AUSTIN – Senators watered down a proposal that originally sought to ensure thousands of new mothers had health insurance for a full year after delivery, offering six-month coverage.
The Medicaid coverage extension bill aims to prevent mothers from dying or developing serious complications after pregnancy. Medicaid covers low-income women during pregnancy and cuts 60 days after delivery, leaving them little time to schedule follow-up appointments or continue treatment, according to advocates.
Senator Lois Kolkhorst, R-Brenham, offered no reason to reduce the time period, which was passed unanimously this week in the steering committee. Lieutenant Governor Dan Patrick said Friday that he supported the bill, “we only needed to do it in less than a year.”
“The language we’re talking about in six months is something the Senate will support,” the Republican told Spectrum News, adding that he is only aware of another state offering 12 months.
If the bill is approved by the Senate, the House should accept the changes or try to eliminate the differences in a conference committee.
The proposed reduction in coverage by half conflicts with the advice of expert legislators who called for help in combating maternal mortality. The expert group recommended a full year of comprehensive care, after finding a significant number of Texas women who died in the months following childbirth due to a number of causes, such as drug overdose, heart events , suicide and infections. Black women in Texas died at a disproportionately higher rate than other new mothers.
Representative Toni Rose, D-Dallas, who introduced the bill to extend Medicaid coverage from two months to a full year for new mothers, did not respond to a request for comment on the change in the Senate. . But Rose told The Dallas Morning News earlier this month that she introduced legislation to make black women die at an alarming rate.
“It’s important for women to seek the treatment they need after having a baby,” she said.
“Women commit suicide because they don’t have access to care,” Rose added. “You’re home after having a postpartum baby and you don’t know what’s wrong with you, but if you can have access to health care or a doctor, you can get the treatment you need.”
The change will affect thousands of women each year. About half of babies in Texas are born to Medicaid mothers.
Expanding coverage a year after birth would cost the state between $ 77 million and $ 102 million a year over the next few years, according to estimates. These projections are not yet available for the Senate’s six-month proposal, but would probably cost less. Medicaid is funded by a combination of state and federal funds.
The House overwhelmingly supported 12 months of coverage and House Speaker Dade Phelan R-Beaumont made it a priority.
The bill, Bill 133, is one of the few that advanced this session that would extend Medicaid coverage to Texas, where one in five people do not have health insurance. A much larger proposal to expand Medicaid to cover hundreds of thousands of low-income jeans did not receive a committee hearing in either chamber.
Proponents praised the legislature’s focus on maternal health, though they said the evidence supports the 12-month coverage period.
“An additional four months is certainly better than cutting off mothers 60 days after delivery, but the evidence is clear that treating mothers’ physical and mental health conditions for a full year after delivery is critical to their health. and for the development of her baby, ”Stephanie Rubin, CEO of advocacy group Texans Care for Children said in a statement.
The federal government only requires Medicaid coverage related to pregnancy to last 60 days after delivery, although several states have extended it to six months or a year, according to the Kaiser Family Foundation.
At a recent Senate hearing on the bill, Kolkhorst said an extension is the right thing to do.
“It protects children, the facts and then childbirth,” she said. “Quite surprising that so few states offer 12-month coverage and that this would put Texas in a different category.”
A bill passed last session allows women access to certain health benefits once Medicaid is over, including mental health services, substance abuse treatment, and asthma medications, but not full insurance coverage.
In its latest report, the Texas State Maternal Mortality and Maternal Morbidity Review Committee found that nearly one-third of the deaths they reviewed as of 2013 occurred in the months following the birth of a child. woman. Chronic illness was an important factor. The committee found that pregnant women who did not have access to care or financial resources often postponed treatment or did not seek it at all.
Marjorie Quint-Bouzid, senior vice president of health and infant health at Parkland Hospital, knows this first hand.
“We will recognize that they have this chronic illness during pregnancy, but we are ill-prepared to do many things about it after giving birth because their insurance expires in two months,” she said.
Many of the conditions that kill women, including hypertension and diabetes, require regular checkups and medications, she said. But without insurance, many women stop seeking care because they can’t afford it. If they get sick enough, they end up in the emergency room, he said.
“If we are able to keep these women healthy, they will get into healthier future pregnancies,” Quint-Bouzid said. “In the end, it affects the child’s health as well as the mother’s health.”