When Medicaid was first established in 1965, the low income families covered by the program generally were headed by single mothers who received welfare cash assistance. In the 1980s, Congress broke the welfare-Medicaid link for low-income pregnant women by first allowing—and later requiring—states to extend eligibility for Medicaid-covered prenatal, delivery and postpartum care (including postpartum family planning services) to all
women with incomes up to 133% of the federal poverty level—an income level far above most states’ regular Medicaid eligibility ceilings. At their option, states could expand eligibility for pregnancy-related services to women with incomes up to 185% of the poverty level or beyond.
1 In the 1990s, Congress continued this piecemeal, state-based expansion of public health coverage—most notably, by enacting the State Children’s Health Insurance Program (SCHIP) in 1997 as a companion program for Medicaid to provide coverage for low-income children.