A pandemic-era rule that gave millions of Texans consistent access to health insurance is expiring at the end of this month.
Since COVID-19 hit the states in March of 2020, no U.S. citizen was taken off Medicaid. Now, for the first time in three years, Texas will begin removing those who no longer qualify for the program.
Medicaid enrollment in Texas has grown by nearly two million since the start of the pandemic. Many could be dropped from the program when this emergency order runs out.
Pat Souter, a professor of health care studies at Baylor University School of Law, said Medicaid functions as a safety net health insurance. The program often serves Texans living under the poverty line, those with disabilities, pregnant patients, children and the elderly.
“It really can cover just about any type of traditional health care,” he said. “It can cover, in certain instances, home care and hospice and even things such as vitamins and minerals supplements.”
Souter said upwards of two million people stand to lose Medicaid coverage with the rollbacks starting in April.
“They were looking at the review of who is qualified for Medicaid in stages and I think that the first group, or what they refer to as the first cohort, is probably those that have a high likelihood of losing their coverage. Those who were pregnant women may be able to transition to the Healthy Texas Women Program,” he said. “Those who aged out of Medicaid – there are certain Medicaid programs that are age-based – and also just adult recipients who no longer meet the eligible dependent child (might lose coverage too).”
This change could also have an impact on health care providers, especially in rural areas.
“Even before the pandemic, you go back the past five or ten years, we’ve seen a notable decline in the number of rural hospitals that have their doors open,” Souter said. “And many of these marketplaces that those rural hospitals serve have a heavy Medicare and Medicaid population. So any impact and that type of reimbursement stream to those types of facilities can have a negative impact on their ability to be financially viable and keep the doors open.”
Souter recommended people be proactive in reaching out to the state and asking about health care options before they get the notice about reapplying for Medicaid.
“Once you receive that renewal package, you have 30 days to submit your information to The Health and Human Services Commission, who operates Medicaid, for them to review it,” Souter said. “If you’re denied renewal because you didn’t provide enough information within that time, there is the ability to start a new application within 90 days of the last day of your eligibility.”
Souter also said that even if you fall outside traditional Medicaid eligibility, you might be able to access programs that grant partial coverage. And if not, healthcare.gov is open for people to apply for coverage.
“The federal government has opened up the healthcare.gov portal for those to be able to apply for commercial coverage, which is much more cost beneficial than if you go out and try to obtain your own coverage,” he said. “If that’s problematic, maybe you can’t afford it, there are other types of financial assistance that the Health and Human Services Commission has… If you’re proactive now, you can start lining up what your options are and then you will not fall within a time period where you don’t have coverage.”
More information about what to do if you are affected by this rollback can be found here.