Take Action on New TX Lege Bills to Expand Health Coverage

As the Texas legislative session starts kicking into gear, we're glad to see that legislators are paying closer attention to health coverage this session compared to recent years. Lawmakers have several more weeks to introduce bills, but we wanted to give you a rundown of the seven main categories of health coverage bills that we've seen filed so far this session.

1. Medicaid expansion: A number of legislators have filed different versions of bills to accept federal Medicaid expansion funding to cover low-income adults. With Texas facing a health care funding cliff and the nation's highest uninsured rate, there is a growing urgency for Texas to draw down these funds and expand health coverage. Examples of these bills include HB 565, HB 590, HB 816, HB 840, HJR 40, HJR 46, SB 327, SB 524, and SJR 34.

2. Children's Medicaid 12-month continuous coverage: Currently, busy parents may have to provide additional documentation on several occasions over a single 12-month period to keep their children enrolled in Medicaid insurance. That state policy leads to additional costly paperwork for parents, doctors, and the state and causes many children to cycle on and off of insurance. Legislators are proposing a change to allow children to remain covered for a year once they are deemed eligible. Along with Medicaid expansion, this proposal is the best way to reduce the state's uninsured rate for children, which is currently the highest in the country. Examples of these bills include HB 342 and HB 829.

3. Women's Medicaid coverage for 12 months after giving birth: Texas currently offers Medicaid insurance to low-income, uninsured women while they are pregnant, but that coverage ends two months after delivery. New legislation would provide coverage for a full 12 months after coverage. The state's Maternal Mortality and Morbidity Task Force called for this 12-month postpartum coverage policy in its recommendations to the Legislature. While similar bills have been filed in the past, the proposal appears to have greater momentum this session. Examples of these bills include HB 241, HB 411, HB 610, HB 744, SB 147, and SB 308.

4. Additional maternal health coverage issues: Other bills have been filed or will likely be filed to address a number of maternal health coverage issues, including Medicaid coverage of transportation to prenatal and postpartum doctor's visits with children, the transition for young women from Children's Medicaid and the Children's Health Insurance Program (CHIP) to Healthy Texas Women, and more. Examples of these bills include HB 25, HB 606, HB 1111, HB 1114, and SB 189.

5. Medicaid managed care reform: The state's current Medicaid system relies on private and non-profit insurance companies to coordinate health care for children, people with disabilities, seniors, and others enrolled in Medicaid insurance. Over the last year, state leaders and advocates have identified a number of challenges with the current system, in part spurred on by a Dallas Morning News investigation. Legislation has already been filed to address the hearing process and other aspects of Medicaid managed care, and we anticipate additional bills will be filed this session. Examples of these bills include HB 394 and HB 1080.

6. Pre-existing conditions protections: If the Texas Attorney General is successful in his lawsuit to eliminate the health care protections provided by the Affordable Care Act, Texans will lose a number of benefits, including $5 billion per year in subsidies that we currently receive to reduce the cost of insurance on healthcare.gov. While there's no proposal to replace that funding, there is legislation to enshrine the ACA's pre-existing conditions protections into Texas law. Example of these bills include HB 565 and SB 145.

7. Funding health care in the state budget: The House and Senate's first drafts of the state budget propose enough funding to cover caseload growth for Medicaid, but budget writers do not sufficiently account for the increase in health care costs (like rising prescription drug prices, for example). This is a recurring approach to funding Texas Medicaid, which will mean that lawmakers would have to once again pass a substantial supplemental budget for health care costs in 2021, just to finish out the two-year budget cycle. Additionally, the current budget proposals fail to provide the additional $71 million needed for Early Childhood Intervention (ECI) for toddlers with disabilities. The Senate Finance Committee will hold a hearing on these and other health and human services funding issues on February 6th. The budget bills for the next biennium are HB 1 and SB 1.

Legislators are already holding hearings on the state budget and will start holding hearings on other bills soon. You can sign up on the Legislature's website to receive notices of hearings scheduled for committees or bills that are important to you.

For more background on these issues, take a look at the Cover Texas Now legislative agenda for 2019.

As they get to work on these bills, we encourage you to let your state Representative and Senator know that expanding and protecting health coverage is a priority for you.

Thank you for fighting for health care!