News Release

Texas legislature takes “monumental step” to improve health, not just health care in addressing maternal health crisis

Governor signs new law that enhances screening for non-medical needs and role of community health workers and doulas to improve health outcomes for Texas moms and babies.

HB 1575 addresses critical gaps in maternal health care under Medicaid

Texas governor Greg Abbott has signed a new law requiring Texas Medicaid to develop a standardized, strengthened screening tool to help determine the non-medical health needs of pregnant Texans and their babies and allows community health workers and doulas to be reimbursed by Medicaid for their work to address those important needs through the state’s Case Management for Children and Pregnant Women program.

More than half of all births in Texas are covered by Medicaid. HB 1575 addresses a critical gap in maternal health care across the state by strengthening the way Medicaid helps identify and impact underlying, non-medical issues like housing, nutrition, transportation, employment, and more. The legislation was sponsored by Rep. Lacey Hull and Sen. Lois Kolkhorst.

“This is a monumental step to putting the concept of improving health, not just health care to work to address the maternal health crisis in Texas,” said Dr. Ann Barnes, EHF’s president and CEO. “Identifying and addressing health-related needs beyond medicine alone improves birth and health outcomes. Allowing Medicaid to reimburse community health workers and doulas for the vital role they play is an important move forward in providing a crucial support system that’s been proven to boost the health of both moms and babies.”

EHF-funded research helped provide evidence showing the significant influence of non-medical drivers of health on high-risk pregnancies in Texas. For example, a report by actuarial firm Milliman found that high-risk pregnancies are about twice as likely to have had a non-medical health need recorded on a health care claim as non-high-risk pregnancies. Researchers estimated that the health care cost in Texas for high-risk pregnancies was more than $770 million a year. The report was cited in committee hearings and in the official analysis of the bill. 

Doulas and community health workers are trained professionals who play important roles in improving health outcomes for those high-risk pregnancies. Their work is particularly important in underserved communities because doulas and community health workers uniquely address non-medical drivers of health and reduce barriers to health care access. They work alongside medical professionals to provide culturally appropriate care and empower individuals to take control of their health.

“Whether it’s connecting mothers to community services or providing emotional support, community health workers and doulas work tirelessly to support Texas mothers,” Barnes said. “Improving opportunities for them to work with families through Medicaid really is crucial to addressing state’s maternal health crisis – especially the alarming Black maternal health crisis.”

Passage of HB 1575 comes after the Texas Health and Human Services Commission released a groundbreaking action plan earlier this year to address non-medical drivers of health through Medicaid & CHIP by focusing on food insecurity, housing, and transportation.

Governor Abbott signed HB 1575 into law on June 2. The law goes into effect on September 1, 2023.