5 Things Texas: 1925 abortion ban, Child health policy recommendations, Medical debt guidance


Eli Kirshbaum


We’re in the final stages of creating the Topical Agenda for the 2022 North Texas State of Reform Health Policy Conference, which is taking place on Sept. 27th at the Irving Convention Center in Dallas. In a few weeks, we’ll share this year’s curated list of panel topics. If you know you’d like to join us in the fall, you can register here. We hope to see you there!

This month’s newsletter includes an overview of the state’s current abortion policy landscape, new policy recommendations for improving children’s health, and guidance for alleviating medical debt.

Thanks for your support!

Eli Kirshbaum
State of Reform


1. Post-Roe abortion law disputes emerge

A state law from 1925 banning all abortions is now enforceable in Texas after the state Supreme Court lifted a district court order last week that temporarily blocked the law from going into effect. The century-old law had been nullified between the passage of Roe v. Wade in 1973 and last month’s repeal of the ruling.

Texas abortion providers filed an ongoing lawsuit in district court in the immediate aftermath of the Roe reversal in hopes of blocking the enforcement of the “antiquated” law. Regardless of the 1925 ban’s status, Texas’s trigger law is slated to go into effect within the next couple of months, effectively banning all abortions after 6 weeks of gestation and deputizing private citizens to sue those who “aid or abet” abortion care.


2. Children’s mental health policy recommendations

Texans Care for Children released their policy recommendations for the 2023 legislature last week, highlighting increased funding for the Texas Child Health Access Through Telemedicine as a key goal. Funding for TCHATT, a program that provides telehealth services to school districts, will expire in 2023 if lawmakers don’t renew it.

The report also recommends increasing Medicaid reimbursement rates for local mental health authority-governed programs like the Youth Empowerment Services waiver program and youth mental health managed care. The YES program, which provides specialized youth behavioral health care, often has more patients on its inquiry list than it has patients that it actually cares for and stands to benefit from increased funding.


3. What They’re Watching: Quianta Moore, MD, Hackett Center for Mental Health

Through her work at the Hackett Center for Mental Health—housed within the Meadows Mental Health Policy Institute—the center’s Executive Director Quianta Moore, MD, focuses on ensuring that state mental health policy is reflective of the mental health needs in local communities. There is often a disconnect between state-level policy and the mental health experiences of communities on the ground, she says. This goal is encapsulated by her organization’s motto: “Putting policy into practice.”

She says an important part of the conversation about bridging siloes in Texas mental health policy is to give equal consideration to the regions of the state that are doing well in terms of mental health. Not only should the state examine areas where mental health is waning to identify areas of improvement, but it should also examine where the state is having success in supporting mental health needs to see what’s working.



4. Strategies for tackling medical debt in Texas

US medical debt owed by patients totaled approximately $88 billion in 2021. Texas has some of the country’s highest rates of medical debt, ranking 48th in the nation in a scorecard of consumer protections. HMA and its subsidiary Leavitt Partners recently released a white paper offering guidance for addressing this harmful debt, suggesting particularly useful tools for a state where debt burdens so many patients.

Recommendations for reducing medical debt include the widespread adoption of payment models that require providers to charge only the health plan-negotiated price for a given service, regardless of whether the patient or insurer is paying. Charges that are arbitrarily raised by a provider when a patient must pay out-of-pocket for services are a critical contributor to medical debt, according to the paper.


5. Burnout continues to weigh on health facilities—particularly in rural Texas

Approximately 55% of physicians across the US are experiencing burnout, according to a study from the University of Texas Medical Branch. State of Reform Reporter Boram Kim recently summarized several initiatives in the state that aim to mitigate ongoing physician burnout, including the Dallas-Fort Worth Hospital Council’s efforts to bring more young professionals into the workforce.

The burnout-induced physician shortage disproportionately impacts rural health facilities, with 40% of Texas’s rural hospitals categorized as being vulnerable to closure. Kelly Cheek, Head of the West Texas Division of the Texas Rural Health Association, told State of Reform the exodus of rural health care professionals is “one of the biggest challenges” currently facing Texas’s rural hospitals.