Despite Texas’ 2023 decision to extend postpartum Medicaid to 12 months, many new mothers still struggle to access care. Delays in implementation and gaps in awareness have left patients and providers frustrated, highlighting the need for further improvements.
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Dr. Joshua Splinter, a physician in rural East Texas, witnesses the essential role Medicaid plays for his pregnant patients. For years, he had only eight weeks to deliver postpartum care, resulting in many patients losing coverage and leaving essential treatments unfinished. In 2023, the Texas Legislature made a significant change by extending postpartum Medicaid to a full year, a decision that Splinter described as a "game changer" for maternal health.
Yet, almost two years later, the situation has not lived up to what was anticipated. Implementing the policy required nearly a year, resulting in many new mothers experiencing uncertainty. Currently, gaps in awareness and access result in many eligible patients not receiving the essential care they need.
Since before the pandemic, the count of pregnant and postpartum Texans enrolled in Medicaid has almost doubled, exceeding 265,000. Nonetheless, a Texans Care for Children survey revealed that numerous new mothers are unaware they retain coverage for an extra 10 months. Many individuals face challenges in obtaining essential physical and mental health services due to provider shortages, inadequate reimbursement rates, and administrative obstacles.
Health advocates assert that although the policy represents a significant advancement, further efforts are necessary to guarantee that postpartum care in Texas is truly enhanced. Diana Forester, health policy director at Texans Care for Children, highlighted the importance of enhancing provider awareness and making necessary system adjustments.
“You can’t simply activate this extended coverage and think that’s all there is to it,” Forester stated. “Our leaders have the chance to enhance postpartum care for families, but it has yet to reach that point.”
With the Legislature back in session, advocates are urging for specific reforms to tackle workforce shortages, enhance patient outreach, and guarantee that extended Medicaid coverage delivers on its commitment to improved postpartum health care.

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