PolicyEngine / PolicyEngine/policyengine-us

Pregnancy-related Medi-Cal

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medicaid states/ca
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Description

Pregnancy-related Medi-Cal is California's Medicaid program for pregnant women with income between 138% and 213% of FPL. It is not comprehensive, only covering medically-necessary pregnancy-related services.

https://www.dhcs.ca.gov/services/medi-cal/Pages/Affordability-and-Benefit-Program.aspx

[KFF also notes](https://files.kff.org/attachment/Table-2-Medicaid-and-CHIP-Coverage-for-Pregnant-Women-and-Medicaid-Family-Planning-Expansion-Programs-January-2021.pdf) that:
>In California, pregnant women below 138% receive the full Medicaid package while women with income above 138% receive coverage for all medically-necessary pregnancy-related services.

The Policy Rules Database does not mention this, and [DB101](https://ca.db101.org/ca/programs/health_coverage/medi_cal/program2a.htm) incorrectly states that pregnant women in this income range are eligible for full Medi-Cal (I emailed them a correction).

We could implement this as a separate program, or make Medicaid coverage an Enum, or there may be other options. Ultimately we'll need to assign actuarial values to different coverage levels.

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