Now Is the Time for Health Care Coverage Expansion

Last Thursday, when the Texas House debated its version of the 2022-2023 budget, it considered hundreds of possible amendments. One we watched closely was Chairman Garnet Coleman’s amendment to increase healthcare coverage. The no-fuss language gave direction to Governor Abbott and HHSC to design and pursue a waiver to expand healthcare coverage for over 1 million Texans. In the face of the COVID pandemic and rising numbers of Texans without health insurance, the House still voted down Rep. Coleman’s budget 80 to 68.

The amendment provided the flexibility state leaders have said they would require before moving ahead with any plan to increase healthcare coverage. But with the amendment’s defeat, it’s clear that lawmakers will continue to defy the will of Texas voters who support the expansion of healthcare coverage by a wide margin.

We know a majority of Texas House members also support coverage expansion. But we also know that Governor Abbott, Lt. Governor Patrick, and Speaker Phelan are blocking the path forward, and spinning false narratives about the costs and benefits of expanding healthcare coverage.

The news on healthcare legislation at the Capitol isn’t all bad. Constituent pressure has moved members of the legislature. The House is closer than ever to passing coverage expansion, and the Speaker is prioritizing healthcare coverage bills for the first time in over a decade.

The work of everyday advocates has built bipartisan support in a majority of the Texas House for coverage expansion. Let’s take a moment and celebrate the folks whose action and personal stories have changed the game for healthcare coverage expansion.

We also want to thank our healthcare champions in the legislature: Rep. Julie Johnson, Rep. Lyle Larson, and most of all, Chairman Garnet Coleman — for not just leading last week’s amendment push, but also his strength, expertise, and commitment to health care justice in his 30 years serving in the legislature.

Now is the time for people to contact their representatives and let them know that coverage expansion must be a priority in these last few weeks of the legislative session. There are several other healthcare coverage bills focused on child and maternal health we’re working on that are part of Speaker Phelan’s slate of priority healthcare bills this session: 

  • HB 133 extends maternal Medicaid to 12 months after pregnancy (instead of just 60 days under current law). Besides full healthcare coverage expansion, this policy is a key step in lowering the number of maternal deaths, according to our state’s own Maternal Mortality and Morbidity Task Force. Read our testimony here.
  • HB 290 streamlines children’s Medicaid by eliminating nearly all periodic income checks. This burdensome, often inaccurate process kicks eligible kids off Medicaid mid-year, interrupting their access to medications, therapies, and doctors’ visits. Read our testimony here

Both are now in the Texas Senate, and we’ll keep fighting to get them across the finish line.

Looking ahead, we have other opportunities to help build political will for coverage expansion, even before the 2023 legislative session.

In April, federal officials rescinded a ten-year extension of our state’s “1115 waiver,” an agreement that helps fund hospitals’ care for uninsured Texans. The extension was made just days before the Trump administration ended, and it bypassed a required public comment process. The original agreement was designed to be temporary, a stepping stone to help Texas move towards Medicaid expansion and reduce the need for unpaid hospital bills. 

Texas must now request a new waiver to keep those funds flowing after October 2022, and this time the public will have an opportunity to weigh in. We’ll have the chance to tell Governor Abbott and other state leaders that they must include coverage expansion in the deal to move Texas towards a more sustainable healthcare system.

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