Texas lawmakers ask feds to reconsider Medicaid expansion proposal

AUSTIN — Nearly 130 Texas lawmakers sent a letter Thursday to the Centers for Medicare and Medicaid Services administrator, asking for reconsideration of Texas' application to extend postpartum health care coverage for new mothers across the state.

A total of 128 lawmakers signed on to the bipartisan letter, which came after federal regulators – who must approve the proposal and help pay for services – told state health leaders last week that they would likely reject Texas' plan to extend Medicaid for new mothers because the benefits are too restrictive.

Specifically, the federal agency took issue with eligibility restrictions Texas imposed in legislation passed in 2021 that would extend the safety net for new mothers from two to six months, but only be available to new moms who deliver the child or have an involuntary miscarriage. If the pregnancy is terminated, even in a medical emergency, the patient is ineligible for coverage.

Lawmakers said the failure to approve the state's application would be a "major setback," though no formal decision by the federal agency to reject the application has been made.

"A large bipartisan coalition of lawmakers at our state Capitol have sought to better support hundreds of thousands of new mothers, children and families — and such a decision will put the care and needs of those Texans at risk," the letter read.

Initially, Texas representatives passed a bill that would extend coverage to 12 months after birth, but state senators chopped that down to six months. House members said they are determined to introduce legislation this coming session that would again attempt to stretch the coverage period to 12 months, as well as push for other proposals that "make meaningful improvements in support of Texas moms, children and families," they said.

While there will be no immediate impact to Texas moms as the pandemic-era rules remain in place that disallow mothers to be kicked off the program, it would be a setback for the state that is already reluctant to expand Medicaid coverage.

Texas is one of 12 states that opted out of expanding Medicaid under the Affordable Care Act, leaving approximately $15.3 billion of federal funding on the table and nearly 1.75 million eligible Texans without coverage. A reintroduction of the bill may have a different outcome as new lawmakers make their way to the Capitol after the November election.

"One of our top objectives in the Texas House has been to make maternal health care efforts and resources a priority of both the most recent and upcoming regular legislative sessions," the letter read. "We remain hopeful that (CMM) will reconsider (its) decision and work with our state to achieve approval so that women enrolled in Texas Medicaid will continue to receive critical postpartum care."