The Fight for Maternal Healthcare in Texas

L’Dor V’Dor: The RAC-TX Campaign Against Maternal Mortality formally launched on March 20th, 2023. The problem we seek to address is clear: 1 in 4 women of childbearing age in Texas are uninsured. That’s 1.4 million women without insurance. It’s the highest uninsured rate in the nation, twice the national average. Medicaid is the primary insurer for over half the births in Texas. Currently, this coverage only lasts for 60 days after birth. This leaves new moms uninsured at an especially critical time. Texas’ Maternal Mortality and Morbidity Review Committee found that 90% of all pregnancy-related deaths were preventable. That is just the tip of the iceberg.

This session, RAC-TX worked to pass House Bill 12 by Representative Toni Rose, a bill that gives new parents access to a full year of Medicaid coverage–not just two months. It had bi-partisan support and was prioritized by both parties. So far, we’ve made significant progress. The bill passed out of committee in the Texas House unanimously and passed the House floor with a margin rarely seen in Texas: 132-8. This bill had momentum. Then it hit the Senate, where it sat awaiting a hearing for over a month. RAC-TX submitted written testimony signed by congregational clergy from across the state outlining the Jewish moral argument for this legislation and the maternal mortality crisis in Texas. I hand-delivered this signed testimony to members of the Senate committee.

The next day, our coalition discovered that the bill’s sponsor wasn’t willing to call the bill up for a vote in her committee. RAC-TX sprang into action. We hosted a call-in day, targeting three of the most conservative members of the Health and Human Services Committee. Every five minutes, their phones rang. RAC-TX leaders bombarded their offices with calls, showing that Reform Jews exist across the state, in every district. We showed that we support this legislation and are working to get it over the finish line. By the end of the day, two of the three Senators had said “yes” to HB 12. We had the votes to get it out of committee. Not only that, it passed the committee unanimously. Our power made the difference.

But in Texas, nothing good is easy.

Over the weekend, the Senate sprung a surprise vote on the bill. At 11 p.m. on a Sunday, the bill’s sponsor introduced amendment language to appease pro-life groups that would halt the implementation of our legislation. 

Because of the unwinding of pandemic-era public health emergency measures, women are currently being kicked off of Medicaid as Texas continues to enforce the current policy that covers only two months of postpartum Medicaid. Every day that we wait to pass this bill, the crisis of maternal mortality looms over us. The addition of this amendment jeopardizes our ability to get these vulnerable people healthcare.

Boilerplate federal language made it possible to fast-track implementation of this legislation. If we were able to avoid amendments, our bill could have passed and be implemented in a matter of months. We’d be able to save lives immediately. However, any changes to the bill trigger a waiver review process that could potentially take years and possibly end with a waiver being denied by the federal government. Adding an amendment, even one to clarify legislative intent, automatically put us in the slow lane.

In this situation, a lobbying group changed the bill in a way that would jeopardize its implementation to make a political point about abortion. In practice, this results in women not getting health insurance because a few legislators wanted to preserve their standing with an advocacy organization. Once again, in Texas, what was politically advantageous won out over what was morally right.

We had one final opportunity to pass the bill without the amendment: a conference committee. This negotiation between Senators and Representatives happens behind closed doors. When they emerged, we had a bill clean enough to qualify for fast-tracked implementation with a compromise in the bill description that would appease pro-life groups. HB 12 passed the day before the legislative session ended. In a session full of darkness, we were able to contribute to a bright spot. This isn’t enough. But it is a start.

Texans are still in crisis. Governor Abbott has indicated that he is going to call multiple special sessions to push his priorities through. RAC-TX has work to do. Here are a couple of ways that you can make a difference: If you’re in Texas, join our campaign. Sign up for our email list here and help build RAC-TX’s work. Don’t live in Texas? Support the work of Texas Jewish communities by being at the forefront of pursuing justice and make a donation to RAC-TX today.