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Medicaid Extension For Pregnant Texans Passes The Senate Early Thursday Morning

The Texas Capitol
Gabriel C. Pérez

A bill that would extend Medicaid benefits for pregnant Texans passed the state Senate around 3 a.m. Thursday morning, after being removed from the chamber's calendar with just hours to go before a crucial deadline that would have likely killed the bill.

The Texas Senate stalled a bill seeking to extend Medicaid benefits for pregnant Texans up to one year after childbirth, during an overnight session Thursday.

House Bill 133, which had bipartisan support, had been delayed when the Senate abruptly took the legislation off the calendar late Wednesday night.

That came after members of the Texas House of Representatives blocked a slate of Senate priorities.

The legislation could now head to a closed-door conference between both chambers to decide whether to provide either a six-month or 12-month extension.

The vote tally was not immediately available Thursday morning.

Original story is below:

The Texas Senate stalled a bill seeking to extend Medicaid benefits for pregnant Texans up to one year after childbirth, during a late-night session Tuesday.

Although House Bill 133 gained strong bipartisan support throughout the session, supporters are now nervous that it will miss a final deadline Wednesday night, similar to what happened to an identical bill that died last session.

The bill did not appear on the Senate's intent calendar Wednesday — the list of agenda items lawmakers plan to vote on. Brandon Rottinghaus, a political science professor at the University of Houston, said it's likely a form of retribution for Senate bills that have died in the House — a political tactic commonly used by both chambers.

"Given where we are in the session and how imminent these deadlines are, the fact that it’s not on the calendar means that they’re not putting it on there for a very specific reason," Rottinghaus said. "The likely reason is that they’re holding it hostage."

That's despite broad support from both Democrats and Republicans. A package of proposals introduced by Republican House Speaker Dade Phelan, R-Beaumont, listed the bill as one of the chamber's top health care priorities. The bill was also sponsored in the state Senate by Republican Lois Kolkhorst, R-Brenham.

State Rep. Toni Rose, D-Dallas, who authored the bill, did not respond to requests for comment.

HB 133 has also received strong support from the greater community: Not a single individual or group from the public testified against the bill during hearings in either Senate or House committees.

The bill has been backed by the Texas Medical Association and the Texas Association of Obstetricians and Gynecologists.

"It’s rare to see a bipartisan bill get this kind of treatment," Rottinghaus said. "I suspect that if the Senate thinks that this is a priority for the House, then it’s something that they can really show to demonstrate clearly that they have the ability to slow things down."

Almost half of all births are covered by Medicaid in Texas. The program covers women throughout pregnancy and ends 60 days after childbirth, even though 31% of pregnancy-related deaths happen after or at the very end of this window of time.

Most of these women don't qualify for Medicaid before and after pregnancy. Texas has rejected Medicaid expansion and has some of the strictest eligibility requirements in the county.

The American Rescue Act, the most recent federal stimulus package signed into law by President Biden, made it easier for states to extend coverage for pregnant women through a State Plan Amendment — a quicker way to get matching funds, as opposed to the waiver process.

A handful of states, such as Florida and Tennessee, have passed laws similar to HB 133 in recent months.

Some lawmakers have questioned the financial aspect of extending coverage to 12 months, projected to cost $90 million in 2026, which is the year the program will be fully implemented. The Senate Committee on Health & Human Services unanimously passed a version of the bill that would extend coverage to just 6 months.

Texas has been working on improving maternal mortality and morbidity since at least 2013 when lawmakers voted to create a review committee of experts tasked with studying the issue and crafting policy recommendations.

In 2020, the committee's top recommendation was to extend health care coverage to 12 months postpartum to prevent both death and certain complications. The rate of these types of complications have remained roughly the same in Texas in the last decade, except for Black women.

Twenty-five percent more Black women in Texas experienced complications in 2018, compared to 2016.

Screenshot fromm the Texas Maternal Mortality and Morbidity Review Committee and Department of State Health Services Joint Biennial Report.

Nationwide, Black mothers are at a 60% greater risk of pregnancy-related death compared to other groups.

Supporters have also pointed to the cost-saving appeal of extending coverage. In 2019, Texas would have saved $2.2 billion if Medicaid benefits lasted longer after childbirth, according to a recent report from Mathematica.

The estimate takes into account the massive health care costs of ignoring symptoms and relying on emergency room care, as well as the ripple effects of death and chronic illness on the workplace and children.

That's largely because a mother and child's wellbeing are intertwined, said Adriana Kohler, the Policy Director at Texans Care for Children.

"If a mom is suffering from postpartum depression, it can really take a toll on both the mom and the infant," Kohler said. "The infant is in that critical stage of early childhood development. A baby’s safety could be at risk, their health and their development could actually be delayed if moms are untreated."

The report states that children are more likely to struggle in school, as well as have health issues, and behavioral and developmental disorders.

"We need comprehensive care for new moms, so they can just focus on raising their babies and making sure they're healthy and developing," Kohler said.

Copyright 2021 Houston Public Media News 88.7. To see more, visit Houston Public Media News 88.7.

Updated: May 27, 2021 at 12:10 PM CDT
This story was updated after the Senate's vote.
Sara Willa Ernst
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