AUSTIN — The new mothers contracted infections. They overdosed on drugs. Their hearts failed. They committed suicide.
The women died in different ways, but all perished within a year of giving birth. Rising rates of maternal mortality spurred Texas leaders in 2017 to reauthorize a special task force to study the deaths and figure out what to do.
But at the end of this year’s legislative session, public health advocates are frustrated that lawmakers left Austin without adopting the task force’s top recommendation: giving women access to health care for a full year after they give birth.
The Legislature agreed to spend $15 million over the next two years on postpartum depression and substance abuse treatment for some low-income women. But a far more sweeping and higher cost plan to expand Medicaid coverage for all eligible new mothers failed, despite having support from Republicans and Democrats.
“We’re disappointed state leaders basically ignored the needs of uninsured moms and uninsured low wage workers this session, by not taking action on bills to extend postpartum coverage,” said Adriana Kohler, a senior health policy associate for the Austin-based advocacy group Texans Care for Children.
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Texas had been considered worst in the country for maternal mortality, until a recent study revealed the numbers were inflated due to bad data. Still, the state’s task force found roughly 80 percent of pregnancy deaths in 2012 may have been prevented with proper intervention.
Roughly half of births in Texas are paid for by Medicaid, but new mothers lose the government-subsidized coverage two months after delivery — a critical time to have access to health care, according to the 2018 report by the state’s Maternal Mortality and Morbidity Task Force.
More than half of pregnancy-related deaths occurred two months after delivery, according to the task force, which studied deaths from 2012 to 2015.
Women with private insurance weren’t immune and accounted for roughly 20 percent of the fatalities, the report found. But nearly 60 percent of new mothers who died had been on Medicaid when they gave birth, the task force found.
The bill on its way to Republican Gov. Greg Abbott’s desk would give the state’s Health and Human Services Commission $15 million to develop a postpartum benefit package for an estimated 10,000 low-income women, according to the bill’s fiscal note. The package could include treatment for depression, substance abuse, asthma and smoking cessation, but would be provided through the state’s Healthy Texas Women program. It remains to be seen exactly what the benefits will include and who will receive them.
“At this point, we are hopeful that there will be sufficient funding and a significant benefit package for these women once they drop off Medicaid,” said Dr. David Fleeger, president of the Texas Medical Association.
The bill’s sponsor, Sen. Lois Kolkhorst, R-Brenham, didn’t respond to request for comment. At a hearing in March she called Senate Bill 750 a “potential solution to what we have seen, in giving more coverage to women after the two months they have Medicaid.”
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The funding, however, will likely cover only some of the roughly 136,000 pregnant women on Medicaid in any given month. And pregnant women who relied on Medicaid for their diabetes medication or other prescription drugs could still lose those benefits in the transition, some public health advocates said.
Other bills filed by Republicans and Democrats to expand the state’s Medicaid coverage for new mothers from two to 12 months, post delivery failed. The change would have cost the state upwards of $75 million a year, according to a fiscal note. The legislation passed the House, but died after not receiving a public hearing in the Senate.
Rep. Garnet Coleman, D-Houston, chalked it up to politics. “Republicans don’t want to be viewed as expanding Medicaid,” he said.
Rep. Toni Rose, D-Dallas, and Rep. Sarah Davis, R-West University Place, who filed bills to extend Medicaid for new mothers, didn’t respond to requests for comment.
Allie Morris covers politics and policy in Austin. Read her on our free site, mySA.com, and on our subscriber site, ExpressNews.com. | amorris@express-news.net | Twitter: @MorrisReports