A Year of Health Insurance After Pregnancy Would Help TX Babies and Moms

UPDATE: HB 133 passed the Texas House on April 15, 2021 is now in the Senate. We have added additional resources regarding the bill, including Speaker’s Phelan’s op-ed endorsing the bill, at the end of this blog.

We strongly support SB 141 by Sen. Nathan Johnson, SB 1187 by Sen. Carol Alvarado, HB 107 by Rep. Senfronia Thompson, HB 133 by Rep. Toni Rose, HB 146 by Rep. Shawn Thierry, HB 98 by Rep. Lina Ortega, and HB 414 by Rep. Armando Walle*. These bills would extend Medicaid health insurance for new mothers from 60 days to one year after pregnancy.

The legislation would implement the top recommendation of Texas’ Maternal Mortality & Morbidity Review Committee — and maternal deaths are only the tip of the iceberg. Many more Texas mothers face severe pregnancy complications that have harmful health effects on mom and baby during the critical early years of a child’s brain development and can lead to expensive hospital or NICU stays. For example, untreated postpartum depression can harm a child’s brain development, language skills, and school readiness. A recent study found that failing to treat maternal mental health conditions costs Texas $2.2 billion for one year of childbirths.

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Access to health insurance is key for addressing these challenges, yet Texas is one of the only states where Medicaid is typically not available to women with jobs below the poverty line, except during their pregnancy and 60 days after pregnancy. When Texas women become uninsured 60 days after pregnancy, they may only have access to the state’s new Healthy Texas Women Plus (HTW Plus) program. HTW Plus is an important advancement for women’s health and could be the backbone for a comprehensive benefit program through postpartum Medicaid. However, as opposed to the proposed 12-month Medicaid coverage, HTW Plus does not cover many important services, including a broad prescription drug benefit, surgical care, hospital inpatient or outpatient care, and physical therapies, and has virtually no network of specialty or mental health providers to deliver covered services right now. Improving access to Medicaid insurance has been shown to increase use of postpartum outpatient care, particularly for women who have had pregnancy complications.

Over 60 national organizations support extending Medicaid postpartum coverage to 12 months, including American Medical Association, the American College of Obstetricians and Gynecologists (ACOG), the American Academy of Family Physicians, March of Dimes, and the Society for Maternal-Fetal Medicine.

In 2019, with strong bipartisan support, the Texas House passed HB 744 to implement 12-month postpartum Medicaid, although the legislative session ended before the Senate took up the bill.

It’s important to note that these bills would only provide an additional 10 months of insurance to mothers with low incomes, whereas Medicaid expansion bills would provide ongoing access to health insurance (not just one year) for all legally present adults with low incomes (not just moms).

Update March 15, 2020:

The COVID-19 relief package recently signed by the President makes it easier for Texas to implement 12-month postpartum insurance legislation — once passed by the Legislature — without the long negotiation process with the federal government that was previously required. Additional information is available here.

Additional Resources:

*Rep. Walle’s bill would extend coverage for two years, while the other bills extend it for one year.