Policy Recommendations for Good Health and Development

The Dashboard data make clear that too many young children in low-income households do not have health insurance, leading to delays getting eye exams, dental care, doctor visits, and developmental screenings they need. Similarly, too many Texas women in their childbearing years have no access to health insurance. Additionally, too many babies in Texas are born preterm, and too few infants and toddlers with disabilities are accessing Texas Early Childhood Intervention (ECI) services. These access barriers and negative health outcomes can profoundly impact a child’s health and learning for a lifetime.

State policy decisions significantly shape whether or not Texas is a healthy place for children to be born and grow up. Medicaid coverage pays for prenatal visits and childbirth for over half of the births in Texas, and half of children in Texas use Medicaid and CHIP coverage to get needed health care and medications. In addition to overseeing Medicaid and CHIP, Texas also manages and funds programs like Healthy Texas Women and the Family Planning Program that help women with low incomes get contraception and well-woman care so they can plan for healthy pregnancies. Finally, Texas manages the state’s ECI program, which is funded through both federal and state dollars. ECI helps Texas infants and toddlers with disabilities reach developmental milestones and reduces the need for special education services. Yet, state lawmakers have significantly underfunded the program for years.

Policymakers have taken recent steps to improve maternal health and address the health and development of young children in Texas. (Learn more here.) Specifically, state leaders took the following actions in 2023: 

  • Passed HB 12 to allow Texans enrolled in Medicaid for Pregnant Women to maintain their health insurance for 12 months after the pregnancy rather than two months.
  • Adopted a $63 million increase in funding to support Early Childhood Intervention (ECI) for toddlers with disabilities.
  • Nearly doubled funding for the state’s Family Planning Program. 
  • Added Very Low Birth Weight (babies born at 3.3 pounds or less) to the state’s list of qualifying medical diagnoses or conditions for automatic referral to ECI so that Texas’ tiniest children connect earlier to life-changing therapies.

However, there is much more work to do. Policymakers can ensure more babies are born healthy, mothers have the health care they need before, during, and after pregnancy, and all eligible children have health coverage and early interventions to get them off to a strong start. Leaders should pursue the recommendations outlined below, which cover three broad strategies.

Improve enrollment of eligible children in health coverage:*

  • Update the state’s eligibility and enrollment system to remove unintended barriers by investing in Texas 2-1-1 call centers, modernizing the YourTexasBenefits website and app, and taking other steps. These are the tools that Texas families use to sign up and renew their children for Medicaid, CHIP, and SNAP. Yet long wait times, technology barriers, and application backlogs create hurdles for families to sign up and renew benefits. 
  • Adopt Express Lane Eligibility – which is used in Louisiana, South Carolina, Iowa, and other states – so children who are currently eligible for Medicaid or CHIP have a faster, simplified process for enrolling in health coverage.
  • Take steps to help newborn babies of a parent enrolled in Medicaid or CHIP Perinate efficiently connect to Children’s Medicaid, such as having hospitals provide mothers with easy-to-read instructions on Medicaid before families are discharged from a hospital or birthing center. 
  • Improve the efficiency of Medicaid renewals for families by using reliable third-party databases to verify a child’s eligibility without requiring redundant paperwork from families.
  • Invest in the state’s health education and application assistance efforts – including funding for community-based organizations, food banks, and local health centers – so that more families receive help enrolling their eligible infants and toddlers in Medicaid and CHIP from trusted messengers in their communities.

* Many of the recommendations for enrolling eligible children are explained in more detail here.

Improve access to high-quality health care for mothers before, during, and after pregnancy:

  • Continue funding for the Healthy Texas Women and Family Planning Program that help women get preventive care and contraception for healthier, planned pregnancies. 
  • Expand the Texas Alliance for Innovation on Maternal Health (TexasAIM) initiative to implement additional AIM Patient Safety bundles statewide. TexasAIM helps hospitals and birthing centers implement protocols and safety practices that improve health care delivery, save women’s lives, and prevent harmful medical complications for mothers and babies. 
  • Promote group prenatal and well-child care innovations, such as CenteringPregnancy and CenteringParenting, that reduce preterm birth, increase prenatal and well-child visit rates, and have lasting benefits for mothers, infants, and toddlers.
  • Promote Medicaid reimbursement for all services and benefits new moms need to support healthy pregnancies, births, and postpartum recovery. 
  • Adopt health insurance options for adults under the poverty line so that Texans can get covered and connected to medical and mental health care before and after their pregnancies.

Improve access to Early Childhood Intervention (ECI) for infants and toddlers with disabilities and developmental delays: 

  • Increase state investments in ECI to sufficiently raise the per-child funding amount so that community organizations delivering ECI services can maintain adequate staffing levels and serve all eligible infants and toddlers in need. (Learn more here and here.)
  • Expand Help Me Grow Texas, which helps local communities offer developmental screenings, raise awareness about child development, and connect families with young children to ECI or other local resources or supports. 
  • Continue investments in ECI programs to promote partnerships between ECI and child care programs and better equip child care providers with information about developmental screenings and ECI services.