AUSTIN, Texas — When Patrice Lott got pregnant during the pandemic, she qualified for Medicaid. She was previously uninsured.
“I had that ability to know that something was going on with me and take the steps that I needed to make to see the doctor,” Lott said.
She benefited from a pandemic-era policy that said new moms couldn’t be kicked off Medicaid after just two months, which is Texas’ coverage limit. In the year after having her baby, Lott discovered many health issues like gestational diabetes and allergy-induced asthma.
“I was able to get on a treatment plan and get immunotherapy shots, and I still see an allergist every month currently,” she said.
Pandemic Medicaid ended on April 1, and hundreds of thousands of women are set to lose coverage. But with overwhelming bipartisan support, the Texas legislature passed a bill by Rep. Toni Rose, D-Dallas, to extend Medicaid coverage for new moms to a full year. Sen. Lois Kolkhorst, R-Brenham, sponsored the bill in the upper chamber. On Friday, Gov. Greg Abbott is expected to sign the bill into law.
After the Supreme Court overturned the constitutional right to an abortion in a case known as Dobbs, nearly all abortions were banned in Texas.
In a statement to Spectrum News, Sen. Kolkhorst wrote in part, “In a post-Dobbs era, the Texas Senate and House have directed significant resources to the health of women, mothers and children with appropriations nearing $1 billion … HB 12 was passed to focus on the health of mothers, improving maternal mortality outcomes and is a natural continuum of Texas’ commitment to the pro-life support of maternal health.”
During the last legislative session, lawmakers passed a bill to extend postpartum Medicaid coverage to six months. Federal officials blocked it from taking effect, so coverage remains at just two months. Once the governor signs this bill, Texas will submit a different form to the federal government, and stakeholders expect it will be accepted this time.
“Our own Texas Maternal Mortality and Morbidity Review Committee, which reviews the cases of death in Texas, has made this a top recommendation ever since they formed almost 10 years ago. It's just really crucial for that year postpartum, that women are able to keep seeing their medical providers, taking their medications, getting healthy, so that they can get back to work and be there for their families,” said Diana Forester, who’s the director of health policy for the advocacy organization Texans Care for Children.
She added that a third of maternal deaths happen past the two-month postpartum period.
“Hypertension often shows up later in that postpartum period, and that's one of our top killers of moms,” Forester said. “And it can just be like headaches that won't go away. It's the difference between having insurance to be able to go to the ER and get that checked out, or having a doctor to be able to call and get advice on, versus just taking some Tylenol and staying at home, which could end up in a critical situation. So I think coverage is like the very first step in ensuring that moms have access to health care during that critical period where they're healing, and they're trying to take care of a baby. And that baby has so many needs that first year of life too, right?”
The expansion is expected to cost the state about $147 million over the next biennium.
"That's because we're recovering moms for longer, right? So instead of two months postpartum, it goes to those 12 months. That's an additional 10 months of coverage that costs money," Forester said. "But one of the things that we say is, that's money well-spent. And it's really hard to put kind of a cost associated with a mom's life, right? Like, if you ask her kid, there's no number that could encompass how much they are worth to them."
Forester added that Texas is the 40th state, including Washington D.C., to opt-in to the 12-month coverage.
"While it does feel monumental for Texas, we're not at the forefront of this in any way," Forester said. "In the months ahead, we're going to be really busy on the Texas maternal and child health front. Urgent asks include moving forward with HB 12 implementation, and monitoring the challenges that eligible Texans are facing as they attempt to renew Medicaid coverage. Now that the pandemic Medicaid rolls have ended, we know that there's about 400,000 women that are about to lose coverage through Medicaid. And so we just really want to emphasize the need to implement HB 12 quickly, and make sure that Texas policymakers continue to look at addressing barriers to health coverage during that critical year between pregnancies, because we know that also contributes and leads to healthier moms and babies and outcomes for everyone."
Lott said she doesn’t want to have more children, but she’s proud of her contributions to the bill. She testified before a House panel back in March to tell them how extended postpartum coverage helped her physical and mental health.
“It means the world to me. I feel like I've done something with my life and my story,” she said.
Forester said the next step is looking at a broader Medicaid expansion, so more Texas women can have access to healthcare even when they’re not pregnant.