| Perspectives on Texas

Whether it’s a cautionary tale or a heartwarming story of overcoming the odds, everyone has a story about a teen mother. What all of these stories have in common is a young person who is likely to experience additional barriers to opportunity. 

Given public cost savings from averting unintended teen pregnancies, thoughtful members of the Texas Legislature on both sides of the aisle are supporting two commonsense measures this session. One deals with repeat births to teen mothers, and the other streamlines access for reproductive health care coverage to teens already eligible for existing programs.

Texas consistently owns one of the highest teen pregnancy rates in the country. You might not know that while a teen mother can make any and all health care decisions for her child, if she’s under the age of 18, she can’t obtain prescription birth control for herself without parental consent under state law.

Obtaining parental consent is not always as simple as it sounds. As the leader of a nonprofit organization working to reduce teen pregnancy, I frequently hear stories about challenges young Texans face when trying to access healthcare. Recently, I learned of a young woman who became pregnant at age 15. When she tried to obtain prescription contraception after the birth of her daughter, she was told her own parents needed to consent. One parent was homeless, one was in prison. And eight months later, the young mother was pregnant again.

It makes no sense to put obstacles to birth control in the path of a teen mother, especially when a baby is already in the picture. Every well-documented negative impact of teens having babies is compounded by a repeat birth.

Is this a real problem? Yes. Of the almost 27,000 births to Texas teens in 2017, 19% were repeat births to mothers still in their teens, according to the Centers for Disease Control.  That means 14 teen mothers in Texas have a repeat birth every day.

This problem has a simple, straightforward solution: allow teen mothers to consent to their own prescription birth control. In the Texas Legislature, House Bill 938 by Rep. Sarah Davis, R-Houston, and companion Senate Bill 149 by Sen. José Rodríguez, D-El Paso, would do just that. 

A second proposed change to Texas law is harder to explain than it is to fix. It involves the automatic enrollment of young women who, when they turn 19, are too old for the government-sponsored health insurance programs that have served them up until that birthday. For you, the reader, this explanation involves many acronyms.

Start with the logical assumption that if you don’t know something exists, you’re unlikely to go looking for it. When a Texas teen turns 19, she is removed from the rolls of Children’s Medicaid and the Children’s Health Insurance Program (CHIP); in government-speak, this is called “aging out.” She would then qualify for the state’s Healthy Texas Women program (HTW) — if she only knew it existed. 

HTW provides access to reproductive healthcare for low-income women, including annual exams, family planning, disease screenings and treatments. Auto-enrollment in HTW would solve the dual problems of making eligibility known and making access easier by eliminating the need to apply. 

During the last legislative session, the Texas Health and Human Services Commission (HHSC) found that this proposed policy change would, over five years, prevent 11,275 unintended pregnancies and produce $58.7 million in savings to the state’s general revenue. The cost savings projected by this report led to House Bill 1879, also by Rep. Davis, and its companion, Senate Bill 189 by Sen. Borris Miles, D-Houston.  

Access to contraception matters for 19-year-olds because they account for 42% of births to Texas teens, according to the CDC. Health insurance matters because highly-effective, long-lasting forms of contraception cost several hundred dollars. A 2018 study of 1,000 Texas women attending state community colleges found that a majority would use the most effective methods of birth control if they could afford it or had insurance. Auto-enrollment in HTW would remove this barrier. 

Let’s make it easier for teen mothers to raise healthy children, and for low-income older teens to have the opportunity to delay having families until they complete their education and start their adult lives with self-sufficiency and promise for the future.