Texas House moves to expand Medicaid coverage to new moms for a year after childbirth

Patients wait to be seen at the People's Community Clinic in Austin, which provides state-subsidized women's health services to low-income women, July 15, 2014. (Callie Richmond For The Texas Tribune, Callie Richmond For The Texas Tribune)

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The Texas House passed a bill Friday that would allow low-income moms to stay on Medicaid for a full year after childbirth. The bill was approved with bipartisan support in a 132-8 vote. All of the votes against the bill were from Republicans; four Republicans who voted no on preliminary passage Thursday switched their votes to support the legislation Friday.

Currently, postpartum Medicaid expires after two months in Texas. The House passed a similar measure last session, but the Senate reduced it to six months of coverage. That proposal is stuck in bureaucratic limbo after the federal government said it is “unapprovable” in its current form.

But in the two years since the Legislature last met, the landscape around this issue has changed dramatically. Most states adopted the 12-month policy, and the U.S. Supreme Court’s overturn of Roe v. Wade engendered more support for new moms.

The Republican Party of Texas, as well as Gov. Greg Abbott and more than 170 Texas groups from across the political spectrum, have come out in support of the legislation. But Lt. Gov. Dan Patrick, who has considerable influence over what passes in the Senate, has not publicized his position on the legislation.

This bill comes at a perilous time for parents on Medicaid. The state has begun moving people off of the health insurance program for the first time in three years as the federal COVID-19 Public Health Emergency comes to an end. Earlier this month, Texas Health and Human Services began redetermining eligibility for more than 5 million Texans who obtained health coverage through Medicaid during the pandemic.

As one of just 11 states that has not expanded Medicaid under the Affordable Care Act, Texas has the largest uninsured population in the country — nearly 1 in 5 Texans have no health insurance. But it’s easier for pregnant and postpartum parents to qualify.

Allowing new moms to stay on Medicaid for 12 months is the top recommendation of the state’s Maternal Mortality and Morbidity Review Committee, which recently documented the staggering risks of pregnancy and childbirth in Texas.

The task force’s recent report found that women without private-pay insurance coverage faced the highest rates of severe maternal morbidity, and a quarter of maternal deaths happened between 43 days and one year after childbirth.

“Moms can face a lot of health challenges during those 12 months — including postpartum depression, cardiac arrest, infection, and extreme blood loss or hemorrhage — so it’s important that they can keep getting the health care they need,” Diana Forester, the director of health policy at the health care advocacy group Texans Care for Children, said in a statement.

House Bill 12, filed by Rep. Toni Rose, D-Dallas, has more than 50 co-authors and is a top priority for House Speaker Dade Phelan, R-Beaumont.

“As I have said before, it is essential that the Texas House makes meaningful progress this year on better supporting mothers and children in the state — and that starts with extending health coverage for new moms to a full year,” Phelan said in a statement announcing his priorities for the legislative session.

Disclosure: Texans Care for Children has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune’s journalism. Find a complete list of them here.

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