Too many Texas women face poor pregnancy outcomes, especially women of color, but with the 2021 legislative session just around the corner, advocates see opportunity for improvement.
According to a 2019 study from the Georgetown University Center for Children and Families, Texas has more uninsured women of reproductive age than any other state in the nation.
“Texas has an un-insurance problem,” said Dr. Eileen Nehme of the University of Texas Health Science Center at Tyler and the Postpartum Access to Healthcare Project Community Health Lead at the Texas Collaborative for Healthy Mothers and Babies.
A new study done by Nehme’s group could serve as a roadmap for increasing access to public health care coverage for uninsured, postpartum women in Texas and for legislative action to help them. The PATH study included interviews with 32 pregnant/postpartum women and 20 providers and clinic staffers.
Among the study’s participants, few had any kind of health care coverage prior to becoming pregnant, suggesting that they may have been unaware of benefits that may have been available to them. They were generally aware that their coverage would end at some point after delivery, but they weren’t always sure when that would happen. Most surprising, none of the participants reported being aware of the auto-enrollment process for the state’s Healthy Texas Women program. They just weren’t aware of the assistance available to them prior to pregnancy and postpartum.
“That’s probably my biggest complaint, it’s just figuring it out … I think I get kicked off my insurance at the end of this month,” stated a woman interviewed for the study. “Because I have the pregnancy Medicaid, so I think now that I’m not pregnant it expires.”
Three key action areas emerged from the PATH study.
1. Close the information gaps.
2. Improve the transition process between Medicaid for Pregnant Women and state health care programs for women.
3. Bolster the Texas Family Planning Program to expand its reach and scale its impact.
“One in seven moms experience these things,” said Adriana Kohler of Texans Care for Children.
Kohler says moms of all backgrounds are at risk, but Black moms and teen moms are disproportionately impacted. She says the pandemic has only made matters worse, with one in three Texas adults now being uninsured.
Medicaid cuts off at 60 days — just as postpartum mental health issues may be emerging. Inclusion of mental health counseling as a covered benefit in the state’s Healthy Texas Women’s postpartum package would go a long way toward addressing this issue.
Advocates also want Medicaid expanded. Following a statewide vote in Missouri Tuesday, Texas is now just one of 12 states without expanded Medicaid.
“I am a woman who has been on Medicaid, who has used services offered by organizations like Planned Parenthood,” said State Rep. Ana-Maria Ramos (D-Richardson). “I know first-hand the benefits and opportunities that can occur when reproductive health care needs are met, and when the health of women is prioritized.
“With Texas continuously opting not to expand Medicaid, as a state, we are leaving no affordable insurance for working-class people below the poverty line. Increasing the accessibility of quality postpartum and prenatal care for low income women is of the utmost importance.”
Rep. Vikki Goodwin (D-Austin) agrees that more can be done to help low-income uninsured moms in Texas. She also provided a statement about maternal health Wednesday.
“We know that there are racial and economic disparities in maternal health in Texas, and we know that there are actionable steps we can take to mitigate these problems: extending Medicaid coverage for eligible mothers to 12 months postpartum, automatically enrolling women in eligible programs, and expanding telehealth services, among others. It’s time we take these steps,” she said.
Here is more coverage of women’s health in Texas: