Texas Postpartum Medicaid Application Stalled

Government, Health, Lifestyle

Baby in hospital nursery | Image by Shutterstock

An effort by the Texas legislature to extend Medicaid coverage for new mothers will likely be rejected by the federal Centers for Medicare and Medicaid Services (CMS) because the benefits are too restrictive, according to government officials.

During the 2021 state legislative session, a bill was passed to lengthen the span of coverage from two months postpartum to six months.

As of now, the CMS has not made a ruling. However, Kelli Weldon, the Texas Health and Human Services Commission spokesperson, has confirmed that the CMS labeled the bill as “not approvable.”

Lawmakers that previously formulated the 2021 bill believe that specific wording is to blame for the rejection. According to the Texas House Women’s Health Caucus, the health insurance benefits were only available to mothers who safely delivered a baby or had an involuntary miscarriage. Under the bill, those who terminate a pregnancy by abortion are not covered.

Rep. Donna Howard (D-Austin), who is a nurse and former health educator, calls the stalled application process a “self-inflicted wound.”

As part of the 2021 American Rescue Plan Act, the federal government eased the application requirements for states that expanded Medicaid for 12 months postpartum. States that expanded Medicaid access for a full year postpartum were almost automatically approved on a federal level.

The Texas House of Representatives approved the 12-month expansion, but the Texas Senate subsequently amended the expansion to only six months. Due to this, the Texas application was not fast-tracked and instead faced a longer, more rigorous application process.

Governor Greg Abbott, who worked to pass the bipartisan Medicaid six-month expansion, laid the blame for the stalled process on the federal government. “The Biden Administration is risking robbing mothers of services that Texas specifically extended for them postpartum,” Abbott said. “President Biden must immediately direct his administration to reverse this unconscionable move or get ready for a fight with Texas.”

In his press release, Abbott did not acknowledge that the final Texas bill shortened postpartum coverage from 12 months to six months or that the bill does not cover postpartum care in all pregnancy outcomes.

The Medicaid program helps fund 4 out of 10 births in the U.S., the Kaiser Family Foundation states. Currently, states must offer continuous postpartum Medicaid coverage to mothers due to the COVID-19 public health emergency declaration. Once the continuous coverage ends, it will ultimately be up to the individual states to determine how long Medicaid coverage shall be extended.

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