Cover Texas Now Report: As Lege Blocks Health Bill for Uninsured Moms, New Report Shows TX Has Worst Uninsured Rate for Women of Childbearing Age

Austin – A new national report finds that Texas has the worst uninsured rate for women of childbearing age in the nation. The uninsured rate for Texas women ages 18-44 is 25.5 percent, compared to an average of only 9 percent in states that have accepted federal Medicaid expansion funding to cover low-wage workers, according to the report by the Georgetown University Center for Children and Families (CCF).

The CCF report comes in the final days of the 2019 Texas legislative session as the Texas Senate has failed to hold hearings or a vote on HB 744 or any other bills that would address the high uninsured rate for Texas women. On a vote of 87-43, the Texas House recently passed HB 744, a bill to extend Medicaid health coverage for low-income women to cover a full 12 months after giving birth. The bill would have implemented the first recommendation included in the 2018 report that the Governor and Legislature commissioned from the Texas Maternal Mortality and Morbidity Task Force. Because the Senate has failed to take up the legislation, the state will continue to cut off Medicaid coverage for low-income mothers 60 days after child birth, leaving many Texas mothers uninsured and with limited access to health care during this critical time for their health and their baby’s health.

Research shows that health coverage prior to pregnancy helps address risk factors such as obesity, diabetes, and heart disease and improves access to timely prenatal care. When mothers abruptly lose health coverage so soon after giving birth, it can force them to abandon medication or other ongoing treatment they may need, including support for postpartum depression.


“No mother should lose her life or her child because she didn’t get the care she needed before, during, or after pregnancy,” said Laura Guerra-Cardus, Deputy Director of Children’s Defense Fund – Texas, a member of the Cover Texas Now coalition. “We’re deeply disappointed that our state leaders have once again failed to support the health of Texas moms in low-wage jobs and the health of their babies. As this research shows, denying health coverage to so many Texas women has serious – and sometimes deadly – consequences for them and their babies.”


The new CCF report found that Medicaid expansion has played a key role in reducing rates of maternal death, decreasing infant mortality rates, and improving the potential for optimal birth outcomes that can increase the promise for a healthy childhood. States that expanded Medicaid saw a 50 percent greater reduction in infant mortality, compared to non-expansion states. The research also showed that this decline was greatest among Black infants, which drove the overall decline and helped to substantially reduce the racial disparity in infant mortality rates.

“Health coverage before, during, and after pregnancy is essential to the health and well-being of both mother and child,” said Joan Alker, executive director of the Georgetown University Center for Children and Families. “Medicaid expansion is the single most effective way to help women of childbearing age get continuous health coverage during this critical stage of life.”

During this legislative session, the Texas Senate did not hold hearings or a vote on legislation filed to accept federal Medicaid expansion funding to cover child care teachers, janitors, cooks, and other low-wage Texas workers or legislation to give Texans an opportunity to vote on Medicaid expansion. The Texas House Insurance Committee held a hearing on Medicaid expansion legislation, the first in several years, but did not hold a vote on the bill. This session the Texas House also voted down an amendment to the state budget that would have drawn down the Medicaid expansion funding from the federal government.

States that have expanded Medicaid have also decreased the likelihood that women’s eligibility for coverage fluctuates, resulting in losing and regaining coverage over a relatively short span of time. Breaks in health coverage, also known as “churn,” can disrupt care and cause existing health conditions to become more serious and more difficult and expensive to treat, according to the report.

“The message of this study is clear: Medicaid expansion can protect the lives and health of women and their babies, especially women of color who are at higher risk for a range of poor outcomes,” said Dr. Rahul Gupta, Senior Vice President and Chief Medical and Health Officer at March of Dimes. “If mom isn’t healthy, then her baby is at higher risk for a whole host of health consequences. If she’s healthy, however, that baby has a much higher likelihood of getting the best possible start in life.”

The American College of Obstetricians and Gynecologists recommends that women have access to continuous coverage prior to becoming pregnant and 12 months postpartum to reduce preventable adverse health outcomes.

“OB-GYNs have long recognized that continuous, quality and affordable medical care is vital to the health and wellbeing of our patients,” said Barbara Levy, M.D., Vice President of Health Policy at ACOG. “This important research demonstrates that Medicaid expansion plays a critical role in reversing the steadily rising rates of maternal mortality in the United States by ensuring women have access to the care they need before, during and after childbirth. As many as 60 percent of maternal deaths are preventable. Therefore, ACOG encourages both expansion and non-expansion states to continue working toward Medicaid policies that fill the gaps in coverage to improve health outcomes for women and babies.”


For more information, Contact Peter Clark of Cover Texas Now: 512-417-9262