Conditions
A State may only elect the option under subsection (a) if the following conditions are satisfied:
(1) Minimum income eligibility levels for pregnant women and children The State has established an income eligibility level— (A) for pregnant women under subsection (a)(10)(A)(i)(III), (a)(10)(A)(i)(IV), or ( l )(1)(A) of section 1396a of this title that is at least 185 percent (or such higher percent as the State has in effect with regard to pregnant women under this subchapter) of the poverty line applicable to a family of the size involved, but in no case lower than the percent in effect under any such subsection as of July 1, 2008 ; and (B) for children under 19 years of age under this subchapter (or subchapter XIX) that is at least 200 percent of the poverty line applicable to a family of the size involved.
(2) No CHIP income eligibility level for pregnant women lower than the State’s Medicaid level The State does not apply an effective income level for pregnant women under the State plan amendment that is lower than the effective income level (expressed as a percent of the poverty line and considering applicable income disregards) specified under subsection (a)(10)(A)(i)(III), (a)(10)(A)(i)(IV), or ( l )(1)(A) of section 1396a of this title , on February 4, 2009 , to be eligible for medical assistance as a pregnant woman.
(3) No coverage for higher income pregnant women without covering lower income pregnant women The State does not provide coverage for pregnant women with higher family income without covering pregnant women with a lower family income.
(4) Application of requirements for coverage of targeted low-income children The State provides pregnancy-related assistance for targeted low-income pregnant women in the same manner, and subject to the same requirements under section 1397cc(c) of this title , as the State provides child health assistance for targeted low-income children under the State child health plan, and in addition to providing child health assistance for such women.
(5) No preexisting condition exclusion or waiting period The State does not apply any exclusion of benefits for pregnancy-related assistance based on any preexisting condition or any waiting period (including any waiting period imposed to carry out section 1397bb(b)(3)(C) of this title ) for receipt of such assistance.
(6) Application of cost-sharing protection The State provides pregnancy-related assistance to a targeted low-income woman consistent with the cost-sharing protections under section 1397cc(e) of this title and applies the limitation on total annual aggregate cost sharing imposed under paragraph (3)(B) of such section to the family of such a woman.
(7) No waiting list for children The State does not impose, with respect to the enrollment under the State child health plan of targeted low-income children during the quarter, any enrollment cap or other numerical limitation on enrollment, any waiting list, any procedures designed to delay the consideration of applications for enrollment, or similar limitation with respect to enrollment.