TWHC Policy Priorities for the 86th Legislature
As we prepare for the 86th legislative session to begin, it’s important to identify our intentions to make the most of each meeting and encounter with legislators and their staff. After conversations with stakeholders, research, and input from TWHC members, we have finalized our list of priorities.
1. Ensure funding for women’s preventive healthcare, including contraception, can fully meet the growing need among low-income, uninsured women.
WHY: Roughly 1.8 million Texas women are in need of publicly funded preventive services, yet less than a quarter of these women currently receive the services they need. Access to preventive and preconception care – including health screenings and contraception – means healthy, planned pregnancies, reducing the risk of maternal and infant complications. Preventive care also provides early detection of cancers and other treatable conditions.
At a minimum, maintain the 2018-2019 funding levels for the state’s women health programs.
· Provide funding to serve as many women with family planning care as were served in State Fiscal Year 2010, considering population growth.
· Ensure the distribution of funding between the state’s women’s health programs matches the need within each program.
2. Identify areas with a shortage of qualified family planning providers and develop strategies to increase provider participation in the state’s women’s health programs.
WHY: Texas needs more providers to deliver preventive care to women, especially in rural areas. The women’s healthcare safety-net is still recovering from cuts to family planning programs in 2011 and the exclusion of some of the state’s largest providers.
· Identify areas of greatest need by collecting and analyzing data that provides an accurate picture of unduplicated provider capacity and fund distributions to contractors in the state.
· Increase provider outreach and eliminate barriers to provider participation.
· Increase provider capacity, particularly in rural and underserved areas.
· Increase payment rates for providers.
3. Ensure women have access to the full range of FDA-approved contraceptives of their choice, including the most effective forms of contraception – implants and intrauterine devices (IUDs) – as well as counseling and medically accurate information on the full range of FDA-approved contraceptives.
WHY: Ensuring women have access to the most effective form of contraception that works for them is key to enabling women to plan and space their pregnancies. All FDA-approved birth control methods should be accessible, including implants and IUDs, which are twenty times more effective than other methods and considered a first-line choice for women by medical organizations. Women should also be counseled on the effectiveness of all FDA-approved available birth control methods.
· Increase access to long-acting reversible contraceptives (implants and IUDs).
· Enable women receive a 12-month supply of birth control at a single pharmacy visit, if prescribed.
· Ensure adequate provider training that aligns with Quality Family Planning (QFP) best practices recommended by the Centers for Disease Control and Prevention.
4. Increase continuity of care for women by eliminating barriers to preventive healthcare access.
WHY: When women experience gaps in their healthcare coverage, it increases their risk for negative health outcomes and unintended pregnancy. Enabling eligible women to access and maintain continuous healthcare coverage improves health outcomes and reduces costs to the state.
· Address policy and system limitations that prevent eligible clients who are enrolled in CHIP from receiving services through the Healthy Texas Women program.
· Address policy and system limitations that prevent eligible clients who have private insurance with high deductibles and/or copays from receiving services through the Healthy Texas Women program.
· Ensure that women receive effective referral services into women’s healthcare programs and other treatment as needed.
· Automatically enroll eligible 19-year-olds into the Healthy Texas Women program when their CHIP or Children’s Medicaid certification period ends.
· Promote use of community health workers for outreach and other services.
5. Maximize the ability of the women’s healthcare safety net to reach more women and save Texas taxpayer dollars.
WHY: 54 percent of the state’s unplanned births are publicly funded, and the most recent research shows that unintended pregnancies in Texas cost taxpayers $2.9 billion ($842.6 of it paid for by the state). For every dollar invested in contraception, taxpayers see a return of $7.09.
· Develop a workable solution for the coverage gap that will maximize federal funding and substantially increase the number of women able to access a medical home where they can receive critical preventive care and family planning services.
· Extend Medicaid coverage for individuals on Pregnant Women’s Medicaid for up to a year postpartum.
· Improve maternal and child health by creating a tailored coverage option for women to
access care before, during, and after pregnancy.
With the challenges 2019 is sure to bring, we look to these properties as the foundation of our work during this legislative session. Thank you to our Coalition members for your continued support and expertise to help us identify the areas where improvement is needed most.
 Frost et al., "Contraceptive Needs and Services, 2014 Update," New York: Guttmacher Institute, 2016.
 The American Congress of Obstetricians and Gynecologists, “Increasing Access to Contraceptive Implants and Intrauterine Devices to Reduce Unintended Pregnancy,” Committee Opinion No. 642, 2015.
 Sonfield & Kost., “Public Costs from Unintended Pregnancies and the Role of Public Insurance Programs in Paying for Pregnancy-Related Care: National and State Estimates for 2010,” New York: Guttmacher Institute, 2015.
 Frost et al., “Return on Investment: A Fuller Assessment of the Benefits and Cost Savings of the US Publicly Funded Family Planning Program,” The Milbank Quarterly, Vol, 92.4, 2014.
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