Honor Moms by Expanding Maternal Health Care

This commentary by Diana Forester, Director of Health Policy for Texans Care for Children, originally appeared in the San Antonio Express-News, the Corpus Christi Caller-Times, and the Amarillo Globe-News.

As we celebrate moms with flowers, brunch or a FaceTime call, we should also take a moment on Mother’s Day to commit to ensuring Texas moms get the health care they need.

There are a number of steps policymakers should take, but one critical proposal has been championed by legislators from Republican Texas House Speaker Dade Phelan to Rep. Toni Rose, D-Dallas, and 66 Texas organizations ranging from the Texas Medical Association to the Lubbock Chamber of Commerce to my organization, Texans Care for Children.

The proposal is simple: When Texas moms get Medicaid health insurance to cover their pregnancy and childbirth, let them continue to see those doctors and keep the insurance until their baby’s first birthday.

Texans across the political spectrum have focused on this first year after childbirth because it is so critical for the health of moms, as well as their babies’ health and development. For example, the Maternal Mortality and Morbidity Review Committee appointed by Gov. Greg Abbott has called for a full year of comprehensive health coverage for moms after their pregnancy as a key strategy for preventing maternal deaths.

And we know maternal mortality is the tip of the iceberg. Many more Texas moms face medical issues and complications in the year following pregnancy, such as postpartum depression, cardiac arrest, infection and dangerous blood clots.

These issues often lead to extra hospital stays, long-term health problems for mother and baby, and higher costs to Medicaid and the state.

Under current state policy, when the pandemic Public Health Emergency rules end later this year (possibly as soon as Aug. 1), Texas will resume its practice of ending moms’ Medicaid health insurance when their baby is just 2 months old.

The Legislature took an important step last year to address this challenge — but it was a partial step, and Texas has not been able to implement it yet. Under Phelan’s leadership, the Texas House passed House Bill 133 to allow moms to keep their health coverage for the full 12 months. The Senate reduced it to six months, Sen. Lois Kolkhorst, R-Brenham, worked valiantly to pass it, and the governor signed it into law.

If Texas had approved 12 months of coverage, it would already be in place for Texas moms. Under federal policy that passed in 2021 and took effect last month, states can easily implement a 12-month coverage plan. In fact, over half the states, including other Southern states such as Alabama and South Carolina, are already implementing this option or planning to do so.

The six-month approach passed by the Texas Legislature, on the other hand, requires states to negotiate with the federal government for a waiver under Medicaid rules — always a slower and uncertain process. We have endorsed the state’s waiver request, but state leaders shouldn’t stop there.

This week, the Texas House is holding a hearing to discuss where HB 133 stands and the best way forward.

The best solution is for the Legislature to finish the job, let new moms stay enrolled in Medicaid for a full year and truly honor Texas mothers.