Feds approve 12 months of Medicaid coverage for low-income Texas moms

Texas moms will be able to stay on Medicaid for a year after childbirth, after the federal Centers for Medicare and Medicaid approved the state's application on Wednesday, according to emails obtained by The Texas Tribune.

The move caps a yearslong effort to extend coverage for low-income moms. Medicaid covers half of all births in Texas, but coverage currently expires after two months.

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In 2021, the federal government found Texas' application for continued coverage "unapprovable" due to medically inaccurate language intended to exclude women who had abortions.

But when Roe v. Wade was overturned in 2022, giving states the right to ban abortion, the idea gained traction. During the last regular session, lawmakers worked to reach a proposal that the federal government would approve.

The Centers for Medicare and Medicaid Services' approval on Wednesday makes Texas the 43rd state to be approved for the extended coverage - which was authorized by the American Rescue Plan Act of 2021 and the Consolidated Appropriations Act of 2023.

The approval goes into effect on March 1, 2024. Under the Texas plan, anyone whose pregnancy ended in the months prior to March 1 and who lost postpartum Medicaid coverage is eligible to re-enroll to maintain coverage until 12 months after their pregnancy ended.

"This is a fantastic step forward to support healthy moms and babies," Diana Forester, director of health policy at Texans Care for Children, said.

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Maternal health advocates have been calling for a full year of postpartum Medicaid for years, and it's long been the top recommendation from the state's Maternal Mortality and Morbidity Review Committee.

During the regular legislative session last year, the bill to expand postpartum Medicaid for Pregnant Women caught bipartisan support from a wide-ranging coalition of legislators and advocates, and it initially passed the Texas House with overwhelming backing.

But the bill hit a snag in the Senate as Republicans demanded an amendment that specified women who had elective abortions do not qualify for the extended Medicaid coverage. The original bill said simply that the coverage began on the last day of pregnancy; it did not specify how that pregnancy had to end.

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Abortion is banned in Texas except to save the life of the pregnant patient. Anti-abortion groups have said that allowing extended Medicaid coverage to go to women who had out-of-state or illicit abortions is tantamount to using state funds to support abortion.

Throughout the session, advocates called for the Legislature to pass a "clean" bill that matches the language in Medicaid guidelines to ensure the federal Centers for Medicare & Medicaid Services quickly accepts the state's application for the extension.

The law now includes a "legislative purpose" section that reads, "Out of the state's profound respect for the lives of mothers and unborn children, Medicaid coverage is extended for mothers whose pregnancies end in the delivery of the child or end in the natural loss of the child."

"We are so grateful to Representative Toni Rose, (D-Dallas), Senator Lois Kolkhorst (R-Brenham), the staff at the Texas Health and Human Services Commission (HHSC), and everyone else who worked hard to make this happen," Forester said in the emailed statement. "Disagreements between elected officials get a lot of attention, but this is an example of how our state legislators really can come together to improve access to healthcare for Texas families."

This bill comes at a crucial moment, as millions of Texans face the end of Medicaid benefits for the first time since the COVID-19 pandemic began in March 2020. Texans who receive Medicaid benefits are encouraged to make sure their information is up to date at YourTexasBenefits.com.

The Texas Tribune is a nonprofit, nonpartisan media organization that informs Texans - and engages with them - about public policy, politics, government and statewide issues.

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