Health Coverage Extensions Will Help Mothers, Children

New Laws Prolong Health Insurance for Potentially Vulnerable People

Women can access critical health care longer after delivering their babies, and more children will continue uninterrupted medical care, thanks to two new bills that will become Texas law.

Gov. Greg Abbott recently signed Texas House Bill 133 and House Bill 2658, ensuring longer Medicaid health care coverage for these populations who are susceptible to health complications – even death – if that care is interrupted.

HB 133 extends Medicaid coverage for eligible women to six months postpartum instead of 60 days after the woman gives birth or miscarries.

“We are moving in the right direction and are really excited the legislators prioritized this issue to successfully pass an extension,” said Kimberly Carter, MD, co-chair of the Texas Medical Association (TMA) Task Force on Health Care Coverage and an Austin obstetrician-gynecologist.

Women can suffer a variety of serious medical problems for a full year after giving birth, according to Emily Briggs, MD, a member of TMA’s Committee on Reproductive, Women’s, and Perinatal Health.

“Too many women die during pregnancy or in the year following, though nine in 10 of these deaths were potentially preventable,” she told lawmakers in written testimony this session. Many women experience problems like postpartum depression, hypertension, and other bad health conditions after delivering a baby. Having routine access to a physician’s care can help manage or reduce these conditions, and even save lives. TMA asked lawmakers to support 12 months of continuous coverage for Medicaid-covered women in the original version of the bill because those conditions tend to linger. 

“When [a woman is] first being treated for, say, hypertension, it’s not like we give her medicine and she’s cured,” said Dr. Briggs, a New Braunfels family physician. “We need time with that medication, for lifestyle management or for coping mechanisms if it's depression. … It’s an ongoing life issue.”

To enact the law, Texas must pursue a federal Medicaid waiver, which TMA urges the state and Centers for Medicare & Medicaid Services to quickly negotiate.
Likewise, Texas children insured by Medicaid are more assured coverage won’t suddenly end, thanks to improvements in House Bill 2658. Children under 19 years old on Medicaid will have two consecutive six-month periods of coverage.

“There was a lot of bureaucracy, a lot of red tapes that resulted in a lot of kiddoes losing their coverage, and this House bill essentially removes [most of] that red tape,” said Dr. Briggs. “It makes it so that children can continue their coverage without having to jump through so many hoops.”
The law directs Texas Medicaid to provide eligible children six months of continuous coverage, then the state will verify a family’s household income electronically to prove the child is still eligible for coverage for another six months. Currently, parents must verify their child’s eligibility four more times after the initial six-month coverage period. If the child remains income-eligible, the family will not need to take additional action. If the electronic verification cannot confirm income (which often occurs), parents will be contacted to verify income before coverage lapses. (Parents previously had 10 days to provide that income-verification documentation; now they will have 30 days.) Parents routinely missed the verification deadline, even though the children would have qualified for coverage. This contributed to Texas’ worst-in-the-nation pediatric insured rate.

“If a parent inadvertently misses a deadline or does not submit all the documentation, his or her child will lose coverage even though in most cases the child remains eligible. Lost coverage means children often have gaps in care,” said Lindy McGee, MD, a pediatrician, in March legislative testimony.

“If this happens, a patient can go without an asthma controller for an extended period and end up in the emergency department to treat a preventable attack,” she told lawmakers.

The measure, which began as House Bill 290 by Rep. Philip Cortez (D-San Antonio), was amended onto House Bill 2658 by Rep. James Frank (R-Wichita Falls). HB 290 originally promised eligible children 12 months of continuous Medicaid coverage, which TMA and other medical societies supported.

Both HB 2658 and HB 133 take effect on Sept. 1, 2021.

TMA is the largest state medical society in the nation, representing more than 55,000 physician and medical student members. It is located in Austin and has 110 component county medical societies around the state. TMA’s key objective since 1853 is to improve the health of all Texans.