Monitoring the Session

HB 136

Medicaid pays separately for lactation consultation

Became law, effective Sep 1, 2025

Verdict: No flags

No flagsInitial review
Rep. Lacey HullRHouse 138

Initial review · graded Oct 20, 2026 · Headline, summary and grade are analysis of the bill text, not a finding about any person · How we grade

Caption

relating to Medicaid coverage and reimbursement for lactation consultation.

Caption from analyzed text · version I.

Summary

Certified lactation providers get their own provider type.

The bill requires Texas Medicaid to cover lactation consultation as its own separately paid pregnancy-related service when a certified lactation provider delivers it. It touches Medicaid recipients who are pregnant or postpartum, community health workers, certified doulas, and lactation consultants, who each get a separate provider type for enrollment and billing. On the ground, these providers can enroll and bill Medicaid directly for lactation help starting September 1, 2025, unless a federal waiver is needed first.

Labels

Labels: CROSS-PARTY HANDOFF. Lead author Lacey Hull (R) in the House. Lead sponsor Carol Alvarado (D) in the Senate. Party as the Legislative Reference Library lists it for the 89th Legislature.ACROSS THE AISLE. Joint authors: 4 Republicans, 1 Democrat. Party as the Legislative Reference Library lists it for the 89th Legislature.

Receipt

The receipt

89R-HB136 · 2025-03-11

SOLD BY

Rep. Lacey HullRHouse 138 Rep. Valoree SwansonRHouse 150 Rep. Toni RoseDHouse 110

+ 2 more authors, 5 coauthors

ITEM

relating to Medicaid coverage and reimbursement for lactation consultation.

WHAT IT DOES

Certified lactation providers get their own provider type.

The bill requires Texas Medicaid to cover lactation consultation as its own separately paid pregnancy-related service when a certified lactation provider delivers it. It touches Medicaid recipients who are pregnant or postpartum, community health workers, certified doulas, and lactation consultants, who each get a separate provider type for enrollment and billing. On the ground, these providers can enroll and bill Medicaid directly for lactation help starting September 1, 2025, unless a federal waiver is needed first.

CHARGES

[ ] NONE FOUND

TOTAL

Net to General Revenue · FY 2026($247,535)

LBB estimate, flow · fiscal note version E · ( ) = negative · source

Sources

Fiscal note · version E · April 28, 2025

Estimated Two-year Net Impact to General Revenue Related Funds for HB136, As Engrossed: a negative impact of ($1,995,065) through the biennium ending August 31, 2027.

First year · FY 2026 · ($247,535)

Probable Net Positive/(Negative) Impact to General Revenue Related Funds

LBB published estimates · flow over the stated periods.

Source snapshot 2026-10-19, Central time.

HISTORY

  1. Filed
  2. Read first time
  3. Referred to Human Services
  4. Scheduled for public hearing on . . .
  5. Considered in public hearing
  6. Testimony taken/registration(s) recorded in committee
  7. Left pending in committee
  8. Considered in public hearing
  9. Committee substitute considered in committee
  10. Reported favorably as substituted
  11. Comte report filed with Committee Coordinator
  12. Committee report distributed
  13. Committee report sent to Calendars
  14. Considered in Calendars
  15. Placed on General State Calendar
  16. Read 2nd time
  17. Passed to engrossment
  18. Record vote RV#325
  19. Statement(s) of vote recorded in Journal
  20. Read 3rd time
  21. Passed
  22. Record vote RV#380
  23. Reported engrossed
  24. Received from the House
  25. Read first time
  26. Referred to Health & Human Services
  27. Scheduled for public hearing on . . .
  28. Considered in public hearing
  29. Testimony taken in committee
  30. Left pending in committee
  31. Considered in public hearing
  32. Vote taken in committee
  33. Co-sponsor authorized
  34. Reported favorably w/o amendments
  35. Committee report printed and distributed
  36. Co-sponsor authorized
  37. Placed on intent calendar
  38. Rules suspended-Intent Calendar
  39. Rules suspended-Regular order of business
  40. Record vote
  41. Read 2nd time & passed to 3rd reading
  42. Record vote
  43. Three day rule suspended
  44. Record vote
  45. Read 3rd time
  46. Passed
  47. Record vote
  48. Senate passage reported
  49. Reported enrolled
  50. Signed in the House
  51. Signed in the Senate
  52. Sent to the Governor
  53. Signed by the Governor
  54. Effective on 9/1/25
FILED UNDER

No verified beat found.

SIGNED FOR BY

House · 130 yea · 16 nay

Senate · 28 yea · 3 nay

Sources

House: Final passage · Apr 23, 2025. Journal. Published stock for this vote. Snapshot 2026-10-19, Central time.

Senate: Final passage · May 8, 2025. Journal. Published stock for this vote. Snapshot 2026-10-19, Central time.

All floor motions and other positions below.

No flags

THANK YOU FOR CHECKING THE RECEIPT

CAMPAIGN PAID FOR BY

CAMPAIGN PAID FOR BY

Lacey Hull

Donors

Texans for Lawsuit Reform PAC$595KTexas Conservative Majority PAC$483KTexas Sands PAC$245K

Not tied to this bill.

Sources

The author's campaign account only. Own money and internal transfers are separate on the member page.

Derived itemized flow · Oct 28, 2024 to Oct 24, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Texans for Lawsuit Reform PAC$595,376.10

Texans for Lawsuit Reform PAC

$595,376.10

Cash
$80,000.00
Paid by others
$515,376.10
Total
$595,376.10
mail $216,305.25advertising $185,974.50Other filed descriptions $66,286.00polling $46,810.35

Also funds 124 other sitting lawmakers.

Derived recipient stock · Jul 10, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Jun 30, 2025 to Oct 23, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101010359, 101033114, 101035066, 101040912, 101044098, 101069436, 101072848.

Texas Conservative Majority PAC$483,456.00

Texas Conservative Majority PAC

$483,456.00

Cash
$150,000.00
Paid by others
$333,456.00
Total
$483,456.00
canvassing $316,956.00polling $16,500.00

Also funds 42 other sitting lawmakers.

Derived recipient stock · Jan 23, 2026 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Feb 13, 2026 to Oct 23, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101040912, 101069436, 101072848.

Texas Sands PAC$244,600.00

Texas Sands PAC

$244,600.00

Cash
$234,000.00
Paid by others
$10,600.00
Total
$244,600.00
polling $10,600.00

Also funds 121 other sitting lawmakers.

Derived recipient stock · Jul 3, 2024 to Oct 24, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Jan 14, 2026 to Sep 25, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101035066, 101040912, 101072848.

Money

Missing data does not establish zero giving. Display amounts are rounded.

×

Texans for Lawsuit Reform PAC

$595,376.10

Cash
$80,000.00
Paid by others
$515,376.10
Total
$595,376.10
mail $216,305.25advertising $185,974.50Other filed descriptions $66,286.00polling $46,810.35

Also funds 124 other sitting lawmakers.

Derived recipient stock · Jul 10, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Jun 30, 2025 to Oct 23, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101010359, 101033114, 101035066, 101040912, 101044098, 101069436, 101072848.

×

Texas Conservative Majority PAC

$483,456.00

Cash
$150,000.00
Paid by others
$333,456.00
Total
$483,456.00
canvassing $316,956.00polling $16,500.00

Also funds 42 other sitting lawmakers.

Derived recipient stock · Jan 23, 2026 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Feb 13, 2026 to Oct 23, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101040912, 101069436, 101072848.

×

Texas Sands PAC

$244,600.00

Cash
$234,000.00
Paid by others
$10,600.00
Total
$244,600.00
polling $10,600.00

Also funds 121 other sitting lawmakers.

Derived recipient stock · Jul 3, 2024 to Oct 24, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Jan 14, 2026 to Sep 25, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101035066, 101040912, 101072848.

Votes6

Senate May 8, 2025

Yea
28
Nay
3
Present, not voting
Not printed
Absent
0
Excused
0
Names

Named positions matched to lawmakers. See the journal for unmatched names.

Senate journal

Sources

The bill was read third time and was passed by the following vote: Yeas 28, Nays 3. (Same as previous roll call)

Published stock of positions for this vote, except where marked derived.

  • Yea: 28 (published)
  • Nay: 3 (published)
  • Present, not voting: Not printed
  • Absent: 0 (derived from named list)
  • Excused: 0 (derived from named list)

Senate journal. Source snapshot 2026-10-19, Central time.

Senate May 8, 2025

Yea
28
Nay
3
Present, not voting
Not printed
Absent
0
Excused
0
Names

Named positions matched to lawmakers. See the journal for unmatched names.

Senate journal

Sources

Senator Alvarado moved that Senate Rule 7.18 and the Constitutional Rule requiring bills to be read on three several days be suspended and that HB 136 be placed on its third reading and final passage. The motion prevailed by the following vote: Yeas 28, Nays 3.

Published stock of positions for this vote, except where marked derived.

  • Yea: 28 (published)
  • Nay: 3 (published)
  • Present, not voting: Not printed
  • Absent: 0 (derived from named list)
  • Excused: 0 (derived from named list)

Senate journal. Source snapshot 2026-10-19, Central time.

Senate May 8, 2025

Yea
28
Nay
3
Present, not voting
Not printed
Absent
0
Excused
0
Names

Named positions matched to lawmakers. See the journal for unmatched names.

Senate journal

Sources

The bill was read second time and was passed to third reading by the following vote: Yeas 28, Nays 3. (Same as previous roll call)

Published stock of positions for this vote, except where marked derived.

  • Yea: 28 (published)
  • Nay: 3 (published)
  • Present, not voting: Not printed
  • Absent: 0 (derived from named list)
  • Excused: 0 (derived from named list)

Senate journal. Source snapshot 2026-10-19, Central time.

Senate May 8, 2025

Yea
28
Nay
3
Present, not voting
Not printed
Absent
0
Excused
0
Names

Named positions matched to lawmakers. See the journal for unmatched names.

Senate journal

Sources

Senator Alvarado moved to suspend the regular order of business and Senate Rule 5.14 to take up for consideration HB 136 at this time on its second reading: HB 136, Relating to Medicaid coverage and reimbursement for lactation consultation services. The motion prevailed by the following vote: Yeas 28, Nays 3.

Published stock of positions for this vote, except where marked derived.

  • Yea: 28 (published)
  • Nay: 3 (published)
  • Present, not voting: Not printed
  • Absent: 0 (derived from named list)
  • Excused: 0 (derived from named list)

Senate journal. Source snapshot 2026-10-19, Central time.

House Apr 23, 2025

Yea
130
Nay
16
Present, not voting
3
Absent
1
Excused
0
Names

Named positions matched to lawmakers. See the journal for unmatched names.

House journal

Sources

Record 380

HB 136 was passed by (Record 380): 130 Yeas, 16 Nays, 3 Present, not voting.

Published stock of positions for this vote, except where marked derived.

  • Yea: 130 (published)
  • Nay: 16 (published)
  • Present, not voting: 3 (published)
  • Absent: 1 (derived from named list)
  • Excused: 0 (derived from named list)

House journal. Source snapshot 2026-10-19, Central time.

House Apr 22, 2025

Yea
133
Nay
13
Present, not voting
1
Absent
2
Excused
1
Names

Named positions matched to lawmakers. See the journal for unmatched names.

House journal

Sources

Record 325

CSHB 136 was passed to engrossment by (Record 325): 133 Yeas, 13 Nays, 1 Present, not voting.

Published stock of positions for this vote, except where marked derived.

  • Yea: 133 (published)
  • Nay: 13 (published)
  • Present, not voting: 1 (published)
  • Absent: 2 (derived from named list)
  • Excused: 1 (derived from named list)

House journal. Source snapshot 2026-10-19, Central time.

Witnesses63
For
59
Against
0
On
4
Names

For

  • American College of Obstetricians and Gynecologists1 registration
  • Baptist General Convention of Texas Christian Life Commission1 registration
  • Central Health1 registration
  • DHR Health1 registration
  • El Paso Health1 registration
  • Episcopal Health Foundation2 registrations
  • Every Body Texas1 registration
  • Harris County Commissioners Court1 registration
  • Methodist Healthcare Ministries2 registrations
  • Partnership for a Healthy Texas1 registration
  • Self3 registrations
  • Self; Breastfeeding Success3 registrations
  • Self; Children at Risk1 registration
  • Self; Dallas Lactation Consultant Association, National Lactation Conultant Alliance Ally1 registration
  • Self; Fort Bend Anti- Trafficking Collective1 registration
  • Self; Legacy Community Health1 registration
  • Self; Maternal by Sentido Health1 registration
  • Self; Texas Academy of Nutrition & Dietetics1 registration
  • Self; Texas Doula Association, GALS Austin1 registration
  • Sentido health1 registration
  • Superior Health Plan1 registration
  • Teaching Hospitals of Texas2 registrations
  • Texans Care for Children2 registrations
  • Texas Academy of Family Physicians2 registrations
  • Texas Association of Community Health Centers2 registrations
  • Texas Association of Community Health Plans1 registration
  • Texas Association of Health Plans2 registrations
  • Texas Coalition For Patients1 registration
  • Texas Council on Family Violence2 registrations
  • Texas Health Resources (THR)2 registrations
  • Texas Hospital Association2 registrations
  • Texas Impact1 registration
  • Texas Medical Association2 registrations
  • Texas Pediatric Society2 registrations
  • Texas Women’s Healthcare Coalition2 registrations
  • The National Association of Social Workers Texas Chapter1 registration
  • Travis County Commissioners Court2 registrations
  • United Ways of Texas2 registrations
  • University Health1 registration
  • University Medical Center of El Paso; El Paso Health1 registration

On

  • Health and Human Services Commission1 registration
  • Health and Human Services Commission (HHSC)2 registrations
  • Self; Lactation Services of Waco and Community Doulas of Waco1 registration
Sources

63 parsed registrations across the loaded witness lists.

Derived stock of witness registrations. Repeated appearances count separately. Organizations and self-representation appear as printed.

House witness list. Source snapshot 2026-10-20, Central time.

Senate witness list. Source snapshot 2026-10-20, Central time.

Fiscal
Net to General Revenue · FY 2026($247,535)

LBB estimate, flow · fiscal note version E · ( ) = negative · source

Sources

Fiscal note · version E · April 28, 2025

Estimated Two-year Net Impact to General Revenue Related Funds for HB136, As Engrossed: a negative impact of ($1,995,065) through the biennium ending August 31, 2027.

First year · FY 2026 · ($247,535)

Probable Net Positive/(Negative) Impact to General Revenue Related Funds

LBB published estimates · flow over the stated periods.

Source snapshot 2026-10-19, Central time.

How this was graded

Analysis of text version I by claude-opus-5-5, Oct 20, 2026, against the published rubric.

Sources

Texas House · Filed Mar 11, 2025

05/24/2025 E Effective on 9/1/25

Texas Legislature Online · Introduced · House Committee Report · Engrossed · Senate Committee Report · Enrolled

Data snapshot Oct 26, 2026 at 4:20 AM CDT. Grades, charges, quotes and corrections follow the published record.

Coauthors
Aicha DavisDHouse 109 Lulu FloresDHouse 51 Jolanda "Jo" JonesDHouse 147 Mihaela PlesaDHouse 70 Joanne ShofnerRHouse 11
Sponsors
Carol AlvaradoDSenate 6
Cosponsors
César BlancoDSenate 29 Sarah EckhardtDSenate 14 Royce WestDSenate 23 Judith ZaffiriniDSenate 21

House committee · Human Services · Committee vote 11 aye, 0 nay · Out of committee

Senate committee · Health & Human Services · Committee vote 7 aye, 2 nay · Out of committee

Subjects

Human Services--Medical Assistance

Insurance--Life, Health & Accident

LACTATION CONSULTANTS

MEDICAID

HEALTH & HUMAN SERVICES COMMISSION

Text

The text as introduced · 305 words

By: Hull
H.B. No. 136

A BILL TO BE ENTITLED

AN ACT

relating to Medicaid coverage and reimbursement for lactation

consultation.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Section 32.024, Human Resources Code, is

amended by amending Subsections (pp) and (qq) and by adding

Subsection (rr) to read as follows:

(pp) For purposes of enrollment as a provider and

reimbursement under the medical assistance program, the commission

shall establish a separate provider type for a community health

worker who provides lactation consultation services, or case

management services under the case management for children and

pregnant women program under Section 531.653(4), Government Code.

(qq) For purposes of enrollment as a provider and

reimbursement under the medical assistance program, the commission

shall establish a separate provider type for a doula who:

(1) is certified by a recognized national doula

certification program approved by the commission; and

(2) provides lactation consultation services, or case

management services under the case management for children and

pregnant women program under Section 531.653(5), Government Code.

(rr) The commission shall provide medical assistance

coverage of lactation consultation as a separately reimbursed

pregnancy related service when delivered to a recipient under the

medical assistance program by an eligible provider who has a

certification in lactation consultation. The executive

commissioner shall establish a separate provider type for lactation

consultant providers for purposes of enrollment as a provider for

and reimbursement under the medical assistance program.

SECTION 2. If before implementing any provision of this Act

a state agency determines that a waiver or authorization from a

federal agency is necessary for implementation of that provision,

the agency affected by the provision shall request the waiver or

authorization and may delay implementing that provision until the

waiver or authorization is granted.

SECTION 3. This Act takes effect September 1, 2025.