HHSC hears calls for extending postpartum coverage to 12 months during hearing on Medicaid programs


Boram Kim


The Texas Health and Human Services Commission (HHSC) held a public hearing on the Texas Healthcare Transformation and Quality Improvement Program, its Medicaid managed care program on Thursday, sharing updates with and collecting feedback from the public.


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The commission sought stakeholder feedback on a State Plan Amendment to House Bill 133, a bill that passed in 2021 and extends Medicaid postpartum coverage from 2 months to 6 months. 

HB 133 in its current form directs HHSC to provide an additional 4 months of postpartum coverage for women receiving Medicaid, translating to 6 months of total eligibility after either childbirth or involuntary miscarriage.

ARPA has made it easier for states to implement 12-month postpartum coverage legislation through Medicaid State Plan Amendments (SPA). Texas is currently one of three states not following CMS guidance on extending postpartum coverage options to 12 months or more.



HB 133 extended coverage to 12 months in its original draft based on guidance by the Maternal Mortality and Morbidity Review Committee and 66 Texas organizations, but Republicans in the Senate amended the bill and reduced the coverage to the current 6 months. 

During Thursday’s hearing, stakeholders urged policymakers to adopt the coverage extension.


“We support this waiver amendment because extending postpartum Medicaid coverage will promote health for mothers and babies,” testified Brittany McAllister, an official from the National Service Office of Nurse-Family Partnership and Child First, a postpartum care provider in the state.

“Pregnancy complications such as postpartum depression, hemorrhage, infection, and cardiac events, remain a concern in Texas and they lead to long-term health issues for mothers and babies, pricier hospital stays, and procedures of higher cost to Medicaid in the state … The ability to obtain important [maternal mental health] diagnoses and treatments [under the public health emergency] have led to healthier and more productive lives for the moms and better safer care and relationships with our children.”


According to the Texas Maternal Mortality & Morbidity Review Committee, “mental disorders, including those associated with substance use disorder (SUD), were a leading underlying cause of pregnancy-related death and occurred most frequently between 43 days to 1 year postpartum.”

Maternal mental health conditions affect more than 1 in 8 pregnant and postpartum women in Texas. Untreated maternal mental health costs the state $2.2 billion annually due to productivity losses, child and behavioral and developmental disorders, and maternal health expenditures.

Texans Care for Children outlined these data in a written statement to the commission on Thursday urging for the adoption of the SPA. 

HHSC is currently awaiting CMS approval for the Medicaid waiver to fund HB 133, a process that is uncertain and more arduous due to the shorter coverage period than the CMS guidance.

When the federal Public Health Emergency ends, which is predicted to happen in July, Texas will have to initiate Medicaid disenrollments which will remove Medicaid postpartum coverage for women who are 2 months removed from childbirth and those whose incomes rose.