Committee advances bill allowing presumptive Medicaid eligibility for pregnant women with sunset clause

Representative Lance presented HB 89, the Alabama Maternal Health Care Act, saying the bill would provide presumptive Medicaid eligibility to pregnant women so they can begin care immediately while formal eligibility verification is completed.

"Basically, what this does is it really just gets women into the process faster," Representative Lance said, noting Alabama's high maternal mortality and poor infant-mortality rankings as motivation for the bill. The sponsor described presumptive eligibility as a 60-day bridge while documentation is gathered and said a provider pregnancy test at the first visit would be used to confirm pregnancy where appropriate.

Representative East Britt asked what happens if someone who receives presumptive eligibility later is found not to qualify. Lance said providers would be covered in those cases and that he worked with the state medical association to address provider concerns.

The committee considered a friendly amendment adding a repeal (sunset) provision. The accepted amendment repeals the preliminary-eligibility section on Oct. 1, 2028, allowing the legislature to revisit the program based on experience and fiscal offsets. After accepting the amendment, the committee voted to give HB 89 a favor report as amended.

Committee members described the bill as a low-cost, early-intervention measure to reduce later, more expensive maternal complications, but no detailed fiscal offset figures were presented during the committee discussion recorded in the transcript. The bill now advances with a sunset clause and staff will work on implementation details and fiscal analysis.