AUSTIN – The GOP-led Senate agreed to give a full year of health care coverage to low-income women who’ve just given birth, but tacked on anti-abortion language that could complicate the bill’s passage.
On Sunday, the Senate unanimously approved the legislation extending postpartum Medicaid, which already passed the House. A last-minute amendment by Sen. Lois Kolkhorst, R-Brenham, says the safety net coverage is meant only for those whose pregnancies end in childbirth or natural loss of the child, not an abortion.
Kolkhorst said her intention is to “get this bill over the goal line” and the addition allays some members’ concerns who “wanted to see at least that we say we are a pro-life state.”
But the bill’s author, Dallas Rep. Toni Rose, fears the change would tie up approval needed from the federal government. The state included similar abortion language when it pushed for a shorter Medicaid extension in 2021, but federal regulators took issue with the carve-out and have still never signed off on the plan.
“It defeats the work that we’ve done,” said Rose, a Democrat. “We just cannot go backwards.”
The two chambers will likely have to hash out a compromise on the competing versions of Rose’s bill with just a week left in the session.
The stakes are high. With the end of a pandemic-era policy this spring, the state will resume cutting off Medicaid benefits at two months postpartum.
Health care advocates contend that’s not enough time to get follow-up treatment, and say a full year of the insurance coverage is critical to keep new mothers healthy.
The policy has long been a top recommendation of the state’s maternal mortality task force, which found pregnancy-related deaths in Texas were mostly preventable, often occurred in the months after childbirth and disproportionately affected Black Texans.
Roughly half the births in the state are financed by Medicaid. While the federal government covers most of the cost, the state would be on the hook for about $80 million a year once the 12-month extension is fully rolled out, according to the fiscal note.
More than 30 states, including Louisiana, Oklahoma and New Mexico, already offer a full year of postpartum Medicaid.
Last session, the House passed the full-year Medicaid extension, but the Senate watered it down to six months. The change was signed into law. But legislators said federal officials refused to approve the plan because it applied only to Texans who delivered a baby or had an involuntary miscarriage and left out anyone who terminated a pregnancy, even in a medical emergency.
“They felt that everybody should be eligible for the benefit and not just certain women,” Rose said.
The wrangling had little impact because states were not allowed to remove people from the Medicaid rolls during the COVID-19 pandemic. That policy ended this spring, however. Now, the state will revert to covering low-income Texans through their pregnancies and for 60 days afterward.
Phelan named the full-year extension a priority this year, and in April, it passed the House with overwhelming support. On Monday, a spokesperson said Phelan’s office is working with the Texas Health and Human Services Commission to understand whether the Senate changes will be approved by the federal government.
The bill faced no opposition in committee hearings, but a representative from Texas Right to Life asked for a change that would prevent Texans who go out of state for an abortion from getting the extra health coverage.
