By Catherine Maxwell, LWVTX Issue Chair for Women's Healthcare and Reproductive Rights
I want to share about HB 12 and why it is important. This bill by Rep Toni Rose is designed to provide twelve months of postpartum healthcare to maternity Medicaid patients. It is supported in the 88th Legislature by Speaker Dade Phelan and Governor Greg Abbott. The committee hearing was held last week and the bill is currently pending in committee. The LWVTX was one of the endorsers of this legislation.
Why all the fuss: Over 50% of the births in Texas are paid for by Medicaid. These patients, who meet the federal guidelines, include students, those who are uninsured for maternity, those who may not have insurance at all such as retail workers, office workers, some healthcare workers, part time employees, and those who live in poverty—in short, it is a huge, diverse group we want to protect and support in our community.
Texas has roughly the eighth highest maternal mortality rate in the United States. A committee set up to study this has concluded that twelve months of postpartum care will save Texas lives. The study reports that 90% of those deaths could have been avoided with good follow-up care.
The challenge: In the 87th Legislature, the House passed the twelve month provision. The Senate bumped it back to six months. The Federal Government said it will not cover this expense because Texas doesn’t meet federal Medicaid guidelines. So, currently, Texas postpartum Medicaid patients receive two months (after the covid funds end) which was what the state originally offered before the 87th Legislature.
HB 12 has a work around. I do not understand it, but several states who have not expanded Medicaid have been able to have the Federal Government authorize this expense in the manner HB 12 works.
The goal: For HB 12 to pass without being cut back in terms of months by the House or the Senate.
I am happy to be wrong in my report last week when I stated that HB465 which creates a Pilot Doula Services program was dead. It is alive! Chock this up to my still learning the ins and outs of the Legislature. This bill provides Medicaid coverage of doula services. Texas is short medical providers, especially in rural areas. Giving patients access to doulas may enhance and enable good healthcare for maternity patients.
No movement on bills pertaining to reproductive rights. There are several including one that proposes a constitutional amendment giving people the right to their own reproductive autonomy (SJR 21). There are a number of bills that ask to repeal or provide exceptions to victims of incest or rape. SB 203 prioritizes the mother’s health over the fetus’s.
There is also HB 2709—currently, pregnant patients who receive an abortion are safe from criminal prosecution under current Texas law. Everyone else involved could be liable for prosecution of some form, but not the pregnant person. This bill would remove that exclusion. It does have a list of situations when an abortion is a medical necessity, but several Texas women are suing because they have been denied medical help even those their cases fit those exclusions.