A bill passed unanimously by Texas senators on Monday will give new mothers a full year of healthcare coverage if reconciled by the House and approved by the Centers for Medicare and Medicaid.
Penned by Senator Lois Kolkhorst (R-Brenham), HB 12 raises the duration of postpartum Medicaid coverage to Texas mothers from six months to one year.
Yet shortly before being approved on May 22, Kolkhorst added an amendment excluding women who had an elective abortion from receiving postpartum coverage. The bill and its new amendment will be returned to the House for reconciliation before it can be submitted for federal approval.
The federal government requires that new mothers have access to Medicaid two months after giving birth. But a provision in the 2021 American Rescue Plan Act allows states to extend this coverage to 12 months for up to five years by funding it themselves or filing a section 1115 waiver.
It is estimated that four in 10 new births nationwide are funded through Medicaid, according to the Kaiser Family Foundation.
All states but Texas, Utah, and Wisconsin have either implemented measures to extend postpartum Medicaid coverage or have a section 1115 waiver pending.
With its new amendment, some lawmakers are concerned that HB 12 will not pass federal approval due to the anti-abortion phrasing.
For instance, Senator Nathan Johnson (D-Dallas) noted that the amendment was unnecessary, considering that elective abortions had been mostly banned in Texas and was an unwarranted risk, according to the Texas Tribune.
“I don’t want to gamble with women’s lives … so I wish you’d take these words out,” Johnson said, according to the Texas Tribune.
The Centers for Medicare and Medicaid has flagged previous proposals to extend postpartum coverage from Texas lawmakers for being too restrictive in the eligibility requirements, according to The Dallas Morning News.
Yet as Kolkhorst explained, the new amendment is actually a compromise with certain senators who are worried that the promise of extended postpartum healthcare would encourage women to get abortions.
“My goal is to get this bill over the goal line,” Kolkhorst said, according to the Texas Tribune.
Senator Kelly Hancock (R-North Richland Hills) argued that if the Centers for Medicare and Medicaid don’t approve the bill with its new amendment, then the consequences lie on the federal government.
“It’s my opinion that as Texans we’re reaching out more than halfway to address the concerns of the federal government,” Hancock said, according to the Texas Tribune. “If they fail us on this one, then they’re failing the women in the state of Texas.”
As The Dallas Express reported, maternal mortality rates across the U.S. have hit the highest level seen in almost 60 years. A total of 1,205 women died during pregnancy or just after giving birth in 2021, representing a 40% increase from the year prior, according to the CDC.
Texas ranks 35th nationwide in maternal mortality.
As The Dallas Express reported, the Texas Maternal Mortality and Morbidity Review Committee found earlier this year that 118 women died during childbirth and pregnancy in 2019, representing approximately 20% of the national average.
Speaking before the Texas Senate Health and Human Services Committee on May 16, Dr. Margaret Whitney of Austin testified on the importance of postpartum care for women as observed during her experience as a practicing OB/GYN.
She noted that when new mothers no longer have health insurance, they seek help from non-specialists in ERs and often to their own detriment.
“What is even more staggering are the women I never see again because they have lost their lives after bringing their baby into this world,” Dr. Whitney said, according to the Texas Senate.
As The Dallas Express reported, in the wake of the COVID-19 emergency ending, the Texas Health and Human Services Commission has resumed redetermination of Medicaid eligibility for the estimated 5.6 million Texans currently benefiting from Medicaid.