomes too high to qualify for Medicaid but that also cannot afford private coverage. CHIP was signed into law in 1997. For more information about CHIP and how it works in different states, see Medicaid’s CHIP website here. As the website explains, CHIP is administered by states but is jointly funded by the federal government and the states. Each state administers its own CHIP program with guidance from HHS’s Centers for Medicare & Medicaid Services (CMS).
In 2009, CHIPRA created a new state option to cover prenatal and pediatric care to all “lawfully residing” pregnant women and children. About half of states have opted to provide this coverage through CHIP.
At the end of August 2012, CMS affirmatively blocked DACA recipients from qualifying for this coverage, even though any other recipients of Deferred Action will continue to qualify as “lawfully residing” according to CMS.