Q&A: Rep. Erin Zwiener discusses Medicaid expansion, access to medical cannabis, and vaccine hesitancy


Soraya Marashi


Rep. Erin Zwiener (D – Driftwood) has been representing Texas’s 45th Legislative District since 2019. She currently sits on the House Public Health, Administration, and Appropriation Committees.

In this Q&A, Rep. Zwiener discusses how she will prioritize Medicaid expansion, expanding access to medical cannabis for non-terminal patients, and ensuring the state’s renal care facilities are resilient in the next legislative session. She also talks about tackling vaccine hesitancy and misinformation in Texas communities, as well as her commitment to continue supporting access to reproductive health care in the state.

Rep. Zwiener will be speaking at the 2022 Texas State of Reform Health Policy Conference on March 10 in Austin. Register here.


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State of Reform: What are your health policy priorities for the next legislative session?

Rep. Zwiener: “Number one, always, should be Medicaid expansion. In Texas, we have too many folks who have no health care coverage whatsoever, which means we provide care really inefficiently. A lot of folks don’t have any access to preventative care and have only been seeking care when they’re quite sick, which both reduces their health care outcomes, makes them more expensive to treat at those costs, and ends up driving up costs for every other Texan. So if we expand Medicaid, we cover another one and a half million Texans, we bring in over $7 billion in federal funding every year that we’re already paying for with our income tax dollars, we help support more medical practices opening and treating people, raise health care outcomes, and drive costs down for everyone.

Other areas I’m interested in working on are improving access to medical cannabis … I think the most gaping hole is around chronic pain. Under the new bill, medical cannabis can be accessed for pain management, but only if someone’s terminally ill. I think that’s still missing a lot of the point–cannabis is not addictive and can be a great alternative to opioid treatments which are addictive for many patients, but we’ve shut the door on that. In fact, many people who are using it for pain even in concentrates are actually guilty of a felony for trying to manage their health conditions. My preference would be to trust medical providers to prescribe cannabis when it’s appropriate. . 

Another priority is [making sure] our renal care facilities are resilient. We had Texans die during the blackout last year because of inability to access dialysis. They lost power, they lost water, and were unable to provide care. It became a big burden on our hospitals in that many kidney patients couldn’t receive care at all. So, I would like us as a state to identify some of these essential facilities by region and make sure that they have the backup generation and the backup water they need to continue to provide those services in extreme situations.”

SOR: What issues do you expect will be most contentious in the House Public Health Committee in the next legislative session?

Rep. Zwiener: “One of the outstanding questions we have is what the legal situation around access to abortion will be. The six week abortion ban is still standing in Texas. We don’t know if it will still be standing, but I suspect it will be by next session. The other thing is the Mississippi 15-week ban case that we expect a ruling from the Supreme Court on in the summer. If that decision rolls back Roe v. Wade, then I expect we will see moves to outright ban and have state enforcement of abortion to whatever level that legal decision allows. That’s the conversation I will say I am least looking forward to because I think we should be spending our time on other things. 

I’m looking forward to having conversations about vaccine hesitancy. Last session, we were still mostly in the throes of vaccine availability being limited and that masked how much hesitancy we were facing. How we do outreach and getting good information to people about the need for boosters is important for our next session, and also getting good information out to people about the values of vaccinating their children for COVID as well as other childhood diseases. One of the things I’m worried about is that hesitancy around the COVID vaccine may turn into hesitancy around other already established common childhood vaccines. We’ve already seen a rise in that hesitancy in Texas and I’m worried we’re going to see that moving into new communities based on how politicized the conversation around the COVID-19 vaccine has become.”

SOR: What health-related work have you been up to in the interim?

Rep. Zwiener: “In March 2020, I feel like my office pivoted into a crisis communication center, and that hasn’t entirely eased up … so we’ve done a lot of work trying to get good information out for the community, and also making sure that I’ve been on the ground in the community to see what people know and what they don’t know. I worked a few rapid testing events over Christmas break, and I was startled to see the level of hesitancy among young women of childbearing age and how many adults had no idea that they could get a booster. So I think us being on the ground and figuring out what these gaps are in our community is really critical.”

SOR: Gov. Abbott and some other leaders in Texas have recently said that gender-affirming care should be investigated as child abuse. What is your response to this?

Rep. Zwiener: “The governor is not a medical provider. Our attorney general is not a medical provider. We have a strong medical consensus that gender affirming care has a place in Texas medicine. There’s a lot of scare language being used, and leadership’s conversations about this that completely misrepresent what gender or look like in different age ranges … I remain committed to supporting our trans youth having access to the full suite of medical care that’s supported by the medical community. This is something that the Texas Medical Association and Texas Pediatric Society stand with us upon, and I think it is very dangerous when the people who make policy second guess [the providers of this care].”

SOR: You’ve also been an advocate for reproductive health care in the state. How will you continue to advocate for it this year and into the legislative session?

Rep. Zwiener: “I’m committed to being the gnarliest speedbump I can be for any further attempts to erode access to abortion care. I’m also committed to continuing to elevate and tell the stories of how that loss of access is impacting everyday Texans. It’s not exactly a glamorous fight, it’s a war of attrition. But if the majority of our colleagues are going to do something this unpopular and this damaging to the people of Texas, it’s our job as the opposition and as the people who support full access to reproductive health to make it as painful as possible for that majority [who want to limit access to reproductive health care].”

This interview was edited for clarity and length.