AUSTIN, Texas — Half a million more Texans are uninsured today than were in March. That’s because pandemic-era coverage benefits, which said people couldn’t get kicked off Medicaid during the health emergency, ended in April.
“Most of those who lost coverage, these half-a-million folks, they're very likely mostly children,” said Stacey Pogue, a senior policy director with Every Texan.
She added that most people probably don’t even know they’re uninsured right now.
“I think what's going to happen in a lot of cases is we have low-income families with children who are going to do their back-to-school physicals, get their back-to-school vaccines, get their asthma inhalers from the pharmacy, and they're going to find out shortly that their kids don't have coverage,” Pogue said.
Data from the Texas Health and Human Services Commission (HHSC) shows that nearly 96,000 Texans were determined ineligible for Medicaid or CHIP. Almost 405,000 were removed for procedural reasons such as “failure to respond.” That means about 80% of the people who have been removed from the rolls could still be eligible for coverage. The HHSC data does not have demographic details for this group of people.
“We are just really emphasizing those procedural disenrollments, because we think that everyone should be determined 'ineligible' if they're going to lose coverage, and not just be kicked off because there's a lot of barriers to actually securing that coverage, especially because we know that lost in that number are very likely very, very many children,” said Adrienne Lloyd, a health policy manager with Children's Defense Fund–Texas.
Other barriers to getting coverage (or renewing it) include long hold times on the phone, trouble navigating the website and language difficulties.
Lloyd worries people are being removed too quickly and without enough care.
“We are disenrolling many, many eligible kids at the cost of more quickly disenrolling the few who are no longer going to be eligible. And when we talk about kids, most people who are no longer eligible are actually people who have aged out of Children's Medicaid,” Lloyd said. “We're spending a lot of money, and a lot of chaos and impact on those kids’ and families’ lives, and most of them, hopefully, are going to eventually be able to go back and re-enroll. That's going to be also a cost to the state. So why are we doing these costs to families, and costs and all this administrative churn, when in fact, we could be methodical, and take our time, and make sure we can keep folks who are eligible and move to other programs folks who are no longer [eligible] since 2020?”
HHSC says it sent mailed or electronic notices to Texans to renew their coverage. It warned, “you may lose coverage if you don’t return information needed for your renewal by the due date.” But experts say some people might not have even gotten mailers if they moved homes, and they could have been delivered in the wrong language.
HHSC Press Officer Tiffany Young wrote in an email to Spectrum News that “HHSC is staggering Medicaid redeterminations over multiple months, prioritizing redeterminations for those most likely to no longer qualify for Medicaid.”
Another group of Texans could lose coverage by September, unless the state steps in to delay the process.
“HHSC is leveraging all community partners to assist with outreach efforts, including collaborating with healthcare providers, community organizations, and advocacy groups to reach a wide range of individuals who may be affected by the changes,” Young wrote. “If Medicaid eligibility ends because the household did not return information, they have 90 days to respond and HHSC will process the information without requiring the household to submit a new application. Beyond 90 days, they will need to reapply.”
Because more Texans are expected to be kicked off Medicaid within the next few weeks, experts want the state to halt the process.
“We're asking the governor to hit pause on removing folks from Medicaid until Texas can ensure that eligible kids, seniors and individuals with disabilities aren't losing coverage,” Pogue said.
For those who have lost coverage, it can be devastating.
“Many say, ‘Well, we can afford maybe a regular pediatrician visit, you know, $60 or $100,'” said Graciela Camarena, a program director at Children’s Defense Fund–Texas. “But when it comes to medication, especially ongoing therapy, that could really bankrupt a family.”
Experts say eligible Texans who want to avoid being kicked off Medicaid should update their information now by visiting YourTexasBenefits.com.
As of 2021, Texas was the most uninsured state in the U.S.