Medicaid : coverage for nearly 1.7 Million Texans Is Now
Medicaid coverage for nearly 1.7 million Texans is about to expire as the state is “unwinding.”
The greatest number of individuals any state has eliminated from health insurance is approximately 1.7 million Texans.
This has happened in the months since the state started removing people from Medicaid as part of the post-pandemic “unwinding.” According to the state, procedural issues accounted for about 65% of these removals.
The process of removing people from state Medicaid insurance who became ineligible during the coronavirus pandemic is almost complete, but it has been a disorganized and burdensome process for Texas’ Health and Human Services Commission.
Prior to this year, the state had not disenrolled any individuals due to federal pandemic regulations that prohibit states from reducing coverage.
Medicaid Coverage for Skilled Nursing Facility
Because of Medicaid, the combined federal-state insurance program for the poor, more than 5 million Texans were able to obtain health care at all times during the pandemic.
The program’s eligibility requirements in Texas are so stringent that it primarily benefits low-income children, their mothers, and elderly and disabled adults.
However, speeding through this process had unintended consequences: still-eligible Texans were turned away for procedural as well as inadvertent reasons, adding to the backlog of hundreds of thousands of Medicaid applications and delaying wait times by several months.
The burden also caused backlogs in SNAP food benefits applications, which are handled by the same state agency, to soar.
United States Representative Lloyd Doggett, a Democrat from Austin, told the Texas Tribune, “The state handled this with an incredible amount of incompetence and indifference to poor people.” “It is truly disgusting.”
Recently, Doggett sent a letter to the U.S. Centers for Medicare and Medicaid Services criticizing their oversight of the state as “woefully inadequate,” continuing his repeated demands for changes to the process.
He said that during this time, he also made contact with the U.S. Department of Agriculture, which is in charge of the country’s Supplemental Nutrition Assistance Program, to discuss ways to improve the state’s access to food benefits.
He recommended delaying future SNAP renewals so Texas employees could prioritize clearing backlogs.
As of Thursday morning, he had received no response from either federal agency, he claimed.
A representative for the HHSC named Tiffany Young stated that as of December 8, there were 288,939 Medicaid applications and 207,465 SNAP applications pending processing.
“The backlog is not surprising to anyone who watched this. Prior to the unwinding, there were delays. After that, we worked incredibly hard on the system, completely front-loading it with work that wasn’t spaced evenly or realistically, according to Stacey Pogue, a senior policy analyst at Every Texan.
“The state is choosing to handle this through a massive, protracted backlog. It harms those who are in need, and that’s a decision,” she continued. “However, they had other options to relieve the system of workload without making people wait forever.”
Now that Texans must wait for their Medicaid application to be approved before applying for SNAP, their wait time has dropped to just over a month. According to Young, this is a shorter wait than the five months that were in effect at the start of December.
According to HHSC spokesperson Jennifer Ruffcorn, some previously submitted applications in the queue as of October 2023 had been there for up to four months.
According to a statement from Ruffcorn, “HHSC is moving 250 eligibility staff from other priority projects to focus on processing applications that request SNAP and another benefit.” In addition, HHSC plans to send 600 of its more recent hires to Medicaid training over the course of the next five months.
Even a month without food is a long time to those in need. Even before the holidays, food banks were feeling the pinch.
Earlier this fall, Celia Cole, CEO of the nonprofit Feeding Texas, said, “It’s just a difficult time, it’s sort of a perfect storm.” “There is a greater demand at food banks. It costs more to get food in and out of the door, and they are having difficulty doing so.
And for those without health insurance, there are still few options available to them. Frequently, they must choose between paying thousands of dollars in medical debt or going to federally qualified health centers, which are obligated to treat patients without regard to insurance.
“It’s heartbreaking to consider that kids aren’t getting the care they need because their Medicaid application is sitting in a state office,” stated Diana Forester, Texans Care for Children’s director of health policy, in a news release on Thursday.
The state has provided some rather dire solutions. Leaders at HHSC proposed that staff members take part in a “6 Days of Merry Service Challenge” in which they would work extra hours each day by either extending their hours or showing up on a Saturday, according to a happy-toned email that Doggett’s office was able to obtain.
Employees who put in more than 15 hours of overtime that week were eligible to enter a prize raffle, according to the email.
Regarding the email, Pogue remarked, “There are other options besides asking an overworked staff to put in more time. “That’s just the last solution on the list, out of all the ones to choose.”
Additionally, Texas has only occasionally used an automated eligibility checking system that pulls information from federally supplied work databases and previously submitted documents like pay stubs. According to state statistics, the automated system was only used for 6% of Medicaid renewals.
Advocates such as Pogue repeatedly called for a halt to allow HHSC staff to clear backlogs before moving more eligible applicants to the front of the line, but their requests went unanswered throughout the process.
After the majority of the state’s “cohorts” of attempts to renew coverage, one million people’s coverage has
renewed — supporters claim there is a chance for the state to make systemic changes.
Legislators in Texas can anticipate asking questions like, “What kind of system do we want? How challenging should the Medicaid renewal procedure be? How can we staff our system so that paperwork can be processed? stated Pogue.
Does Medicaid Cover Bills Before Coverage
The topic of how we’re going to handle unwinding has changed. “How are we going to manage the Medicaid program?” is the question.
To this report, Karen Brooks Harper contributed.
Through a collaboration between The New York Times, The Texas Tribune, and the National Center on Disability and Journalism, which is housed at Arizona State University’s Walter Cronkite School of Journalism and Mass Communication, Neelam Bohra is a 2023–24 New York Times disability reporting fellow.
Disclosure: The Texas Tribune is a nonprofit, nonpartisan news organization that receives funding from corporate sponsors, foundations, and members.
Every Texan, Feeding Texas, Texans Care for Children, and the New York Times have all contributed financially to the organization. Supporters of the Tribune’s finances have no bearing on its journalism. Here’s a comprehensive list of them.
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