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HB1351 • 2026

Presumptive Medicaid Eligibility for Pregnant Women

Presumptive Medicaid Eligibility for Pregnant Women

Children Healthcare
Passed Legislature

This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.

Sponsor
Daniels ; Franklin
Last action
2026-03-13
Official status
House - Died in Health Care Facilities & Systems Subcommittee
Effective date
2026-07-01

Plain English Breakdown

Checked against official source text during the last sync.

Medicaid Help for Pregnant Women

This bill allows certain organizations to help pregnant women get Medicaid coverage quickly and ensures they receive necessary medical care during their pregnancy and postpartum period.

What This Bill Does

  • Allows specific groups, like hospitals and health centers, to check if pregnant women qualify for Medicaid right away.
  • Requires the Department of Children and Families to make sure these organizations are trained properly.
  • Makes it so that once a woman is found eligible for Medicaid during pregnancy, she gets full coverage until her baby is born plus one year after birth.
  • Ensures all medical services needed by pregnant women are covered under Medicaid.
  • Keeps any prior approvals for care in place to avoid disruptions in treatment.

Who It Names or Affects

  • Pregnant women who need Medicaid coverage
  • Healthcare providers and organizations that help with eligibility checks

Terms To Know

Medicaid
A government program that helps low-income people pay for healthcare.
Presumptive Eligibility
When a person is given temporary Medicaid coverage while their full eligibility is being checked.

Limits and Unknowns

  • The bill did not pass the final stages of approval and died in committee.
  • It's unclear if federal approval will be granted to extend the period of presumptive eligibility beyond current limits.

Bill History

  1. 2026-03-13 House

    • Died in Health Care Facilities & Systems Subcommittee

  2. 2026-01-15 House

    • Referred to Health Care Facilities & Systems Subcommittee • Referred to Health Care Budget Subcommittee • Referred to Health & Human Services Committee • Now in Health Care Facilities & Systems Subcommittee

  3. 2026-01-13 House

    • 1st Reading (Original Filed Version)

  4. 2026-01-09 House

    • Filed

Official Summary Text

Presumptive Medicaid Eligibility for Pregnant Women; Authorizes certain entities meeting specified criteria to serve as qualified Medicaid providers for purposes of making presumptive Medicaid eligibility determinations for pregnant women; requires DCF to ensure that such providers are adequately trained & monitored for compliance when serving in such roles; requires AHCA to provide Medicaid coverage to pregnant women deemed presumptively eligible for duration of specified time period; provides that pregnant women deemed presumptively eligible are entitled to coverage of all medically necessary services under Medicaid program during such eligibility period; requires that all prior authorizations granted before or during such period remain in effect for duration of such period; requires agency, within specified timeframe, to seek federal approval to extend allowable period of presumptive Medicaid eligibility coverage for pregnant women; requires agency & department to initiate certain rulemaking within specified timeframe.

Current Bill Text

Read the full stored bill text 
HB 1351 2026

CODING: Words stricken are deletions; words underlined are additions.
hb1351-00
Page 1 of 4
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S

A bill to be entitled 1
An act relating to presumptive Medicaid eligibility 2
for pregnant women; amending s. 409.903, F.S.; 3
authorizing certain entities meeting specified 4
criteria to serve as qualified Medicaid providers for 5
purposes of making presumptive Medicaid eligibility 6
determinations for pregnant women; requiring the 7
Department of Children and Families to ensure that 8
such providers are adequately trained and monitored 9
for compliance when serving in such roles; requiring 10
the Agency for Health Care Administration to provide 11
Medicaid coverage to pregnant women deemed 12
presumptively eligible for the duration of a specified 13
time period; providing that pregnant women deemed 14
presumptively eligible are entitled to coverage of all 15
medically necessary services under the Medicaid 16
program during such eligibility period; requiring that 17
all prior authorizations granted before or during such 18
period remain in effect for the duration of such 19
period; requiring the agency, within a specified 20
timeframe, to seek federal approval to extend the 21
allowable period of presumptive Medicaid eligibility 22
coverage for pregnant women; requiring the agency and 23
the department to initiate certain rulemaking within a 24
specified timeframe; providing an effective date. 25

HB 1351 2026

CODING: Words stricken are deletions; words underlined are additions.
hb1351-00
Page 2 of 4
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S

26
Be It Enacted by the Legislature of the State of Florida: 27
28
Section 1. Subsection (5) of section 409.903, Florida 29
Statutes, is amended to read: 30
409.903 Mandatory payments for eligible persons.—The 31
agency shall make payments for medical assistance and related 32
services on behalf of the following persons who the department, 33
or the Social Security Administration by contract with the 34
Department of Children and Families, determines to be eligible, 35
subject to the income, assets, and categorical eligibility tests 36
set forth in federal and state law. Payment on behalf of these 37
Medicaid eligible persons is subject to the availability of 38
moneys and any limitations established by the General 39
Appropriations Act or chapter 216. 40
(5) A pregnant woman for the duration of her pregnancy and 41
for the postpartum period consisting of the 12-month period 42
beginning on the last day of her pregnancy, or a child under age 43
1, if either is living in a family that has an income that is at 44
or below 185 percent of the most current federal poverty level. 45
Such a person is not subject to an assets test. Further, a 46
pregnant woman who applies for eligibility for the Medicaid 47
program through a qualified Medicaid provider must be offered 48
the opportunity, subject to federal rules, to be made 49
presumptively eligible for the Medicaid program. 50

HB 1351 2026

CODING: Words stricken are deletions; words underlined are additions.
hb1351-00
Page 3 of 4
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S

(a) Qualified Medicaid providers that may conduct 51
presumptive eligibility determinations for Medicaid for pregnant 52
women include, but are not limited to, hospitals participating 53
in the Medicaid program; federally qualified health centers; 54
birth centers; nonprofit maternal and child health 55
organizations, such as healthy start coalitions; clinics 56
operating under the Special Supplemental Nutrition Program for 57
Women, Infants, and Children; and local housing authorities, 58
provided such entities have met the applicable training and 59
certification standards established by the department for such 60
purpose. The department shall ensure such providers are 61
adequately trained and monitored for compliance with federal and 62
state requirements relating to presumptive eligibility 63
determinations. 64
(b) For pregnant women deemed presumptively eligible under 65
this subsection, the agency shall provide such coverage under 66
the Medicaid program for the maximum period allowable under 67
federal law or until a full Medicaid eligibility determination 68
is made, whichever occurs earlier. 69
(c) Pregnant women deemed presumptively eligible under 70
this subsection are entitled to coverage of all medically 71
necessary services under the Medicaid program, including, but 72
not limited to, services provided by specialists and 73
subspecialists needed to comanage high-risk pregnancies, 74
including for issues outside the scope of general obstetrics. 75

HB 1351 2026

CODING: Words stricken are deletions; words underlined are additions.
hb1351-00
Page 4 of 4
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S

All prior authorization approvals granted before or during the 76
presumptive eligibility period remain valid for the duration of 77
such period to ensure continuity of care and to reduce the risk 78
of adverse maternal or infant health outcomes. 79
Section 2. Within 60 days after this act becomes a law, 80
the Agency for Health Care Administration shall seek federal 81
approval to extend the allowable period of presumptive Medicaid 82
eligibility for pregnant women to 180 days under s. 409.903, 83
Florida Statutes, and the agency and the Department of Children 84
and Families, as applicable, shall initiate any necessary 85
rulemaking to implement the amendments made by this act to s. 86
409.903, Florida Statutes. 87
Section 3. This act shall take effect July 1, 2026. 88