Fund treatment for postpartum depression for low-income mothers

"As a starting point, the coverage period for postpartum doctor visits for the mother under" the Children's Health Insurance Program's perinatal coverage "should be extended from 60 days to up to one year." Abbott calls for spending $3 million more over two years.


Document, "Bicentennial Blueprint, Greg Abbott's Working Texans Plan," Oct. 28, 2013

News story and chart, "Divide pronounced on health care for Texans," Dallas Morning News, Oct. 14, 2014


Lawmakers inactive on Greg Abbott call to expand postpartum depression care

Greg Abbott campaigned for governor saying state law needs to give more mothers access to mental health services.

The Republican leader framed his case for expanding insurance coverage of treatment for "postpartum depression" in his campaign's compendium of promises — and by mentioning the 2001 drownings of five Texas children by their mother.

Abbott wrote:

"If left untreated, symptoms of postpartum depression may last for months or years, jeopardizing the health and safety of the mother and her child. In 2001. Clear Lake mother Andrea Yates drowned her five children while suffering from a rare disorder called postpartum psychosis. In the aftermath of this tragedy, lawmakers passed a bill requiring health care providers who provide prenatal care to a pregnant woman to give her a list of resources that provide postpartum counseling and assistance to parents. The Yates case, and laws passed in its aftermath, raised awareness of postpartum depression, but more needs to be done to ensure new moms have access to screening and care."

Abbott credited plans to spend more money on prenatal services, then said: "Lawmakers should also consider expanding benefits under CHIP Perinatal and Medicaid for Pregnant Women to cover screening, diagnosis and treatment for postpartum depression." As a starting point, Abbott said, the coverage period for postpartum doctor visits for mothers should be extended from the existing 60 days after birth to up to a year.

If this change happened, Abbott said, a "woman who reports having symptoms of postpartum depression to her postnatal care provider will be screened for postpartum depression and may be referred to a mental health care provider that accepts Medicaid for diagnosis and treatment." Abbott added that a state study established the cost of establishing such a program to be $3 million in 2016-17.

Refresher: The Children's Health Insurance Program offers low-cost health coverage to families of the working poor. Medicaid, the federal-state insurance program, benefits lower-income residents.

As of May 2016, Bryan Black, spokesman for the Texas Health and Human Services Commission, told us by email that Medicaid in Texas covers optional screening and treatment for postpartum depression, for eligible women for 60 days after birth. Black said mothers whose births are covered by CHIP can be screened for postpartum depression for 60 days afterward, but the program doesn't cover treatment--unless the mother is under age 19 and eligible for CHIP in her own right.

"To allow for treatment of postpartum depression under CHIP Perinatal," Black wrote, "Texas Medicaid would need legislative direction."

We asked Abbott's office about movement on his expansion promise and didn't hear back.

Separately to our query, Mandi Kimball of Houston-based Children at Risk, a nonprofit that says it focuses on children's needs, replied that legislation to widen access to postpartum mental health services didn't win approval in the 2015 legislative session.

By email, Kimball pointed out House Bill 3115, co-authored by Reps. Garnet Coleman, D-Houston, and John Zerwas, R-Richmond, and Senate Bill 1698 by Sen. Joan Huffman, R-Houston, each one calling for women giving birth and already enrolled for CHIP- or Medicaid-backed perinatal services to be eligible for "screening and treatment for postpartum depression for the 12-month period after the" child's birth.

Legislative records show the House Public Health Committee held a hearing on Coleman's measure, taking no further action; the Senate held no similar hearing.

We rate this previously unrated Abbott promise STALLED.

Stalled — There is no movement on the promise, perhaps because of limitations on money, opposition from lawmakers or a shift in priorities.


Document, "Bicentennial Blueprint, Greg Abbott's Healthy Texans Plan," Oct. 28, 2013 (posted online September 2014)

News story and chart, "Divide pronounced on health care for Texans," Dallas Morning News, Oct. 14, 2014

Emails, Bryan Black, press officer, Texas Health and Human Services Commission, May 16 and 18, 2016

Web page,  "CHIP Perinatal Benefits," Texas Health and Human Services Commission, 2014 (viewed May 11, 2016)

Emails, Mandi Kimball, director of public policy and government affairs, Children at Risk, April 18-19, 2016

Background paper on postpartum depression issues, Children at Risk, December 2014 (received by email from Mandi Kimball, April 18, 2016)