How health care bills fared in the Texas Legislature
Successful bills this session focused on the shortage of nurses in Texas and on eliminating the tax on feminine hygiene products.
The regular legislative session ended Monday, and all this week, we’ll be taking a closer look how certain issues fared — what passed and what failed.
Here’s how health and health care issues played out at the Capitol:
Nursing workforce retention
Several successful bills this session focus on the shortage of nurses in Texas, a long-standing issue heightened by COVID-19. A pre-pandemic study from the Texas Center for Nursing Workforce Studies projects Texas will have a deficit of 57,000 active registered nurses by 2032.
Senate Bill 840 will raise the penalty for physical assault of hospital personnel from a misdemeanor to a felony in many cases. Serena Bumpus, CEO of the Texas Nurses Association, said threats of violence cause emotional burnout among nurses and other health care workers
“If we can put things in place in our health care organizations to address workplace violence, then the likelihood is that we will retain more nurses, because they’re tired of being assaulted and verbally abused every day when they go to work,” Bumpus said.
Currently on Gov. Greg Abbott’s desk is a bill that aims to help more students become nurses in training: SB 25 will create a scholarship and loan repayment program for nursing students, along with nurses who serve as academic nursing faculty, which are also in short supply.
Diane Santa Maria, dean of the Cizik School of Nursing at the University of Texas Health Science Center in Houston, spoke in support of the bill while addressing the Senate Committee on Health and Human Services in March.
“Unless we do something dramatic, which is what this bill supports, we’re not going to have the nursing workforce we need tomorrow, let alone in what we need in 10 years,” Santa Maria said.
– Olivia Aldridge, KUT
» MORE LEGISLATURE 2023: How education issues like special ed funding, school book bans fared
An end to the ‘tampon tax’
A bill eliminating what some call the “tampon tax” on feminine hygiene products went to the governor’s desk this session.
The legislation removes sales tax from period products like tampons and pads, as well as supplies for new and expecting parents: diapers for both adults and children, baby wipes, maternity clothing and breast pumps.
Democratic Rep. Donna Howard of Austin, one of the bill’s sponsors, spoke with The Texas Newsroom about the legislation earlier this session.
“It’s supposed to be a bill that’s focused on everyday essentials that a family might need and a woman in particular might need,” Howard said.
These essentials will join products like food and medicine in being exempt from sales tax.
– Aurora Berry, The Texas Newsroom
More options for hearing-impaired Texans
House Bill 109 prevents health insurance companies from denying claims for hearing aids based solely on cost.
For example, if a person’s plan includes a $1,500 benefit for hearing aids, and the necessary device costs $2,000, the enrollee would be able to pay the difference out of pocket – the insurance company cannot deny the claim outright like it could previously.
That means more options for hearing-impaired Texans. The law applies to both adults and children who use hearing aids.
Michelle Pho, a pediatric audiologist at Dell Children’s Medical Center in Austin, testified in favor of the bill.
“Certain features of hearing aids may not be available in the level of technology covered by a patient’s insurance,” Pho said. “So passing this bill would allow families to select the level of hearing device most appropriate for their child’s needs, regardless of any limitations in insurance coverage.”
An identical bill passed out of committee unanimously last session but did not make it to the governor’s desk.
– Alexandra Hart, Texas Standard
Extended health coverage for pregnant Texans
House Bill 12, authored by Rep. Toni Rose, extends postpartum Medicaid coverage for Texans from two months to 12 months.
Texas is among the states with the highest maternal mortality rate in the nation, and many of those deaths happen between “43 days to one year after the end of pregnancy,” according to the Texas Maternal Mortality and Morbidity Review Committee. The committee and advocates like Diana Forester, director of health policy for Texans Care for Children, said a longer coverage window would help people get care to prevent those deaths.
“Because we’re not maintaining access to care and allowing people to manage chronic conditions between pregnancies, it creates harder pregnancies,” Forester said. “It creates worse health outcomes, and it costs the state more, honestly.”
The House passed a 12-month extension in 2021, but the Senate version of the bill, signed into law by Gov. Greg Abbott, only approved six months of coverage. The Centers for Medicare and Medicaid Services (CMS) are still reviewing Texas’ application for six months of coverage.
Surrounding states, like New Mexico, Oklahoma and Louisiana, all approved and implemented the 12-month extension for pregnant people in their state.
“We’re behind,” Forester said. “We’re so behind at this point.”
In a hearing on HB 12 in March, mother Connie Bunch testified in favor of the bill. She had Medicaid coverage for both of her pregnancies, which allowed her to get treatment for chronic conditions like high blood pressure and diabetes.
“If I didn’t have that extension of Medicaid, I don’t know what I have done,” Bunch said. “I probably would not be alive, to be honest. Aneurysms can kill you. Heart conditions can kill you. And all of that would have been untreated because I don’t go [to the hospital]. I don’t have the money.”
The bill had widespread support from both Democrats and Republicans, including House Speaker Dade Phelan identifying HB 12 as one of his priorities this year, but has changed over the session.
The bill’s original language specified coverage would end “on the last day of the woman’s pregnancy,” which matches CMS’s federal language for Medicaid coverage. Republican lawmakers and representatives from anti-abortion groups like Texas Right to Life were concerned that would allow HB 12 to cover people’s post-abortion care.
The Senate version of the bill, which was approved in a conference committee and now heads to the governor’s desk, still includes the original language but includes a “legislative purpose” section that states coverage is extended for pregnant people “whose pregnancies end in the delivery of the child or end in the natural loss of the child.” If signed into law, it goes into effect Sept. 1.
– Elena Rivera, KERA
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