New Texas Law Takes Important Step Towards Healthy Moms and Babies, Medicaid’s Future Will Determine Success

By Adriana Kohler, Texans Care for Children

A new Texas law recognizes the powerful link between mothers’ mental health and children’s health, development, and long-term success. And it all started with discussions at a Center for Children and Families conference last summer.

Last month, after Texas lawmakers packed their bags and returned home following a tough legislative session, Governor Greg Abbott signed a bill passed by the Legislature that allows more new mothers to be screened for postpartum depression. Under the new law, when mothers take their babies to well-check appointments that are covered by Children’s Medicaid or Children’s Health Insurance Program (CHIP), they can receive a postpartum depression screening covered through their baby’s insurance. About 200,000 mothers in Texas will be eligible for the postpartum depression screenings each year, according to state estimates.

State and national experts played a key role turning this policy proposal into a reality. Texans Care for Children worked closely with national and state partners over the past year to develop and advance this bill, which, once implemented, has great potential to improve early detection of postpartum depression and promote young children’s healthy development.

Of course, if Congress goes through with the Medicaid caps it’s considering or fails to renew CHIP funding, national leaders could undercut the progress Texas has made on this important issue.

Postpartum depression — sometimes called maternal or perinatal depression — is one of the most common complications of pregnancy. In fact, about one in seven mothers experience postpartum depression, and in Texas estimates are as high as one in six. The effects can be devastating for new families. As a new mother tries to console her crying baby, settle into a feeding routine, and help her child grow and play, she may be suffering from crippling anxiety, panic attack or major depressive episodes. While postpartum depression is treatable, it often goes unrecognized or untreated.

Early detection of postpartum depression is critical for a mom’s health and a baby’s health, development, and school readiness. Although all mothers are at risk, rates are higher among teen parents, women with low incomes, and women with personal or family histories of depression. If undetected or untreated, postpartum depression can harm a child’s language and brain development, leading to higher chances of behavioral problems, social disorders, and learning disabilities down the road. Child safety is also at risk — untreated postpartum depression increases the risk of child abuse or neglect, and parents may be less likely to use injury prevention measures, such as putting their baby on her back to sleep.

Given the direct impact on an infant’s well-being, it’s no wonder the American Academy of Pediatrics (AAP) recommends screening mothers for postpartum depression during well-child visits. In fact, the AAP recently updated the Bright Future/AAP Periodicity Schedule for well-child visits and recommended postpartum depression screening at the 1-, 2-, 4-, and 6-months visits. Also, the Centers for Medicare and Medicaid Services (CMS) issued a bulletin in May 2016 explaining that states may allow postpartum depression screenings to be billable as a service for the child under Medicaid’s Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) benefit.

Release of the CMS Bulletin initiated many conversations and brainstorming sessions among national and state children’s groups, including discussions at the Center for Children and Families 2016 conference. Personally, I remember several times when ‘light bulbs’ went off in my head and I thought: “Why don’t we try this in Texas?”

Thanks to the support of CCF and state advocates, Texans Care for Children worked with state and national health experts to understand how this policy has been implemented in other states and develop a screening proposal for Texas. We released a policy report on postpartum depression during legislative session and worked closely with legislators and our partners to pass the bill.

Momentum around postpartum depression increased as Texas state leaders pledged to prioritize mental health during legislative session and as new national and state reports showed a disturbing spike in pregnancy-related deaths in Texas.

The state’s Maternal Mortality and Morbidity Task Force concluded that mental health and behavioral health disorders played a significant role in the rise of maternal mortality in our state and, tragically, suicide is one of the leading causes of Texas maternal deaths. This new law takes a modest yet meaningful step by helping to identify postpartum depression early and start the process of recovery before symptoms get worse.

Certainly, there’s much more work to do, including ensuring that women have access to counseling and effective treatment once they are diagnosed. Texas must do more to address the sky-high rate of maternal mortality and improve access to treatment. Nevertheless, leveraging the opportunities of well-child check-ups, this new law is an important step toward early detection and connecting more new moms with the care they need to stay healthy and support their babies’ health.

We look forward to continue working with partners and state leaders to implement this new law, build on this success, and ensure that Texas families and babies are off to a healthy, strong start. And we hope that the federal government will maintain its firm commitment to funding Medicaid and CHIP.