Abbott promise on postpartum depression goes unmet

Gov. Greg Abbott agreed with lawmakers this year on a move that could encourage more Texas mothers to get checked for postpartum depression. For a second time, though, Abbott’s 2013 campaign call to spend money qualifying low-income mothers for a year’s worth of mental health screenings and services after giving birth didn’t pass into law.

Last year, we had marked this Abbott campaign promise Stalled on the Abbott-O-Meter, where we track progress on the governor’s major promises.

The 2015 Legislature had done little more than taken testimony on a proposal to expand mental health screenings and treatment. After another legislative session, we decided to take a fresh look to see if the campaign promise is any closer to becoming reality.

As a candidate, Abbott 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 in 2013: “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 wrote: “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, such coverage for mothers should be expanded from the existing 60 days after giving birth to up to a year.

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

Abbott said that with the expansion he was urging, 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.” A state study had established the cost of establishing such a program to be $3 million in 2016-17.

In updating progress on this promise, we spotted no decisions in the 2017 legislative session to make women who give birth under CHIP eligible for mental health screenings and treatments more than 60 days after delivery. Some other actions still could benefit mothers going forward.

An October 2016 report requested by lawmakers stated that in a recent year, the share of Texas mothers on Medicaid diagnosed with postpartum depression or other mental health challenges after giving birth considerably trailed national averages.

A few months earlier, the Texas Health and Human Services Commission had launched Healthy Texas Women, a program generally open to low-income women who are legal U.S. residents ages 18 through 44 and who lack insurance coverage for family planning services. Commission spokeswoman Kelli Weldon told us that provisions were made to automatically enroll women in Healthy Texas Women 60 days after a Medicaid-covered birth.

Such mothers, Weldon said, would remain eligible for mental health screenings and treatment. “Office visits for diagnostic evaluation, and basic follow-up and monitoring of treatment response, are covered,” Weldon said. “For those who require more intensive services, providers are requested to refer the patient to local behavioral health care providers.”

Legislative records show a House panel approved a proposal in keeping with Abbott’s promise that would have extended mental health screenings and treatment to low-income women through the first year of each baby’s life. But House Bill 2135 by Rep. Garnet Coleman, D-Houston, died short of a House vote.

Members agreed on a measure potentially leading more mothers to be screened and treated. Abbott in June signed into law House Bill 2466 specifying that mothers of children whose births are covered by CHIP or Medicaid now qualify for mental health screenings and referrals (though not treatment) when the mothers take their infants in for a checkup. The measure’s author, Rep. Sarah Davis, R-West University, told us that she expects mothers to embrace screenings by their children’s pediatricians.

We emailed aides to Abbott about progress on this promise and didn’t hear back.

Our ruling:

The measures enacted so far are short of the governor’s promise.

We rate this campaign vow a Promise Broken.

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