Women’s Health Advocacy During the 87th State Legislative Session

By Improving Maternal Health
January 12, 2021

Every odd year, on the second Tuesday in January, the Texas Legislature convenes for 160 days. This year is no exception, with the 87th Legislature convening today, January 12, 2021. The pandemic, however, has made regular business look a little bit different.

What we know is not different though is that the need for women to have access to affordable health care and women’s health services. With that in mind, the following four priorities from the Texas Women’s Healthcare Coalition should be addressed during the legislative session.

Ensure funding for the state administered women’s health programs to help fully meet the growing need for preventive healthcare among low-income, uninsured women across Texas.

Healthy Texas Women (HTW), Healthy Texas Women Plus, and Family Planning Program (FFP) provide women with essential healthcare services. While these programs are not a substitute for comprehensive coverage benefits, they provide women access to a range of services, including contraception; screening for diabetes, high blood pressure, and high cholesterol; and an annual check-up.

More than 40% of women report that because of the COVID-19 pandemic, they changed their plans about when to have children or how many children to have. Overall, one-third of women (34%) want to get pregnant later or want fewer children because of the pandemic.

Ensure Texas has a strong qualified provider network with the capacity to serve all women in need of preventive health services.

With the addition of Healthy Texas Women Plus, a limited benefits program designed to address the drivers of maternal mortality during the postpartum time period, postpartum women must have access to a robust physician and provider network – not just obstetrician-gynecologists and family medicine providers but also including cardiologists for cardiovascular benefits and mental health professionals for postpartum depression and mental health benefits – to meet their care needs.

In Texas, the reimbursement rate for Medicaid is very low, which creates barriers to care for Medicaid patients seeking care with private physicians. Because women cannot see the physician of their choice, many do not receive the care they need. In addition, low reimbursement rates can shorten the length of patient visits, which affects the quality of care women receive from their physician. Increasing reimbursement rates will increase access to see the physician of their choice and preserve quality of care for all women.

During the pandemic, many OB/GYN physicians adopted a modified schedule of in-person and telemedicine/telehealth visits see pregnant and postpartum patients. Health plans must pay for telemedicine visits as a covered service, however, excepting the waived policies enacted during the pandemic, health plans do not have to pay a physician the same rate for a telemedicine/telehealth encounter as for a similar in-person visit. Additional waived policies during the pandemic have included the allowance of audio-only services, allowing those individuals without access to broadband or video service to receive care.

Ensure women have access to the full range of FDA-approved contraceptives of their choice, including the most effective forms of contraception – implants and intrauterine devices (IUDs), as well as counseling and medically accurate information on the full range of FDA approved contraceptives.

Unintended and adolescent pregnancy are associated with late entry into prenatal care, which can lead to poor birth outcomes. Access to a full range of contraceptive options, including long-acting reversible contraceptives, for all women of reproductive age is a fundamental step toward prevention of pregnancy. Effective prevention practices will significantly reduce the social and economic burden of unintended and adolescent pregnancy.

Support innovative new healthcare policies that benefit the health of Texas’ women and families.

According to the 2020 biennial report from the Texas Maternal Mortality and Morbidity Review Committee (MMMRC), 31% of maternal deaths occurred between 43 days and 1 year from the end of pregnancy.

Currently, women qualifying for Medicaid due to pregnancy are covered for 60 days after giving birth. The loss of coverage directly contributes to poor health outcomes for mothers, which negatively affects the health of babies. Prolonging coverage is essential to protect mothers and babies.

The number one recommendation from the MMMRC is to increase access to comprehensive health services during pregnancy, the year after pregnancy, and throughout the preconception and interpregnancy periods to facilitate continuity of care, enable effective care transitions, promote safe birth spacing, and improve lifelong health of women. This includes extending health coverage to 12 months postpartum to help identify and properly manage health conditions before they become life-threatening.

Recent studies have shown states with Medicaid coverage for all low-income women were shown to have 1.6 fewer deaths per 100,000 pregnant or postpartum people, a meaningful decrease, as well as improvements in addressing certain preconception health risks among low income women, including increased preconception health counseling, increased folic acid intake the month before conception, and effective postpartum contraception use.

In Episode 2 of Mothers First, Juanita Coleman provides her personal experience with the state’s Medicaid system. Hear directly from her about the challenges she faced while pregnant and in-between her pregnancies.