Bills, Bills, Bills: What Happened to Our Bills?

By Perdita Henry and Leah Joiner

The 87th Legislative Session is a wrap. Advocates worked hard to bring attention to and garner support for several bills. The Coalition specifically looked at and supported bills that spoke directly to our policy priorities. We identified a select few that stood to improve the women’s health safety net—HB 133, HB 2651, and HB 320—and encouraged everyone to advocate for those bills. So, let’s take a moment to review them and see how they fared.

There was so much collaboration and support behind HB 133, which ultimately passed in the last week of session. The version that passed the finish line allows women to keep their Medicaid coverage for 6-months postpartum, instead of just 2 months.

Though there were differences in the House and Senate version of the bill, the language from the Senate version is what was agreed upon and sent to the Governor for final approval. Texas must now seek a waiver from the federal government to implement the provisions of HB 133 allowing eligible postpartum Medicaid clients to receive 6-months of comprehensive healthcare coverage.

The Senate version of HB 133 also wraps in SB 1149—which moves HTW and other case management services currently housed in DSHS into managed care. The SB 1149 language was updated to include the following recommendations TWHC presented in our testimony.

• Require HHSC to consult with the State Medicaid Managed Care Advisory Committee (SMMCAC) -- an existing and successful advisory committee at HHSC -- as the state transitions HTW to managed care. This step ensures vital opportunity for public and provider input.

• Direct HHSC to identify and implement options to reduce enrollment gaps stemming from forthcoming changes in eligibility and enrollment policies.

• Specify that current HTW and FPP Providers will be designated Significant Traditional Providers in the course of implementation. Ensure requirements apply statewide to Medicaid managed care organizations for providers serving individuals in the Healthy Texas Women program.

TWHC will work with HHSC, Healthy Texas Women providers, and women's health stakeholders to ensure public input and traditional family planning provider prioritization in the process to move Healthy Texas Women into managed care. We will keep membership updated on ways to advocate during the legislative interim and implementation process.

HB 2651 would have allowed women to receive 12-months of their birth control prescription at one time, but ultimately did not pass. It received a hearing, but was left pending in the House Insurance Committee.

Currently, most health plans only allow women to obtain one or three months of birth control at a time, meaning they must refill the prescription incrementally over the year. Twelve-month prescription access would have improved continuity of care and prescription adherence. Women who can access a full-year prescription are 30 percent less likely to experience an unplanned pregnancy.[1]

Contraceptive access will continue to be a priority for TWHC, and we are hopeful for opportunities to continue to educate lawmakers and the public on the common sense solution to reduce barriers to prescription contraception by increasing the supply a client can receive at one time.

HB 320 would have brought back the Women’s Health Advisory Committee (WHAC), but it did not receive a hearing and did not pass.

Before it was disbanded after the 85th legislative session, the WHAC served as an important body for guiding decision-making about program design, sharing information with the public, and providing a forum for stakeholders to weigh in on the programs’ development. Streamlining communications between stakeholders and the state is essential to ensuring more transparent development processes necessary to improving Healthy Texas Women (HTW) and the Family Planning program (FPP).

There are always many moving pieces during a legislative session, and though this bill to bring back the WHAC was not successful, there are some provider input requirements in the final adopted version of HB 133. There is still opportunity for greater provider engagement, and TWHC will remain dedicated to pursuing those opportunities, or seeking ways to create forums for regular communication between women's health stakeholders and the state agency.

While this session proved to be a challenging one – we all navigated a pandemic, a snowstorm induced blackout, and a continuously evolving fiscal landscape - we remain steadfast to our mission to ensure that women have access to preventive healthcare, including contraception. We’ll have more to share on the session in the coming weeks, so keep an eye out for announcements and our upcoming Coalition meeting.

[1]Foster DG, Hulett D, Bradsberry M, Darney P, Policar M. Number of oral contraceptive pill packages dispensed and subsequent unintended pregnancies. Obstet Gynecol. 2011 Mar;117(3):566-572. doi: 10.1097/AOG.0b013e3182056309. PMID: 21343759.