87th Legislature88th LegislatureHealthcareIssuesTaxes & SpendingBiden Administration Signals Rejection of Texas Postpartum Health Care Extension, State Officials Push Back

It's the second time the Biden administration has rejected a Medicaid waiver application from the State of Texas in as many years.
August 12, 2022
An application to extend postpartum Medicaid coverage for new Texas mothers from two months to six was rejected by the Biden administration last week — a move broadly criticized by a bipartisan array of state officials.

The Texas Health and Human Services Commission (HHSC) received verbal word last week that the Centers for Medicare and Medicaid Services (CMS) had rejected its application to extend Medicaid postpartum coverage to six months. The state agency requested written confirmation of the rejection but has yet to receive it from the federal department.

The policy change is in conjunction with House Bill (HB) 133 passed by the state legislature last year, which extends to six months the availability of medical assistance under the program for recent mothers.

As originally passed by the Texas House the extension would have been for a full year, but the state Senate’s version cut the time in half, which was then accepted by the lower chamber and signed into law by Gov. Greg Abbott.

In addition to mothers whose children are born alive, the law includes women who experienced an “involuntary miscarriage.”

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While CMS has not provided its justification, some legislators who passed the bill believe that language is at the issue’s center — namely that it would exclude women who have abortions.

“We are hopeful CMS will work with us toward approval before the end of the Public Health Emergency to ensure women in Texas Medicaid continue to receive postpartum care,” the HHSC spokesman said.

On Thursday, 129 members of the Texas House from both sides of the political aisle, including the bill’s author, Rep. Toni Rose (D-Austin), issued a joint letter condemning the application’s rejection.

“If a formal decision is made to deny Texas’ application, it will not have an immediate impact on new Texas mothers so long as the federal public health emergency remains in place,” reads the letter.

“The Texas House will again prioritize passing a 12-month coverage extension during the 88th Legislature — just as we successfully passed in our chamber during the most recent regular legislative session — along with other proposals to make meaningful improvements in support of Texas moms, children and families.”

After the state received word of the application’s rejection, officials responded and didn’t mince words.

“The Biden Administration is risking robbing mothers of services that Texas specifically extended for them post-partum,” Abbott said in a statement. “President Biden must immediately direct his administration to reverse this unconscionable move, or get ready for a fight with Texas.”

“This is the latest hypocritical, disappointing move by the Biden administration that puts the care and needs of Texas mothers and babies at jeopardy — all in the name of partisan politics,” House Speaker Dade Phelan (R-Beaumont) said.

“It’s unconscionable and a major setback to the work of the Texas House, which acted on a bipartisan basis during the 2021 session to pass legislation that marked a major step forward for the health of women and newborns in our state.”

Last year, the Biden administration pulled a similar maneuver over Texas’ Section 1115 Medicaid waiver allowing the state to be reimbursed for the costs it incurs in uncompensated health care. State Republicans viewed it as an attempt to force the state’s hand toward expanding Medicaid under Obamacare.

Attorney General Ken Paxton sued, and after a year of back and forth, the federal government relented and allowed the waiver to be approved.

The legislature doesn’t reconvene until January, at which point it can take additional action on the law.


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Brad Johnson

Brad Johnson is a senior reporter for The Texan and an Ohio native who graduated from the University of Cincinnati in 2017. He is an avid sports fan who most enjoys watching his favorite teams continue their title drought throughout his cognizant lifetime. In his free time, you may find Brad quoting Monty Python productions and trying to calculate the airspeed velocity of an unladen swallow.