Medicaid expansion for new moms denied
State lawmakers who successfully passed a measure last year extending postpartum Medicaid benefits said Thursday the Biden administration will reject the proposal, citing concerns over its eligibility criteria.
The administration did not immediately explain the decision, but Texas Democrats said the issue has to do with the plan’s limitations. It only includes patients who deliver or have “involuntary miscarriages,” excluding those forced to get abortions because of severe medical complications.
Nearly all abortions are banned or unattainable in the state, except for lifethreatening medical complications to a pregnant patient.
The decision will not immediately impact mothers on Medicaid, since that coverage is protected temporarily under a federal health emergency for the pandemic. But it could become a problem if lawmakers cannot respond with a fix before the health emergency ends; it’s currently extended through Oct. 13.
“Being disappointed is an understatement of how I feel about this,” said Rep. Toni Rose, D-Dallas, who led the fight for the bipartisan measure. “It was a historic win for Texas moms and families.”
Rose and other lawmakers, including Republican House Speaker Dade Phelan, said they were committed to pushing the measure when the Legislature convenes for its next biennial session in January.
“The Texas House will again prioritize passing legislation that extends health coverage to a year for new Texas moms in 2023 as well as other measures that focus on better supporting mothers, children and families in our state,” Phelan said in a statement.
The Centers for Medicare and Medicaid Services said Friday that it was still reviewing the plan, and that no formal determination had been made.
Low-income mothers who give birth in Texas have been typically eligible for two months of continued Medicaid coverage. The extension passed last year pushed it to six months, while most states have extended their postpartum coverage to a year.
Medicaid covers hospital visits and specialty care that other programs don’t typically cover.
The Biden administration had offered to fasttrack approval for states that extended coverage to a full year, but since Texas chose six months, it was required to go through a lengthier approval process. Rep. Donna Howard, an Austin Democrat, said the state health agency submitted the application earlier this summer.
“The good news about this, if there is any good news, is that the public health emergency is still in place, and it’s expected it will be in place perhaps till January, which means that nobody’s going to be dropped off of this program right now,” Howard said.
Howard, a trained nurse, said she was unsure where the term “involuntary miscarriage” had come from in the first place and that it was probably meant to rule out coverage for patients seeking elective abortions.
“Where I think this could be of concern is for those who are further along in their pregnancies and have complications and elect to have an abortion to protect themselves,” she said. “And or to lessen the pain of having a non-viable fetus.”
Texas has the highest uninsured rate in the U.S., and many low-income women don’t have access to the postpartum care that experts say is critical to preventing maternal deaths and complications that disproportionately affect women of color.
Howard said she is hopeful that Gov. Greg Abbott will expedite the measure next session and both chambers can pass a revised version that includes 12 months of coverage. The House had approved 12 months last year, but the Senate cut it to six. Both chambers are controlled by Republicans.