A new bill may allow mothers in Texas with Medicaid to retain their health insurance coverage for 6 months postpartum, in place of two months. As for maternal health champions, the bill could lessen Texas’s rate of maternal mortality as well as aid mothers with health conditions such as postnatal depression or complications over the months following successful delivery.
Medicaid may cover low-income people from pregnancy up to two months postpartum, but one-third of the fatalities in Texas have occurred 43 or more days after labor. As per state reports, African-Americans die disproportionately during pregnancy or postpartum.
The extension of 6 months in the Texas State Senate’s HB 133 version is stingier as compared to a proposal that the House of Representatives passed, with the GOP House speaker’s support. That would provide mothers with a year of postnatal coverage, in keeping with the recommendations of professionals and a Texas committee that is devoted to exploring maternal mortality.
State legislators are likely to negotiate the bill’s changes away from the public eye.
The proposal may affect thousands of mothers in Texas, a state with the US’s biggest uninsured resident count. Mothers with Medicaid give birth to around 50% of Texas babies, around 181,000 babies before three years.
Many of the women are ineligible for Texas Medicaid before pregnancy or after it since the US state has stricter eligibility limits than the rest of the country.
Senator Lois Kolkhorst, the draft law’s sponsor, said that making the legislative move means choosing women and their health. The US media may have portrayed the bill version as one with 6 months fewer, but Kolkhorst clarified that legislators are including four more months in it. That would make Texas one of America’s first states to expand the bill past two months.
As per the US federal government, states must offer postpartum coverage for two months to mothers with Medicaid, even as many states have looked to expand it to 12 months.
In the US states where Medicaid is expanded, mothers who make around $3,000 monthly for their four-member family, can continue to be eligible for Medicaid after successful labor. Texas is among the few states in this country that have chosen against expanding Medicaid. Here, qualifying for the insurance program requires parents to make below the poverty level, which is around $200 per month per mother with a child.
The Texas Senate’s bill version might cost this state $49,000,000 in 2026, in the event of it being completely ramped up. Conversely, experts project that the House’s measure would cost below $90,000,000 in the same year.
Studies and experts have discovered that the US has a higher rate of maternal mortality than other nations that fall under the ‘high-income economy’ category. They have also found that several maternal deaths can be prevented. As per a Texas report, drug overdoses, heart issues and suicide are among the reasons for pregnancy-related fatalities in the US state.
The Texas Maternal Mortality and Morbidity Review Committee’s chair, Lisa Hollier, said that complications such as mental health issues and heart disease are likelier to occur well after labor.
As for Hollier, women must be able to access the entire range of health services, such as hospitalizations and emergency room trips, that can aid them in recovering from heart conditions.
A program known as HTW Plus offer mothers coverage for one year for substance use/mood disorders, asthma, cardiovascular disease, and diabetes. According to Hollier, HTW Plus is a useful but limited outpatient service package. Medicaid offers not only the same health services but also additional drugs, hospitalizations and testing that the state’s program does not cover.
Maternal health proponents have stated that there is virtually no mental health or specialty provider network in the Texas program to deliver the said services. Previously uninsured women might know that they have non-diagnosed health issues during pregnancy and might be getting Medicaid’s coverage. Anyhow, the advocates also said that those women might be incapable of treating their issues before the coverage expires.
HB 133 authors from the House stated that the State Senate version’s 6-month extension of the coverage in place of 12 has made them disappointed.
Cindy Zavala, a 19-year-old from El Paso, found six months to be not sufficiently long to address women’s health concerns after successful labor. Zavala gave birth to a boy two years ago, but she approached her doctor after feeling bladder pain six months later. She chose to wait until its end, thinking that the unpleasant issue might have occurred due to carrying her baby, or a device put into her uterus and removed postpartum. However, Zavala’s pain did not go away until that doctor prescribed pregnancy prevention pills for her.
She still had Medicaid coverage as the US federal government prevented states from removing new mothers from it during the pandemic. Zavala is unsure what would have happened if it was unavailable to her.
She feels that many hormones go through the body when mothers breastfeed, so a number of things happen to them even post six months.
The state-modified bill version also includes provisions from another legislative move that would shift Medicaid’s case management coverage for children and pregnant people to a model of managed care. The Senate makes a change like the above with the program known as ‘Texas Healthy Woman’.
The bill passage follows legislators’ action of passing on a much broader attempt to extend Medicaid to Texans who come under the ‘working poor’ category. As for proponents, the broader effort would let individuals access preventive healthcare in a better way instead of having to fall back on expensive emergency room trips. Opponents find Medicaid to be a badly managed program, which is also not sustainable in financial terms.
An earlier federal relief act incentivized US states to waive a cumbersome and lengthy process that they would usually have to undergo, thus expanding postnatal coverage from Medicaid to one year. It is not clear whether the streamlined procedure holds for that six-month expansion.
