A General Check-Up on Health Care Bills at #TxLege

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CPPP and our Cover Texas Now and Children’s Health Coverage Coalition partners are watching bills on several big topics aimed at improving access to health care in Texas. Here are just a few examples, with more bills still expected to be filed:

Medicaid expansion, or coverage for low-income adults who can’t get subsidies in the Affordable Care Act Marketplace: Several bills have been filed, including HB 590 and HJR 40 by Israel; HB 565 by Coleman; HB 840 and HJR 46 by Bucy; HB 816/SB 327 by Bernal and Alvarado.

Children’s Medicaid 12-month continuous coverage: Children in Medicaid are subject to multiple income checks each year, and too many lose coverage even though they remain eligible. These bills would give Medicaid kids the same 12-month coverage that higher-income children on CHIP get. HB 342 by Cortez and HB 829 by Rose have been filed, with more bills expected.

Extending Medicaid Maternity coverage for 12 months after giving birth: Texas Medicaid maternity benefits cover over half of Texas births each year, but coverage ends two months after delivery. These bills would extend the post-partum coverage for a full 12 months, to better address ongoing health conditions and reduce maternal mortality.  Several bills have been filed to enact this recommendation by Texas’ Maternal Mortality and Morbidity Task Force, including HB 241 by Farrar; HB 610 by Walle; HB 411 by Thierry; HB 744 by Rose; SB 147 Rodriguez; SB 308 Watson.

Medicaid Managed Care reforms: Almost all of Texas’ 4 million Medicaid enrollees get their care through contracts with commercial or non-profit Health Maintenance Organizations (HMOs). A 2018 Dallas Morning News investigative series led to legislative hearings on serious problems faced by enrollees.  More comprehensive bills are expected to be filed; one bill HB 394 by Minjarez, has been filed to add a medical review to “Fair Hearings” when services are denied or cut back; and HB 1080 by White to reduce barriers to physical therapy.

Pre-existing conditions protections: The Texas Attorney General’s lawsuit to eliminate the Affordable Care Act, if upheld by the US Supreme Court, would cause Texans to lose pre-existing condition coverage protections, along with $5 billion per year in subsidies that reduce the cost of insurance. Bills to add the ACA’s pre-existing conditions protections to Texas law include SB 145 by Rodriguez and HB 565 by Coleman.

These are all constructive bills that we support, though they take varying approaches to solving issues.

Other health coverage issues are on our radar as well, including more maternal health coverage issues, improving access to women’s health and family planning, and potential legislation to strengthen the individual (direct purchase) health insurance market and make coverage there more affordable. More on these–and any bad bills you need to know about — in the weeks to come.

Anne Dunkelberg oversees health care policy for CPPP. She focuses on policy and budget issues related to health care access and immigrants’ access to public benefits. She joined the Center in 1994 from the State Medicaid Director’s Office at the Texas Health and Human Services Commission. Anne is a founding member of the statewide Children’s Health Coverage Coalition (formerly the Texas CHIP Coalition) and the Cover Texas Now Coalition. She has been recognized by Families USA as an outstanding Consumer Health Advocate and by the LBJ School of Public Affairs Alumni Association as a Distinguished Public Servant. She was the primary author of the first edition of Texas Medicaid in Perspective (“the Pink Book”) and serves on the Texas Medicaid Managed Care Statewide advisory committee and the Texas Healthcare Transformation Waiver Executive Waiver Committee. Anne is a native Texan, and received her B.A. from the University of Texas at Austin, and her M.P.A. from the LBJ School of Public Affairs at the University of Texas at Austin.

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