Texas Legislature passes bill to offer new moms a year of Medicaid coverage

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New moms in Texas will likely soon qualify for a year of Medicaid coverage, after state lawmakers approved a bill to extend coverage to 12 months after childbirth.

The House voted 134-9, with bill sponsor Rep. Toni Rose, D-Dallas, leading a round of applause for House Speaker Dade Phelan, R-Beaumont, who made the bill a priority item this session. The Senate, which last session reduced a similar proposal to six months of coverage voted unanimously to grant the full year of Medicaid to new moms. The bill now goes to Gov. Greg Abbott, who has said he supports the legislation.

This caps a yearslong effort to extend postpartum Medicaid beyond two months in a state with increasing maternal mortality rates and where one in four women of childbearing age have no access to health insurance outside of pregnancy.

Maternal health advocates have been calling for a full year of postpartum Medicaid for years, and it’s long been the top recommendation from the state’s Maternal Mortality and Morbidity Review Committee.

This session, in the wake of the overturn of Roe v. Wade, the bill to expand postpartum Medicaid caught bipartisan support from a wide-ranging coalition of legislators and advocates, and it initially passed the House with overwhelming backing.

But the bill hit a snag in the Senate as Republicans demanded an amendment that specified women who had elective abortions do not qualify for the extended Medicaid coverage. The original bill said simply that the coverage began on the last day of pregnancy; it did not specify how that pregnancy had to end.

Abortion is banned in Texas except to save the life of the pregnant patient. Anti-abortion groups have said that allowing extended Medicaid coverage to go to women who had out-of-state or illicit abortions is tantamount to using state funds to support abortion.

Throughout the session, advocates called for the Legislature to pass a “clean” bill that matches the language in Medicaid guidelines to ensure the federal Centers for Medicare and Medicaid Services quickly accepts the state’s application for the extension.

Sen. Nathan Johnson, a Dallas Democrat, said on the floor Sunday that Republican senators’ amendment left “the entire program…vulnerable to not being approved.”

“I don’t want to gamble with women’s lives…so I wish you’d take these words out,” Johnson said.

Bill sponsor Sen. Lois Kolkhorst, R-Brenham, said this was a necessary compromise to get the bill to pass the Senate.

“My goal is to get this bill over the goal line and allay some of the … concerns of members on this floor,” she said. “I think that this is a compromise that is best.”

In a closed-door conference committee this week, House members agreed to accept the bill with a version of the Senate’s amendment. The bill now includes a “legislative purpose” section that reads, “Out of the state’s profound respect for the lives of mothers and unborn children, Medicaid coverage is extended for mothers whose pregnancies end in the delivery of the child or end in the natural loss of the child.”

Rose told the House on Sunday that the compromise amendment was “perfectly crafted” to allow the state to still seek accelerated approval of the 12-month extension through a state plan amendment. It will be up to the federal government to decide whether to approve the proposal.

This bill comes at a crucial moment, as millions of Texans face the end of Medicaid benefits for the first time since the COVID-19 pandemic began in March 2020. Texans who receive Medicaid benefits are encouraged to make sure their information is up to date at YourTexasBenefits.com.

“We’re thrilled that Texas is taking this critical step forward to support healthy moms and babies,” said Diana Forester, director of health policy at health advocacy group Texans Care for Children. “This legislation will ensure that more Texas moms can keep seeing their doctor, continue their medications, and take other steps to stay healthy during a time that is so important for their health and their baby’s health.

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