Lawmakers consider extending Medicaid coverage for new moms
Even though new mothers can die of pregnancy-related complications within a year of giving birth, they currently get kicked off Texas Medicaid 60 days after having a baby — a situation some lawmakers and medical experts are hoping to change by extending coverage 12 months after pregnancy.
A key group of Texas representatives considered a proposal this week that would lengthen health insurance coverage for low-income mothers, a measure endorsed by medical professionals and health care administrators across the state. Not one person spoke against it during a hearing.
“Our women are dying, or having severe pregnancy-related complications, for the simple fact that they choose to have a baby, and they choose to be a mother,” Marjorie Quint-bouzid, vice president of nursing for Women & Infants Specialty Health at Parkland Health & Hospital System in Dallas, told lawmakers during the hearing held Tuesday.
“I’m here today to appeal to you as a clinician, a hospital administrator, a woman and a mother,” she continued, urging lawmakers to advance the proposal.
Today, American women are 50 percent more likely to die in childbirth than their own mothers were. The U.S. is one of the most dangerous wealthy countries to be pregnant or have a baby, and the risks are highest for Black and Native American women, who are two and three times more likely to die of pregnancy-related complications than white women, according to federal data.
In Texas, it’s estimated that the vast majority of new mothers’ deaths could be prevented, according to a state task force that examines maternal health. One of the task force’s main recommendations to stop women from dying: make it easier for them to seek health care in the year after birth.
A similar proposal to cover mothers one year postpartum passed the Texas House in 2019 with support from both Democrats and Republicans but died in the Senate. About half of births in Texas are covered by Medicaid, and extending coverage was estimated to cost the state upward of $75 million a year.
Texas has both the largest number and highest rate of people without health insurance in the nation. It’s among a dozen states that haven’t expanded Medicaid to cover more low-income Americans, and women here typically only qualify for coverage if they’re disabled or after they’re already pregnant.
That means women often discover undiagnosed conditions such as diabetes and high blood pressure during prenatal appointments, rather than treating those conditions before they conceive, medical experts say. Then they’re cut off from lifesaving care 60 days after giving birth.
Dr. Lisa Hollier, who chairs of the Texas Maternal Mortality and Morbidity Review Committee, spoke in support of the measure on behalf of a several major health providers and medical organizations, including Texas Children’s Health Plan, Texas Children’s Hospital, Children’s Hospital Association of Texas, Texas Medical Association, American College of Obstetricians and Gynecologists’ Texas district, and the Texas Hospital Association.
Hollier, a leading maternal health expert, said new mothers with low incomes in Texas can currently access some services through the state’s Healthy Texas Women program, which was designed to provide preventative care to new mothers. But it is “a limited set of services,” she said.
“By extending Medicaid with a more comprehensive set of services, we would be able to reach more women and address their needs,” Hollier said.
The services that aren’t covered by the state’s Healthy Texas Woman program range from broad prescription drug benefits to surgical care to hospital stays, according to the Austin-based advocacy group Texans Care for Children.
Another major issue that could be addressed by extending Medicaid is mental health care for new mothers.
It’s estimated that 1 in 8 women experience symptoms of depression after giving birth, and over half of pregnant women aren’t treated, according to the federal government. In Texas, suicide is one of the most common causes of death for new mothers.
Although the Healthy Texas Woman program does cover mental health care, the nonprofit said there’s “virtually no network” of participating providers to deliver that care right now.
Adriana Kohler, the policy director of Texans Care for Children, said that when mothers’ mental health suffers, “kids pay the price.”
Babies need nurturing and attentive parents to thrive, and research shows that postpartum depression is linked to developmental delays, behavioral problems and chronic diseases later in life.
A recent study sponsored by Kohler’s organization and the St. David’s Foundation found that failing to treat mental health conditions from the time a woman conceives to her child’s fifth birthday takes a significant financial toll: an estimated $44,460 during those six years.
The study said the largest costs came from lost productivity in the workforce and additional health care spending.
“Moms of babies can’t wait,” Kohler said. “We need our state leaders to act.”
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