In 2025, Texas lawmakers passed House Bill 136 by Rep. Lacey Hull and Sen. Carol Alvarado, a major step toward expanding access to lactation support for Texas families. Texans Care for Children was proud to support this legislation, which added lactation consultation services as a covered benefit under Medicaid health insurance.

This is an important win for Texas mothers and babies. Medicaid covers almost half of all births in Texas, so making lactation support available through Medicaid has the potential to connect thousands of families with professional support during pregnancy and after birth.

The Texas Health and Human Services Commission (HHSC) has now proposed rules for implementing the new Medicaid benefit. We appreciate the agency’s work and stakeholder engagement in developing the rules. Overall, we believe the proposed rules provide a strong foundation. 

However, we recently submitted comments to HHSC outlining important changes the agency should make before finalizing the new rules. 

One of our biggest concerns is making sure the new benefit can actually reach families who deliver at rural hospitals and other facilities that do not employ their own lactation consultants.

Many rural hospitals do not have the resources to keep a lactation consultant on staff. That should not mean a mother has to go without professional lactation support simply because she lives in a rural community.

HHSC should clarify that an external lactation consultant can provide Medicaid-reimbursable services to a mother during her hospital stay when the hospital does not have its own lactation consultant. This is particularly important for ensuring that the new benefit expands access in communities where lactation support may otherwise be difficult to find.

We also recommend changes to make the benefit easier for providers to bill for and easier for families to access.

HHSC should clarify that lactation services can be provided individually or in groups and through telehealth when appropriate. The agency should also clarify that providers such as federally qualified health centers, rural health clinics, hospitals, and other qualified organizations can bill Medicaid on behalf of lactation consultants they employ.

Finally, the rules should clearly state that lactation consultation services are separately reimbursable from other professional services. Clear billing rules will make it easier for providers to participate in the benefit and help ensure that Medicaid families can actually access the services the Legislature intended to provide.

Read our full comments to HHSC.

Texans Care for Children gratefully acknowledges Methodist Healthcare Ministries of South Texas, Inc., for their financial support of this publication. The opinions expressed in this document are those of Texans Care for Children and do not necessarily reflect the views of Methodist Healthcare Ministries.