Healthy Texas Women 1115 Waiver

Texas Health and Human Services (HHS) announces its intent to submit an application to the Centers for Medicare & Medicaid Services (CMS) to request a new waiver under Section 1115 of the Social Security Act for the Healthy Texas Women Section 1115 Demonstration Waiver (HTW demonstration). The proposed effective date is Sept. 1, 2018, for a 5-year period ending Aug. 31, 2023.

HHS launched the Healthy Texas Women (HTW) program on July 1, 2016. The program provides women's health and family planning services at no cost to eligible, low-income Texas women. HHS is requesting a new Section 1115 demonstration waiver for the HTW program.

About the Demonstration

Through the HTW demonstration, HHS seeks to enhance women's health care services by increasing access to and participation in the HTW program. HTW demonstration services will be made available statewide to eligible women.

The goals and objectives of the HTW demonstration are to:

  • Increase access to women's health and family planning services to avert unintended pregnancies, positively affect the outcome of future pregnancies, and positively impact the health and well-being of women and their families.
  • Increase access to preventive health care, including screening and treatment for hypertension, diabetes and high cholesterol; to positively impact maternal health; and reduce maternal mortality.
  • Increase access to women's breast and cervical cancer services to promote early cancer detection.
  • Implement the state policy to favor childbirth and family planning services that do not include elective abortions or the promotion of elective abortions within the continuum of care or services and to avoid the direct or indirect use of state funds to promote or support elective abortions.
  • Reduce the overall cost of publicly funded health care (including federally funded health care) by providing low-income Texans access to safe, effective services consistent with these goals.

This waiver will not change the Healthy Texas Women client or provider experience. A beneficiary within the current HTW program will not experience a gap in coverage and will be able to receive the same benefits previously provided under the HTW program. HTW providers will continue to bill the Texas Medicaid & Healthcare Partnership (TMHP) for HTW covered services and will continue to be reimbursed for HTW covered services provided to HTW demonstration clients on a fee-for-service basis.

Federal Review and Comment Period

On July 5, 2017, CMS notified HHS it has completed its preliminary review and determined the Healthy Texas Women Section 1115 Demonstration Waiver application to be complete, thus beginning the 30-day federal public comment period.

Click below to view the application documents on the CMS website and to submit comments.

Waiver Application Submission

On June 30, 2017, Texas submitted the Healthy Texas Women Section 1115 Demonstration Waiver application to CMS. You may download the submitted cover letter and waiver application by clicking below. The final waiver application submitted to CMS includes a summary of and response to comments received during the public comment period.

Public Notice of Intent

HHS published a public notice of its intent to submit a waiver application in the Texas Register on Friday, May 12, 2017. A more detailed public notice is available for download below.

Draft Waiver Application

You may download the draft waiver application by clicking below.

To obtain free copies of the waiver application or receive other information about the application, mail:

Texas Health and Human Services Commission
P.O. Box 13247
Mail Code H-600
Austin, Texas 78711-3247

Call: 512-424-6969

Fax: 512-487-3403


Public Forums

HHS hosted a series of meetings to provide information about the waiver application as well as to allow an opportunity for the public to provide comments. The meetings were held on the following dates and times:

Public Comment

The public was invited to submit comments on the Healthy Texas Women Section 1115 Demonstration Waiver application for a period of 30 days, beginning Friday, May 12, 2017. The public comment period ended on Monday, June 12, 2017.

Submit comments by mail:

Texas Health and Human Services Commission
P.O. Box 13247
Mail Code H-600
Austin, Texas 78711-3247

Fax: 512-487-3403


Next Steps

HHS will maintain this webpage and update it as necessary throughout the public comment and review process.

Within 15 days after Texas submits the waiver application to CMS, the federal government will hold an additional 30-day public comment period. HHS will update this webpage with a direct link to submit comments to CMS when the federal comment period begins.

You can learn more about Section 1115 demonstration waivers at the CMS website: – Section 1115 Demonstrations.

Learn about Texas' other Section 1115 demonstration waiver that allows the state to expand Medicaid managed care while preserving hospital funding, provides incentive payments for health care improvements, and directs more funding to hospitals that serve large numbers of uninsured patients: Texas 1115 Healthcare Transformation waiver.