In the 2018-2019 Texas state budget, the Health and Human Services Commission was directed to conduct and provide the legislature with an analysis of the cost-effectiveness and projected savings that an auto-enrollment measure could provide. Specifically, the measure would impact women who become ineligible for the Children’s Health Insurance Program (CHIP) or the Children’s Medicaid program when they turn 19.

In a report released by HHSC in May, the commission found that the state could stand to save approximately $58.7 million in general state revenue over the course of five years by implementing the auto-enrollment measure. HHSC found that the state could realize such savings through the fact that they would be providing auto-enrolled women with better access to family-planning services and therefore preventing an estimated 11,275 unplanned pregnancies.

HHSC’s cost-analysis does operate under the assumption that the Centers for Medicare and Medicaid Services (CMS) will approve the HTW 115 waiver that the state submitted over a year ago. If approved, the waiver could go into effect on Sept. 1, 2018, and it would allow the HTW program to draw down federal funding.

HHSC estimates that it would take a year to implement the policy and set up the technology needed for the auto-enrollment process. The agency previously implemented auto-enrollment for women in Pregnant Women’s Medicaid into HTW, so this will not be a completely new exercise.

The TWHC would strongly support this programmatic change, and we believe it would be a step in the right direction towards reducing unplanned pregnancies, increasing access to health screenings and contraception for Texas women, and creating savings for the state. Automatically enrolling eligible 19 year-old women into HTW when they age out of CHIP or Medicaid would also increase continuity of care and help eliminate some barriers to preventive healthcare access by reducing the burden of re-applying for a new program.

If this measure is adopted, the TWHC will continue to advocate for a strong HTW provider network, with providers that meet the standards for Quality Family Planning services as recommended by the Centers for Disease Control and Prevention.

It is not enough to have greater reach through higher enrollment numbers. Texas must also ensure that the women enrolled in HTW are receiving the preventive services they need.


You can read the full report here.