Latest news with #TexansCareforChildren
Yahoo
29-05-2025
- Business
- Yahoo
Texas poised to add $100 million to child care scholarship program
Texas lawmakers are providing an extra $100 million in child care scholarships and giving regional workforce development boards more freedom to allocate money to key providers. Nearly 95,000 Texas children are on a waitlist for child care scholarships. Meanwhile, brick and mortar facilities are closing and the cost of child care in Texas is making it difficult for working parents to make ends meet. 'Because of this funding, thousands more parents will be able to go to work while their children thrive in high-quality child care,' said David Feigen, the director of early learning policy for the child care advocacy group Texans Care for Children. 'This is a huge step, and we are grateful and energized to help get these funds to the families who are counting on them.' Feigen's group is one of several that have put pressure on Texas lawmakers this session to address critical issues affecting child care centers. Texas' decision to use previously unallocated federal dollars to address these issues is a massive step forward, experts say. The funding was added to Senate Bill 1, the budget bill, after the Senate finance committee removed it from the House's supplemental appropriations bill. Rep. Armando Walle confirmed the move Tuesday in a statement to the Texas Tribune. 'I am proud to announce that, through diligent negotiations and collaboration with stakeholders across the board, we secured $100 million in the state budget for child care scholarships,' Walle said. 'Access to quality child care is essential for both economic stability and our children's future. By exploring every budgetary option and building consensus, we achieved a result that will make a real difference in the lives of Texas families.' Marilyn Hartsook, the interim director for the Deep East Texas Workforce Development Office, is cautiously optimistic about what the money means for the region. She expects the region's budget for the child care program will grow by about $14 million. The workforce region currently receives about $17.8 million for direct care, which translates to $23.73 per child per day. Hartsook's team aims to reach 2,945 children per day under the current budget. That number would increase substantially with new funding, but it is only one part of the solution to child care. It is also important to recognize that no one-size solution fits all – regions don't just need additional funding, but some flexibility in how they work with providers, said Kim Kofron, the senior director of early childhood education for ChildrenAtRisk, a child advocacy group. House Bill 2294, which was sent to the governor, allows for more flexibility in how local workforce boards spend money. The bill gives the boards the discretion to allocate more funding to providers struggling financially, especially in high-need areas. 'We need scholarships,' Kofron said. 'We have 95,000 kids on the waitlist. But we also have to make sure that we have the buildings. We also have to make sure we have the teachers. And we have to make sure that it's affordable. This bill allows us to hopefully address all three of those things in various ways.' It costs a lot to keep a childcare facility running, and most operate at around a 1% profit margin, Feigen said. In 2024, the cost was too much for many facilities, and they closed. Texas lost 75,000 child care seats and more areas found themselves to be child care deserts, according to Kofron. 'These child care providers are trying to run a business, but they can't charge a lot because parents can't afford it,' said Mandi Kimball, vice president & chief government affairs officer for ChildrenAtRisk. 'Even though they're quality, they're not getting reimbursed for their quality, and that is impacting the sustainability of child care. Which is why we're seeing these deserts.' Sen. Judith Zaffirini, a Laredo Democrat who sponsored the bill in the Senate, said the bill will help high-quality child care centers that serve families in low-income areas catch up. Providers often must keep their rates low to remain affordable and current law prevents the workforce development boards from reimbursing them above those rates, even if they earn high ratings in the Texas Rising Star program. 'That's not fair, and it threatens the sustainability of high-quality care in the communities that need it most,' Zaffirini said. This bill allows the commission to reimburse those providers at a higher rate. The senator believes that this bill will create more options for quality child care, which would increase enrollment and have broader implications on Texas' workforce. Disclosure: Texans Care for Children has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here. First round of TribFest speakers announced! Pulitzer Prize-winning columnist Maureen Dowd; U.S. Rep. Tony Gonzales, R-San Antonio; Fort Worth Mayor Mattie Parker; U.S. Sen. Adam Schiff, D-California; and U.S. Rep. Jasmine Crockett, D-Dallas are taking the stage Nov. 13–15 in Austin. Get your tickets today!
Yahoo
26-02-2025
- Health
- Yahoo
Texas' has the highest rate of uninsured children, and it's getting worse
HOUSTON — Almost 1 million Texas children and teens went without health insurance at some point over the most recent year recorded. Many of them live in Houston, which has a higher rate of uninsured children than any other major metropolitan area in the nation. Overall, Texas has the worst coverage rate for kids in the country, with nearly 12% going uninsured in 2023 — up from nearly 11% in 2022. A number of issues are driving the numbers. But the fact that many uninsured Texas children are actually eligible for public insurance exposes what experts say are alarming gaps in the state's enrollment and outreach system — gaps that can limit health-care access for low-income kids and endanger their health. Among the issues is a backlog of thousands of families who applied for Medicaid or the Children's Health Insurance Program, known as CHIP. For most of 2024, the average waiting time for a decision by the state was well over two months, which triggered a federal probe under the Biden administration. The application process remains tedious and confusing, requiring families to sometimes round up dozens of documents to prove they're eligible. Some give up. The state has booted more than 1 million children from Medicaid since it began reviewing recipients' eligibility again in 2023 after a pause during the COVID-19 pandemic. Many were dropped not because they were ineligible, but for procedural reasons, such as their parents' failure to submit a renewal packet. Texas lawmakers also have rejected or stalled proposals that typically help more children access CHIP or Medicaid. A 2023 state House bill would have streamlined Medicaid and CHIP enrollment for kids by relying on information already verified via other state benefit programs, such as food assistance. Despite bipartisan support, the bill failed to advance. It's been introduced again in this year's session. Texas has shunned broad proposals enacted by other states, such as expanding Medicaid for low-income adults. Research shows Medicaid expansion has a 'welcome-mat' effect for children, with parents on Medicaid more likely to sign up their eligible kids as well. The range of barriers mean many Texas children go without vital medical care or health screenings, health experts and advocates say. 'When kids are enrolled in Medicaid, they do have better access and better health care outcomes,' said Alec Mendoza, senior policy associate for health at Texans Care for Children. Until recently, Houston native Maria Reyes was terrified that her 7-year-old daughter, Maya, might join the ranks of Texas' uninsured. No child should miss out on regular medical checkups, but Maya really can't. She was born with a rare genetic condition that prevents her pancreas from properly absorbing nutrients and her bone marrow from producing enough blood cells. As a baby, she couldn't put on weight and her breathing was erratic, a symptom of rib-cage abnormalities caused by the condition, known as Shwachman-Diamond syndrome. After multiple hospitalizations, she was diagnosed at 8 months old. Maya needs frequent care to stay healthy, including visits with a blood specialist every two months and a bone marrow biopsy every year, Reyes said. Without Texas Medicaid coverage, which Maya has had since she was a baby, the family would be swimming in medical debt, Reyes said. Just one of her prescriptions costs about $1,500 a month. Reyes was braced for that reality last fall when the state conducted its yearly assessment of Medicaid eligibility for Maya and her two younger siblings. She was worried that her new job as a medical assistant, making less than $20 an hour, might bump her income enough to disqualify her kids. While the family could visit a local community health center that serves the uninsured, finding affordable specialty care would be very difficult. She spent weeks trying to prove their eligibility. 'It's like they don't believe you need it,' she said. Maya has more complex medical needs than most kids. But research shows that going without health insurance has serious risks for all children, particularly in their early years, when their bodies are still developing and they're vulnerable to infections. In interviews with Public Health Watch, health providers and advocates in Houston said their experiences mirror what the research already reports: Uninsured children are more likely to have unmet health-care needs. As a result, their families, who typically have low incomes, face more financial stress. The number of Texas kids who are eligible for public insurance but not signed up is especially frustrating, advocates said. A 2023 report from Texas 2036, a public-policy nonprofit, estimated that 400,000 uninsured Texas children were eligible for Texas Medicaid or CHIP but weren't enrolled. For Reyes, her hunch about her kids' Medicaid coverage wasn't totally off. Maya was still eligible, but to keep all three of her children covered and healthy, Reyes had to cut her work hours. In April 2023, states began dropping people from Medicaid rolls when federal pandemic protections came to an end. Texas disenrolled 2.5 million people by September 2024 — the most of any state, according to a Kaiser Family Foundation tracker of the Medicaid 'unwinding.' A year after it began, more than 1.3 million Texas kids had lost their Medicaid coverage, most of them for procedural reasons, Texas Human Health and Services Commission reported. While community health centers can still serve as medical homes for the uninsured, parents of uninsured kids are often less likely to bring them in for care, said Jana Eubank, executive director of the Texas Association of Community Health Centers. They are often worried about incurring unexpected bills they can't pay. 'If they need specialty care or inpatient care, they often just go without or wait until it's very serious and present at the emergency room,' she said. Regular checkups for kids are vital. They give doctors a chance to catch developmental delays early, such as low weight gain or trouble walking and talking. In the first two years of life, the American Academy of Pediatrics recommends that children visit with their physicians nearly a dozen times. Years of research show that people with health insurance, including kids, are more likely to access preventive care and receive medical treatments they need. One study, published in 2017, followed a group of 237 children in Dallas County who were eligible for Medicaid or CHIP. Researchers found that uninsured children were almost four times more likely than insured ones to have no primary care provider and three times more likely to delay or skip needed health or dental care. With Medicaid or CHIP, families rarely have out-of-pocket costs, said pediatrician D. Maneesh Kumar, who runs a small practice in Southwest Houston. About 70% of his patients rely on public insurance. 'It's actually really good coverage,' he said. But for uninsured kids in households with few resources, even minor medical needs — like treatment for an ear infection or head lice — can be a financial strain, said Dr. Kavon Young, chief clinical officer at El Centro de Corazón, a community health center with three clinics in East Houston. About 40% of its 5,500 pediatric patients are uninsured. 'Something very simple for a child who's insured can pose a lot of difficulty for a child who is not,' Young said. The health center can offer families low-cost primary care for their uninsured kids, but parents have far fewer, if any, affordable options if their child needs more complex medical care. Keren, who asked that only her first name be used, has been bringing her three young children to El Centro de Corazón for the last year. All three are uninsured, she said last fall through an interpreter, but the clinic offers a sliding-scale rate she can afford. She said at times it can be stressful to cover the costs, especially for her children's dental work. But she said she is nervous about filling out the paperwork to apply for Medicaid or CHIP. Providers and advocates say parents' hesitancy is one reason so many Texas children remain uninsured despite being eligible for state coverage. Some parents are confused by the application process; still others have tried and been rejected for procedural reasons. Then there are the huge backlogs at the state level in reviewing Medicaid and CHIP applications. One of the biggest impediments to enrolling eligible kids is the current 'political environment around immigration,' said Marcie Mir, CEO of El Centro de Corazón, referring to state and federal policies, such as Gov. Greg Abbott's 2024 order requiring public hospitals to collect information about undocumented immigrants who seek treatment. Even if their children do qualify, many immigrant parents don't want to draw any attention from government officials, Mir said. Nearly half of Houston children are in a household with at least one immigrant parent, according to a 2023 report. The checklist that Maricela Delcid gives parents wanting Texas Medicaid for their kids is long and tedious: Social Security cards, birth certificates, lease contracts, child support records, utility bills, bank statements and two months of detailed income verification. The paper application is 33 pages. Delcid is team leader for benefits assistance at Epiphany Community Health Outreach Services, or ECHOS, a Houston nonprofit that helps residents apply for public programs like Medicaid. Last year, the nonprofit assisted with about 1,400 applications for Medicaid or food assistance. Many of them families with mixed eligibility status, meaning parents might not be eligible for assistance but their children are. Delcid is well acquainted with the Texas online benefits portal. She whips around the site with her mouse and keyboard, peppering clients with questions as she helps them apply. The system is confusing to most, she said, especially those who aren't proficient in English or computer use. The Medicaid application process confuses even medical students who visit the nonprofit to learn about challenges their clients face, said Cathy Moore, ECHOS' executive director. 'We can all hear about it, but until you see how difficult it is, you don't know,' she said. On top of the application process, the waiting period for a decision can take many weeks longer than it should. The bottleneck became so bad at one point that some families stopped trying, even though their kids were eligible, Delcid said. In mid-September, the median statewide wait time for an eligibility determination for Medicaid was 83 days, state officials reported — longer than the 45-day federal limit. Delcid said that at one point last summer, the wait time reached more than 90 days. 'I'd never seen anything like that,' Moore said. As of Jan. 31, more than 244,000 applications for Texas Medicaid or CHIP were waiting to be processed, up from nearly 132,000 in late November, said Jennifer Ruffcorn, a spokesperson for the Texas Health and Human Services Commission. Applicants were waiting an average of 54 days for an answer. The backlog has grown even after Texas HHSC dealt with major staffing shortages. By April last year, the agency had reduced its vacancy rate for eligibility advisers to 2.5%, down from over 21% in March 2022. As of November, Ruffcorn said the vacancy rate was about 3.5%. The long waits prompted the U.S. Centers for Medicare and Medicaid Services, or CMS, to open an investigation into the backlog last May. At ECHOS, Delcid said wait times are back to normal — no more than 45 days. But the delays have had a lasting impact, as it's hard to convince families who got caught up in the backlog to try again, she said. When wait times were much longer, some kids were rejected and their families told to re-apply — not because they were ineligible, but because the information they had submitted was too old to process by the time they reached the front of the line. At that point, some families give up, believing the system doesn't work, Delcid said. 'It gets to the point that they're hopeless. It's a story we kept seeing.' Delcid and Moore said they suspect the children who remain uninsured see a doctor only when they're sick and don't get all the preventive care experts recommend. Their families also risk being saddled with medical bills they can't afford and that Medicaid would have covered. In a statement to Public Health Watch in November about its investigation, CMS said it 'continues to be actively engaged to bring [Texas] into alignment with federal requirements.' Emails to CMS earlier this month about the probe's status went unanswered. Ruffcorn at Texas HHSC confirmed the review was still ongoing. When Congress reauthorized CHIP in 2009, it included a new option for states — "express lane eligibility' — that made it easier for eligible kids to get covered. But first state lawmakers had to adopt it. In Texas, State Rep. John Bucy III, an Austin Democrat, sponsored a bill to create an express lane in the 2023 legislative session. The bill passed the House with bipartisan support. It was even endorsed by leading conservative groups such as the Texas Public Policy Foundation, an opponent of Medicaid expansion. But it died in the state Senate, where it never got a hearing. 'Increasing access [to health coverage] is such an uphill fight here,' said Bucy, who has introduced the bill again in the current session. As of 2021, seven states had an express lane for children's Medicaid; two had it for Medicaid and CHIP. The idea is that states use the information that families submit for other safety-net programs, such as the Supplemental Nutrition Assistance Program, to determine kids' eligibility for Medicaid or CHIP. Bucy's bill requires parents' permission before an eligible child is enrolled in Medicaid. But families wouldn't have to endure another application process. Bucy said an express lane could reach hundreds of thousands of uninsured Texas kids who are eligible but unenrolled. Research shows express lane laws for children have yielded significant coverage gains and administrative cost savings for states. Alabama started express-lane eligibility in 2010 and has experienced such results, said pediatrician Marsha Raulerson, who is on the state's medical advisory committee for Medicaid. 'It's rare a child doesn't have access to health insurance here,' she said. While Alabama has one of the country's worst child poverty rates, just under 4% of children there are uninsured — about a third of the Texas rate. In Texas, newer technology and more eligibility workers would help fix the state's enrollment problems, the Texas HHSC said. In its 2026-2027 appropriations request, the agency wrote that without more funding, wait times for Medicaid applicants will 'continue to fluctuate' and Texas will be unable to fully comply with the 45-day federal standard. State lawmakers have responded with budget bills in the Texas House and Senate that include the $300 million that HHSC requested to meet federal waiting-time rules, said Mendoza at Texans Care for Children. If approved, he said the funding would help Texas Medicaid streamline its enrollment process. But in Congress, Republican proposals to cut federal Medicaid funding could dampen efforts to insure more low-income kids. Children face the brunt of such cuts, said Edwin Park, a Medicaid researcher at Georgetown University's Center for Children and Families. As of October 2024, about 75% of Texas Medicaid's 3.8 million enrollees were kids. 'In Texas, it's mostly kids, seniors and people with disabilities on Medicaid,' Park said. 'That's where the cuts would hit. There isn't anywhere else.' Most of the people who rely on Hope Clinic, a community health center with five clinics in Houston, are immigrants and refugees. Its patients speak more than 30 languages. Dr. Andrea Caracostis, the clinic's CEO, said its staff is well versed in helping parents overcome application obstacles to Medicaid and CHIP enrollment for their kids. In Texas, children who are lawfully in the country are eligible for the programs. But misinformed fears that applying will hurt a family's immigration status persist and are a major reason children remain uninsured, Caracostis said. 'I have patients that I beg — I say 'Please get on Medicaid. You have a complicated pregnancy, anything can happen, you're going to rack up debt,'' Caracostis said. 'And they won't … They're afraid of being perceived as a public charge.' Under federal law, people deemed likely to become dependent on public assistance can be denied lawful permanent residence. The policy doesn't include Medicaid, but that changed under the first Trump administration. Biden rescinded the change, but policy experts expect it to return during Trump's second term. While Trump's public charge change never applied to children, Caracostis said many parents remain confused and afraid to enroll anyone in the family. According to Every Texan, fears about accessing public services in immigrant communities was likely the main reason for a 237,000 decline in children in Texas Medicaid and CHIP from December 2017 to February 2020. Caracostis expects those fears to roar back. 'There are lives at stake,' she said. This story is part of 'Uninsured in America,' a project led by Public Health Watch that focuses on life in America's health coverage gap and the 10 states that haven't expanded Medicaid under the Affordable Care Act. Public Health Watch is a nonprofit, investigative news organization based in Texas. Disclosure: Texans Care for Children, Texas 2036, Texas Association of Community Health Centers and Texas Public Policy Foundation have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here. We can't wait to welcome you to the 15th annual Texas Tribune Festival, Texas' breakout ideas and politics event happening Nov. 13–15 in downtown Austin. Step inside the conversations shaping the future of education, the economy, health care, energy, technology, public safety, culture, the arts and so much more. Hear from our CEO, Sonal Shah, on TribFest 2025. TribFest 2025 is presented by JPMorganChase.
Yahoo
30-01-2025
- Health
- Yahoo
Many new moms in Texas don't know they qualify for a year of Medicaid, doctors say
Almost all of the pregnant women Dr. Joshua Splinter sees at his rural East Texas practice are on Medicaid. For years, he would treat these patients during pregnancy, deliver their babies and then start the mad dash to squeeze in a follow-up visit before they lost insurance just eight weeks after giving birth. This just didn't work for him or his patients. He'd get someone on a treatment plan for a chronic condition, but then the hormone and weight changes after childbirth would require different interventions. He'd see early signs of postpartum depression or partner violence, and then lose contact with the patient once she lost insurance. 'These aren't things where I start a medication and we're done,' he said. 'This requires close follow-up with continued treatment and non-medical intervention, and we can't get that done in two months.' So when the Texas Legislature voted to extend postpartum Medicaid to a full year in 2023, Splinter was ecstatic. This was going to be a 'game changer' for his patients, he said. But almost two years later, many of his patients and those like them across the state are still struggling to get the full range of health care they were promised. It took almost a year for the extended coverage to go into effect, leaving many of his patients in limbo, and even now, they're still often falling through the cracks in Texas' health care system. The number of pregnant and postpartum Texans enrolled in Medicaid has almost doubled since before the pandemic, to more than 265,000. But many patients are unaware that they are still covered for an additional 10 months, according to a survey from Texans Care for Children, a health advocacy group. New moms report being unable to access the physical and mental health services covered by Medicaid, and doctors say changes are needed to ensure the workforce, reimbursement rates and coverage can keep up with a full year of need. As the Legislature returns, Diana Forester, health policy director with Texans Care for Children, said there's still much work to be done, such as increasing provider awareness and patient access, to ensure new moms are fully benefiting from this extended coverage. 'You can't just turn on this extended coverage and expect that to be the end,' Forester said. 'We as a state need to figure out what postpartum care looks like in Texas … Our leaders have an opportunity to make that work better for families, but it's not there yet.' When Gov. Greg Abbott signed House Bill 12 into law in May 2023, Texas became the 41st state to extend postpartum Medicaid to 12 months. It was a victory years in the making, after several sessions of advocacy from health care providers, maternal health experts and moms themselves. The state almost passed it in 2021, after the federal COVID relief package eased the way for states to get this extended coverage approved, but the Legislature instead passed a six-month extension that the federal government deemed 'not approvable.' But when the Legislature returned in 2023, Roe v. Wade had been overturned, abortion was virtually banned in Texas, and there was new momentum around bills to support pregnant women and families. Sen. Lois Kolkhorst, a Republican from Brenham, carried the bill on the Senate side, and said at a hearing that extending coverage was about making sure 'women who give birth to children in this pro-life environment are cared for … You cannot raise a child without being healthy.' The bill passed with overwhelming bipartisan support, and Abbott signed it into law in May 2023. HHSC submitted the waiver request to the federal government, which approved it last January. The state began offering extended coverage March 1, 2024. After all that back and forth, half-steps and setbacks, many doctors were unaware that the extended coverage was actually in effect, Texans Care for Children found in its survey. Some doctors found out for the first time through their billing departments. Several said they wanted more outreach from the state health agency and the managed care organizations, like a flyer or training for doctors. 'The state could do a lot more in that area,' said Helen Kent Davis, a senior policy advisor to the Texas Academy of Family Physicians. 'They've tried, to the extent that there's funding for outreach, to get the word out, but there's more to be done, for sure.' In a statement, a spokesperson for Texas' Health and Human Services Commission said they used a variety of approaches to inform the public about these changes, including calls and webinars, provider notices, posting information to their websites and working with managed care organizations to get the word out. But knowledge gaps remain, Kent Davis said. As an example, she said pediatricians have not been educated on this change the way OB/GYNs and family physicians have. Since they're seeing the baby regularly, these doctors could be a key ally in making sure the mom knows she still has coverage. Doctors also report confusion about who is responsible for overseeing this year of health care. Texas Medicaid changed its policy to allow an OB/GYN to serve as a patient's doctor for the whole year, but the survey found many doctors across specialties were not aware of that and, when asked, said they would prefer patients be handed off to a primary care provider. 'Patients have been seeing their obstetrician this whole time and the health care system is not good at handing them back to a primary care physician for the rest of that period,' Kent Davis said. 'This is a significant culture shift for patients and providers.' And with a shortage of primary care physicians, especially in rural areas, more coverage doesn't automatically translate into more health care. One new mother in Mineral Wells told Texans Care for Children she would have to travel almost an hour to Fort Worth to see a primary care provider. 'Every day, I get really bad headaches… very bad headaches,' she said. 'And it's getting more consistent. I just deal with it.' In a state where almost half of all pregnant women typically lost insurance two months after giving birth, convincing new moms that they can continue engaging with the health care system has been an uphill battle. Home-visiting nurses, community health workers and others who work closely with new moms report significant confusion and resistance from patients. 'They really had to talk their patients into accessing care, essentially, because they're so used to not having coverage and so worried about the cost and having to absorb that personally,' Forester said. It didn't help matters that this extended coverage finally went into effect amid a historic fracture to the state's Medicaid system. For three years during the pandemic, states kept everyone enrolled in Medicaid, but in spring 2023, were allowed to move people off their rolls. Texas removed more people, including postpartum women, faster than any other state, against federal guidelines, The Texas Tribune and ProPublica found. The state required almost everyone to resubmit documents proving their eligibility, rather than relying on automatic approvals like other states. More than a million people lost coverage for bureaucratic reasons like failing to return a form. The state has acknowledged some errors, which they later fixed. Amid this upheaval, Texas implemented the extended coverage, including reinstating women who lost Medicaid at two months but were still in their one-year postpartum period. 'It was really confusing for members who were like, 'you terminated my Medicaid a month ago, I have the notice,' and then they're told that it's being turned back on for a few more months,' Forester said. 'And it's really hard for a doctor to be able to educate their patients when it's totally dependent on where they are in the postpartum period.' Splinter said he's had at least a dozen patients over the last year who had to call their managed care organization to get their coverage reinstated. 'I'm having to act a little like a social worker and educate the patient on who they need to call and what they need to say,' he said. As a family physician trained in high-risk pregnancies practicing in an underserved area, Splinter said, 'there's only so much of me to go around, especially if I have to spend more time on non-doctor work like this.' A spokesperson for the state's health agency said everyone who was enrolled in Medicaid or CHIP during their pregnancy were automatically reinstated for the remainder of their postpartum period. While some of this is naturally sorting itself out the longer the policy is in effect, Splinter said he was surprised at the work his patients had to do to get the coverage they qualified for. 'You're leaving pregnant patients and new moms to fight up the chain and solve it themselves from the bottom' he said. 'That just isn't the right way to be doing this.' As more new moms are able to take advantage of this extended coverage, doctors and advocates hope the health care system is able to meet their needs. In the short term, Splinter said, he's hopeful that the state can proactively go back through its records and ensure women who qualify for this coverage are actually getting it. In the long term, the state needs to address long-standing structural problems facing its health care system, like significant shortages in primary care and mental health providers. Advocates are pushing for increased reimbursement rates and reforms to the bureaucracy that providers must go through to accept Medicaid, to ensure doctors are willing to see these patients. They also want Medicaid coverage to catch up to the extended time period women can receive these benefits. For example, Texas Medicaid covers one postpartum depression screening, even though national groups recommend at least four, Kent Davis said. With an extra ten months of coverage, that's a lot more touch points for doctors to be screening patients for mental health needs. She'd also like to see Medicaid cover lactation support among other needs that can emerge in the first 12 months postpartum. 'It takes a comprehensive strategy,' Kent Davis said. 'Obviously the coverage issue was one part to address and, and we're so happy that we were able to pass House Bill 12. But now that we have this coverage, what do we do to make sure women can get it?' Disclosure: Texans Care for Children has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.
