Bills in the 88th Legislative Session addressing maternal mortality

AUSTIN (KXAN) — At the last legislative session, Texas failed to pass several bills aimed at positively impacting the maternal mortality rate in the state. Most of these bills have been presented again in this session along with new ones echoing some of the Maternal Mortality and Morbidity Review Committee's (MMMRC) recommendations.

“As we talk about educating those who care for all women in general, but Black women in particular, efforts around training for cultural competence, cultural humility, bias reduction, and addressing biases have not been fully utilized,” MMMRC chair, Dr. Carla Ortique said. “There's a lot of room for improvement there. Simple things like increasing the number who qualify for insurance, the duration of insurance, and really ultimately having access across the whole course of the reproductive lifetime as opposed to episodic coverage.”

Along with a few co-sponsors, Rep. Shawn Thierry’s bills focus mainly on mandating cultural competency and implicit bias training in medical school and for continuing education purposes, Medicaid expansion and extension, expanded membership for the MMMRC, establishing a work group to create a maternal mortality and morbidity online registry to address the significant backlog – as evidenced by the fact that the report recently released by the state analyzes information from four years ago.

“Last session, the data we were looking at was from 2013. The only way we can really craft meaningful policy in the Texas legislature is for us to have up to date, real data,” Thierry said. “This bill will go a long way in creating that, and I'm happy to say during Black Maternal Health Week, which we're in right now, that that bill is moving forward.”

The MMMRC's top recommendation from its 2022 report calls for Texas to increase the availability of comprehensive health care coverage during pregnancy, the year after pregnancy and throughout the time women are able to bear children.

Nakeenya Wilson, currently the only community advocate on the MMMRC could possibly get a co-advocate depending on the outcome of HB 1958, one of the bills in the current legislative session with a focus on maternal health and related services.

Here’s a breakdown of what some of the bills would address:

HB 465 - relates to a pilot program to provide Medicaid coverage of doula services; implement a pilot program no later than September 1, 2024 extending Medicaid coverage to doula services in the most populous county and the the county with the greatest maternal health support needs.

HB 663 - relates to the confidentiality and reporting of certain maternal mortality information to the Department of State Health Services; provides for confidential and voluntary reporting of pregnancy-associated deaths and pregnancy-related deaths by family members with a deceased patient.

HB 852 - expands the MMMRCs member composition to include one more community member and physicians specializing in emergency care, cardiology, anesthesiology, and a representative of a managed care organization.

HB 1162 - relates to continuing education in cultural competence and implicit bias for physicians who submit an application for renewal of a registration permit to practice medicine and who practices in the area of general practice, pediatrics, obstetrics, or gynecology.

HB 1165 - relates to medical education coursework in cultural competence and implicit bias.

HB 1824 - extends Medicaid eligibility for a period of not less than 12 months following the last month of a woman's pregnancy.

HB 1958 - relates to maternal mortality and morbidity in this state and Medicaid eligibility of and coverage for certain services provided to pregnant women; expands the MMMRCs member composition etc.

HB 465 and 852 are currently in the Senate health and human services committee. HB 663 passed the House and now heads to the Senate. HB 1162 and 1165 has been referred to the public health committee. HB 1824 and 1958 has been referred to the health care reform select committee.

“There should be more than one seat at the table for community members especially for those who have lived experience,” UT Arlington's Maternal and Child Health Research Lab director, Kyrah Brown said. “For those in the communities seeing the issues day to day.”

However, Thierry expressed concern on the possibility of the bills requiring cultural competency training not passing again this session.

“I am very concerned with all of the discussions and with the bills that seem to be advancing in the legislature where there is going to be a ban on diversity, equity and inclusion,” she said. “It's kind of counterproductive to the conversation about cultural competency and implicit bias.”