Texas, red states consider expanding Medicaid after abortion restrictions

Robinson worried what would happen after that.

“I wouldn’t be able to go to the doctor,” she said. “ … I’m having financial problems. The Medicaid really helped.”

The limits on Robinson’s Medicaid coverage after the emergency insurance lapses hinges on Texas’s long-standing rejection of Obamacare, which included provisions for expanded Medicaid. And it has set up an uncomfortable dynamic: While Texas and nearly a dozen other red states have resisted expanding Medicaid for those who are pregnant, many of them have also restricted access to abortion, leading to more new mothers needing coverage.

Now Republican lawmakers in Texas, Mississippi, Wyoming and other red states face a choice: Focus exclusively on further restricting abortion, or join antiabortion groups and Democrats lobbying to expand postpartum Medicaid coverage.

“There’s a discussion among Republicans and those who are anti-choice about what should we be doing to support mothers?” said Usha Ranji, associate director for reproductive health policy at the Kaiser Family Foundation.

Some national antiabortion groups that support postpartum Medicaid expansion have proposed other legislation to expand funding for those who are pregnant, in the wake of new state curbs on abortion after the Supreme Court’s Dobbs decision erased the protections of Roe v. Wade.

“On our side, there is an awareness and a very strong move after Roe’s overturn toward caring for women,” said Steve Aden, general counsel and chief legal officer for Washington-based Americans United for Life. “I think the whole movement is looking for ways to implement policy on the state level to support the increasing number of women who will have children.”

Republicans have long controlled both chambers of the Texas legislature, which allowed them to pass one of the strictest abortion laws in the country last year ahead of the Supreme Court’s decision. Last year, the Texas House also passed a measure that would have expanded postpartum Medicaid for a year. But the Texas Senate — including Sen. Bryan Hughes, author of the state’s restrictive abortion law — halved postpartum Medicaid to six months. Abbott signed the bill, but because it didn’t cover those who had had abortions, the Biden administration refused the extension.

Now Texas Right to Life and other antiabortion groups are lobbying for passage of a year-long postpartum Medicaid extension at the next legislative session that starts in January.

“This policy fits into a bigger…