LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 89TH LEGISLATIVE REGULAR SESSION March 24, 2025 TO: Honorable Lacey Hull, Chair, House Committee on Human Services FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB136 by Hull (Relating to Medicaid coverage and reimbursement for lactation consultation.), As Introduced Estimated Two-year Net Impact to General Revenue Related Funds for HB136, As Introduced: a negative impact of ($1,995,065) through the biennium ending August 31, 2027. General Revenue-Related Funds, Five- Year Impact: Fiscal Year Probable Net Positive/(Negative) Impact toGeneral Revenue Related Funds2026($247,535)2027($1,747,530)2028($1,662,122)2029($1,706,118)2030($1,722,565)All Funds, Five-Year Impact: Fiscal Year Probable Savings/(Cost) fromGR Match For Medicaid758 Probable Savings/(Cost) fromFederal Funds555 Probable Revenue Gain/(Loss) fromGeneral Revenue Fund1 Probable Revenue Gain/(Loss) fromFoundation School Fund1932026($247,535)($1,446,215)$0$02027($1,799,507)($2,695,125)$38,983$12,9942028($1,791,540)($2,683,259)$97,019$32,3992029($1,783,238)($2,670,893)$57,840$19,2802030($1,773,795)($2,656,829)$38,423$12,807 Fiscal AnalysisThe bill would require the Health and Human Services Commission (HHSC) to provide coverage of lactation consultation as a pregnancy-related service in the Medicaid program when delivered by an eligible provider who has a certification in lactation consultation. The bill would require HHSC to establish separate provider types for community health workers and doulas who provide lactation consultation services.The bill would take effect September 1, 2025.
LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 89TH LEGISLATIVE REGULAR SESSION
March 24, 2025
TO: Honorable Lacey Hull, Chair, House Committee on Human Services FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB136 by Hull (Relating to Medicaid coverage and reimbursement for lactation consultation.), As Introduced
TO: Honorable Lacey Hull, Chair, House Committee on Human Services
FROM: Jerry McGinty, Director, Legislative Budget Board
IN RE: HB136 by Hull (Relating to Medicaid coverage and reimbursement for lactation consultation.), As Introduced
Honorable Lacey Hull, Chair, House Committee on Human Services
Honorable Lacey Hull, Chair, House Committee on Human Services
Jerry McGinty, Director, Legislative Budget Board
Jerry McGinty, Director, Legislative Budget Board
HB136 by Hull (Relating to Medicaid coverage and reimbursement for lactation consultation.), As Introduced
HB136 by Hull (Relating to Medicaid coverage and reimbursement for lactation consultation.), As Introduced
Estimated Two-year Net Impact to General Revenue Related Funds for HB136, As Introduced: a negative impact of ($1,995,065) through the biennium ending August 31, 2027.
Estimated Two-year Net Impact to General Revenue Related Funds for HB136, As Introduced: a negative impact of ($1,995,065) through the biennium ending August 31, 2027.
General Revenue-Related Funds, Five- Year Impact:
2026 ($247,535)
2027 ($1,747,530)
2028 ($1,662,122)
2029 ($1,706,118)
2030 ($1,722,565)
All Funds, Five-Year Impact:
2026 ($247,535) ($1,446,215) $0 $0
2027 ($1,799,507) ($2,695,125) $38,983 $12,994
2028 ($1,791,540) ($2,683,259) $97,019 $32,399
2029 ($1,783,238) ($2,670,893) $57,840 $19,280
2030 ($1,773,795) ($2,656,829) $38,423 $12,807
Fiscal Analysis
The bill would require the Health and Human Services Commission (HHSC) to provide coverage of lactation consultation as a pregnancy-related service in the Medicaid program when delivered by an eligible provider who has a certification in lactation consultation. The bill would require HHSC to establish separate provider types for community health workers and doulas who provide lactation consultation services.The bill would take effect September 1, 2025.
The bill would require the Health and Human Services Commission (HHSC) to provide coverage of lactation consultation as a pregnancy-related service in the Medicaid program when delivered by an eligible provider who has a certification in lactation consultation. The bill would require HHSC to establish separate provider types for community health workers and doulas who provide lactation consultation services.
The bill would take effect September 1, 2025.
Methodology
According to HHSC, necessary policy revisions and rate hearings associated with creating a new benefit can take approximately 12 to 18 months to complete; therefore, HHSC assumes that services would begin September 1, 2026.This analysis assumes that HHSC would require $247,535 from the General Revenue Fund ($1,693,750 from All Funds) in fiscal year 2026 for development costs associated with establishing new provider types and $9,867 from the General Revenue Fund ($39,467 from All Funds) in subsequent fiscal years for ongoing system updates.The additional average monthly caseload associated with the new benefit is estimated to be 54,861 in fiscal year 2027, increasing to an average of 56,916 by fiscal year 2030, with an assumed per diem rate of $54.20 and an average of two lactation consultation sessions per utilizer. This analysis assumes a net client services cost of $1,789,640 from the General Revenue Fund ($4,455,165 from All Funds) in fiscal year 2027, including offsetting adjustments to managed care capitation rates due to decreased claims related to improved health outcomes for infants.This analysis assumes that these costs would be partially offset by an estimated $38,983 to the General Revenue Fund in fiscal year 2026 and an estimated $97,019 to the General Revenue Fund in fiscal year 2027 from client services payments through managed care that are assumed to result in an increase to the General Revenue Fund from insurance premium tax revenue and revenue adjusted for assumed timing of payments and prepayments, all of which results in increased revenue collections. Pursuant to Section 227.001(b), Insurance Code, 25 percent of the revenue collection is assumed to be deposited to the credit of the Foundation School Fund ($12,994 in fiscal year 2026 and $32,339 in fiscal year 2027).
Technology
The total technology cost is estimated to be $1,693,750 from All Funds in fiscal year 2026 and $39,467 from All Funds in fiscal year 2027.
Local Government Impact
No significant fiscal implication to units of local government is anticipated.
Source Agencies: b > td > 529 Health and Human Services Commission
529 Health and Human Services Commission
LBB Staff: b > td > JMc, NPe, ER, ESch, NV
JMc, NPe, ER, ESch, NV