From the Texas Tribune:
Half a million Texans have lost their Medicaid coverage since April, mostly for procedural reasons like not responding to messages from the state.
Preliminary data, released Friday by the state’s Health and Human Services Commission, paints a grim picture of Texas’ early efforts to redetermine Medicaid eligibility for the first time since COVID-19 hit three years ago.
Nowhere was this “unwinding” going to be easy. But Texas — with its high uninsured rates, strict rules to qualify for Medicaid and persistent delays in verifying eligibility — was on particularly poor footing to handle the sudden influx of renewals.
Now, hundreds of thousands of Texans are scrambling after suddenly losing health insurance — and the consistent care from trusted health care providers that it enabled them to access. Meanwhile, advocates say many of the people who lost coverage may actually still be eligible, and they’re calling for the state to pause redeterminations until they can ensure low-income children don’t fall through the newly apparent cracks in the renewal system.
“If the high percentage of procedural denials continues, then Texas is on the verge of knocking a lot of eligible kids off of their health insurance,” said Diana Forester, director of health policy at Texans Care for Children. “If state leaders can’t quickly pivot to a more effective process, then they should consider pausing the Medicaid removals until they can get this right.”
Unwinding after three years
Texas is one of just 11 states that has not expanded Medicaid eligibility under the Affordable Care Act, and the state has the highest rate of uninsured residents in the country. Before the pandemic, Medicaid in Texas mostly served children, disabled adults and pregnant women up to two months postpartum.
Once the pandemic hit in March 2020, federal regulations prohibited moving anyone off of the program. The extended coverage allowed about 3 million Texans to continue receiving Medicaid after they normally would have been removed from the program.
Federal funding legislation lifted those protections in April, kicking off a yearlong process for states to determine who should remain on Medicaid and move those who do not onto other state programs or into the public health insurance marketplace.
“Texas’ normal rules are the most restrictive in the United States,” said Anne Dunkelberg, senior fellow at Every Texan, a health care advocacy group. “We were carrying all of these desperately poor parents for the entire pandemic period, and we knew the lion’s share of them would not requalify.”
In the first month of this process, Texas reviewed the eligibility of almost 800,000 people. The state has not released demographic data, but said they are starting with people who likely no longer qualify for the program, like people who have aged out or those who no longer have an eligible child in their home.
Of those initial cases, about 111,000 people were determined to still qualify for Medicaid or the Children’s Health Insurance Program. About 95,000 people were found to no longer qualify.
But an additional 400,000 people were moved off of Medicaid for procedural reasons, meaning the state terminated their coverage without reviewing their eligibility. This includes people who didn’t submit the renewal packet the state sent through the mail or via YourTexasBenefits.com within 30 days.
