TX Legislature Passes Moms’ Health Coverage, Fails on Medicaid Expansion and More

The Texas Legislature just wrapped up its regular 2023 session, taking an important step on maternal health coverage but failing to pass Medicaid expansion or other critical health coverage policies. We’re so thankful to all the Texans who raised their voices to help pass good legislation for Texans and hold state leaders accountable for failing to pass other key bills. Here’s a quick look at what the Legislature did and didn’t do on some of the most important health coverage bills of the session.

Let’s start with the good news.

Thanks in large part to all of the Texans who have kept the pressure on legislators, the Legislature passed HB 12 by Rep. Toni Rose to extend moms’ Medicaid health coverage to 12 months after pregnancy. This is a big win for Texas moms and babies! Currently, Texas cuts off health coverage for moms just two months after their pregnancy. The final version that passed the Legislature allows state officials to request accelerated approval from the federal government (through a Medicaid “State Plan Amendment” instead of a Medicaid Waiver) and quickly implement the health coverage extension. 

However, the Legislature mostly let Texans down when it comes to health coverage.

The Legislature did not pass Medicaid expansion — or even hold a hearing on the bills! Several Cover Texas Now member organizations recently blasted state leaders for their inaction on the issue. Under Medicaid expansion, an estimated 1.4 million uninsured low-wage Texans would become eligible for Medicaid health insurance. No other state policy proposals would come close to reducing the state’s uninsured rate — the highest in the US — as much as Medicaid expansion would. Recent polling shows that 73% of Texans, including 61% of Republican voters in Texas, support Medicaid expansion. Texas is one of just 10 states that continues to reject Medicaid expansion. 

The Legislature also failed to pass any legislation to reduce the children’s uninsured rate. We were pleased to see the Texas House pass HB 1599, which would have connected more uninsured but eligible children to health coverage through Medicaid or CHIP using an “express lane” option. Unfortunately, the Senate did not pass the bill (or even hold a hearing on it), so it did not become law. The Legislature also failed to pass the bills that would have expanded opportunities for schools to seek Medicaid reimbursement for health-related services provided to students, such as HB 1571.

Additionally, we’re disappointed that the Legislature did not provide all of the funding requested by the state’s Health and Human Services Commission (HHSC) for processing Medicaid renewals now that the pandemic-era Medicaid rules have ended. The state needs the staffing, technology, and planning in place to reduce delays in processing applications, make sure that kids and others who are still eligible for Medicaid insurance can renew their coverage, and help Texans transfer to other programs if they are no longer eligible for Medicaid health insurance.

We have plenty of work ahead of us.

Looking ahead, we will need to make sure that Texas quickly and effectively implements 12 months of postpartum health coverage. We are also monitoring how the state is managing Medicaid renewals after the pandemic Public Health Emergency. We will need to hold state leaders accountable for failing to pass Medicaid expansion and other health coverage priorities. And we need to lay the groundwork for the next legislative session. We look forward to working on these goals with you and our other partners so that all Texans have access to the health coverage they need.