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Healthy Texas Women Medicaid 1115 Demonstration Waiver Effective March 20, 2021

Last updated on 3/23/2021

On January 22, 2020, the Centers for Medicare and Medicaid Services approved the Healthy Texas Women (HTW) Medicaid 1115 Demonstration Waiver for a five-year period ending December 31, 2024, which allows the Health and Human Services Commission to utilize federal funding for the HTW program for women who are 18 through 44 years of age.

HTW eligibility policy is now aligned with the requirements of Modified Adjusted Gross Income (MAGI) Medicaid programs. Although the waiver only provides federal Medicaid funding for adult HTW recipients, the eligibility changes apply to the entire program.

Services for HTW minors (people who are 15 through 17 years of age) are still covered with state general revenue funds, and minors must have a parent or legal guardian apply for HTW on their behalf.

HTW Eligibility Changes

The following changes to the HTW program are effective March 20, 2021.

  • HTW will use the same rules to determine household composition, countable income, and deductions as the rules used for Medicaid for Pregnant Women, Medicaid for Parents and Caretaker Relatives, Children’s Medicaid, and the Children’s Health Insurance Program (CHIP).
    • Household composition is based on the woman’s tax filing status and her tax relationships.
    • Only taxable income is counted and women can only claim MAGI allowable deductions.
       
  • HHSC will determine financial eligibility for all HTW applicants.
    • Women eligible for Women, Infants, and Children (WIC), Supplemental Nutrition Assistance Program (SNAP) or who have a child eligible for Medicaid will no longer be automatically financially eligible for HTW (adjunctive eligibility).
       
  • The HTW Federal Poverty Level (FPL) threshold is increased to 204.2% FPL to account for the loss of previously allowed deductions, changes in household composition, and countable income.
     
  • HTW is now considered a Medicaid program with limited services, and women will be determined ineligible for full Medicaid and CHIP coverage before being determined eligible for HTW.
    • Women can apply for HTW using YourTexasBenefits.com, by filling out and submitting Form H1010, Texas Works Application for Assistance - Your Texas Benefits, or Form H1205, Texas Streamlined Application for Medical Assistance. Note: The HTW Application (Form H1867) will be retired.
    • Women will be automatically tested for HTW eligibility without requiring a separate application when their eligibility for other Medicaid programs or CHIP ends. Women must be determined eligible before they are enrolled.

For more information, call the TMHP Contact Center at 800-925-9126.