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, which delays getting eye exams, dental care, doctor visits, and developmental screenings they need. 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 have profound impacts on 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 required by federal law, 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 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 on a strong start. Leaders can 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 – including investments in Texas 2-1-1 call centers and modernizing YourTexasBenefits website and app. 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 significant staff vacancies create hurdles for families to sign up and renew benefits. (Learn more here).
• Adopt Express Lane Eligibility – which is used in Louisiana, South Carolina, Iowa, among others – so children eligible for Medicaid or CHIP have a faster, simplified process for enrolling in health coverage.
• Help newborn babies of a parent enrolled in Medicaid or CHIP Perinate efficiently get connected 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 having the state use reliable third-party databases to reverify a child’s eligibility without making a family do redundant paperwork.
• 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 get help enrolling their eligible infants and toddlers in Medicaid and CHIP from trusted messengers in their communities.
• Allow school districts to receive Medicaid reimbursement through the School Health and Related Services (SHARS) program for school-based health and mental health services to connect more eligible children to care.

* 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:

• Extend Medicaid coverage for 12 months postpartum to promote healthy mothers and babies during the first critical year of a baby’s life. (Learn more here.)
• Increase funding for the Healthy Texas Women and Family Planning Program that help women get preventive care and contraception for healthier, planned pregnancies. 
• Expand Texas Alliance for Innovation on Maternal Health (TexasAIM) initiative to reach every hospital and birthing center in Texas. TexasAIM helps hospitals and birthing centers put in place maternal safety practices that improve health care delivery, save women’s lives, and prevent harmful medical complications for mother and baby. 
• 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 doulas and lactation consultants, including reducing the administrative burden for these professionals to join Medicaid networks, so that new mothers can choose these options that support healthy pregnancies, births, and postpartum recovery. 
• Adopt health insurance options for adults under the povery 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: 

• 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. 
• Increase state investments in ECI that will 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.)
• 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.
• Add 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 get connected to life-changing therapies at earlier stages.