Healthy Beginnings

Texas must address critical health needs of pregnant mothers and newborns by increasing access to prenatal and postpartum health services for children in families with low incomes. These policies are more critical now than ever, as the COVID-19 pandemic has shown clear needs and disparities in healthcare access, including during the critical time around pregnancy, delivery, and the first three years.

Resources & Articles

The Texas PN-3 Collaborative was highly successful in advancing its Healthy Beginnings policy agenda during the 2021 Texas legislative session, although there is still significant work to do. 

Two of the biggest highlights were passage of HB 290 (as an amendment to HB 2658) and HB 133. HB 290 will ensure more young children are able to go to their doctor’s appointments, receive immunizations, attend therapy sessions for disabilities and developmental delays, and more. The bill reduces the number of eligible children who are mistakenly removed from their Medicaid health insurance due to inaccurate midyear eligibility reviews. HB 133 will ensure that more Texas mothers receive the health care they need after pregnancy, a critical time for their health and their baby’s health and development. Texas typically removes moms from their Medicaid health insurance two months after pregnancy, often leaving them uninsured, but HB 133 will allow moms to keep their health insurance for six months after their pregnancy. While PN-3 preferred the original twelve-month version of HB 133, the six-month version is a clear improvement on the status quo. Before six-month postpartum coverage is available to Texas moms, state and federal officials must negotiate a Medicaid waiver to implement the bill. It will be important for Texas to develop a plan to ensure that mothers have access to comprehensive health care before pregnancy and beyond the six months.

We also led the successful coalition effort to stop the budget cut that the Senate passed for Early Childhood Intervention funding for infants and toddlers with disabilities and developmental delays. While we were pleased to stop the cut to ECI, in the future it will be important for the Legislature to continue the successful efforts made during the 2019 legislative session towards increasing ECI appropriations to restore funding to the same per-child level at which it was funded from 2012 to 2015. 

The state budget was a mixed bag in other ways for the PN-3 Healthy Beginnings agenda, too. Like ECI, Healthy Texas Women (HTW) and Family Planning Program (FPP) received flat funding compared to the amount appropriated last biennium — certainly better than a cut, but not enough funding to meet the state’s needs. We were pleased the Legislature continued $16 million over the biennium for a $500 Medicaid add-on payment for labor and delivery services provided by rural hospitals and maintained $7 million over the biennium to continue maternal health initiatives at the Department of State Health Services, including the TexasAIM initiative to better equip hospitals to prevent pregnancy and birth complications.

Additionally, we were disappointed that the Legislature failed to pass SB 1858 by Sen. Beverly Powell, which would have promoted group prenatal and group well-child care models, such as CenteringPregnancy and CenteringParenting.
More details are available here from Texans Care for Children.

Resources & Articles

Advancing Equity in Maternal Mental Health: Strategies for State Medicaid by the Center for Law and Social Policy

Connecting the Brain To the Rest of the Body: Early Childhood Development and Lifelong Health Are Deeply Intertwined by the Center On the Developing Child at Harvard University

Prenatal-to-3 State Policy Roadmap on Healthy Beginnings and Equitable Births

HHS: Call to Action to Improve Maternal Health