Comments to HHSC on the Healthy Texas Women (HTW) Waive

We are concerned that the Healthy Texas Women (HTW) 1115 Demonstration Waiver implementation has included the removal of three critical HTW components:

  1. Auto-enrollment of new mothers from Pregnant Women’s Medicaid into HTW; 
  2. Adjunctive eligibility for women applying for HTW that are already enrolled in WIC, have a child in Medicaid, or in a household that receives SNAP or TANF; and
  3. the Simplified HTW Application Form (Form H1867). 

The policies above have been very popular and have helped boost client enrollment in HTW over the last several years – thereby reducing unintended pregnancies, improving health, and reducing costs to the state. In fact, in fiscal year 2019 alone, over 80,000 new mothers were auto-enrolled into HTW. Now, with the removal of these three critical policies as part of the HTW 1115 waiver, we are concerned that the goals of HTW — including connecting women to health care and encouraging HTW provider participation — will be undermined. Ultimately, eliminating the above three policies could drastically decrease enrollment in HTW and access to women’s preventive care, which presents a serious risk to Texas’s ability to achieve the budget neutrality expenditure targets included in the Standard Terms and Conditions of the approved waiver and could risk continued federal funding.