Why Millions of Texans Are Losing Medicaid Coverage

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Two million Texans lost their Medicaid health insurance coverage in part due to state errors after federal funding to Texas ended after the COVID-19 pandemic, according to a recent article from ProPublica and The Texas Tribune.

Many who feel “wrongly removed” are struggling to regain their coverage.

“Texas’ zealousness in removing people from Medicaid was a choice that contradicted federal guidelines from the start,” according to the article. “That decision was devastating in Texas, which already insures a smaller percentage of its population through Medicaid than almost any other state and is one of 10 that never expanded eligibility after the passage of the Affordable Care Act.”

If you’re struggling with a Medicaid application in Texas, you can share your story in English and Spanish with ProPublica and The Texas Tribune.

Let’s dive deeper into the Medicaid issue in Texas.

Why is Medicaid Important?

During the COVID-19 pandemic, the number of people receiving Medicaid benefits grew to 6 million in Texas, a rise of about 50%.

Medicaid offers healthcare coverage to:

• Children
• Parents
• People who are pregnant
• Elderly people with certain incomes
• People with disabilities

Medicaid is a crucial coverage option for Latinos, who are less likely to obtain private health insurance from their employers (the most common source of health coverage in the US).

Racial/ethnic minorities make up about 60% of Medicaid enrollment.

Why Are People Losing Medicaid Coverage?

However, studies show that Latino and Black Americans are twice as likely than white Americans to lose Medicaid coverage due to process-related issues, according to a Salud America! resource.

This is apparent in Texas following the pandemic, according to the article from ProPublica and The Texas Tribune.

“Nearly 1.4 million of those who lost coverage were disenrolled for bureaucratic reasons like failing to return a form or completing one incorrectly, not because they weren’t eligible,” according to the article.

For Latinos and people of color, the loss of coverage adds to the other barriers that they face in getting healthcare, such as language and transportation to medical appointments.

The article shed light on a families impacted. For example, a boy a with a rare heart condition lost Medicaid coverage because his parents didn’t sign a form that even the family’s caseworker was unaware the family needed to complete.

Due to this, the boy’s parents couldn’t afford his $6,000 monthly pulmonary hypertension medication or pay for an ultrasound that would help determine whether he could survive without the drugs.

The Impact of Losing Medicaid Coverage

In April 2023, federal protections regarding coverage were lifted.

“In preparation, federal officials advised states not to review more than 11% of their caseloads each month, cautioning that moving more quickly could overwhelm their systems and lead to the wrongful removal of eligible people,” according to the article from ProPublica and The Texas Tribune.

Since this was only a recommendation, Texas began the reviewing process for about a million cases (17% of the case load).

The article also highlights that Texas’ median processing time for Medicaid applications is almost three months.

“[Texas] also decided against the more vigorous use of automatic renewals urged by the federal government, forcing nearly everyone to resubmit documents proving they qualified. Nearly 1.4 million of those who lost coverage were disenrolled for bureaucratic reasons like failing to return a form or completing one incorrectly, not because they weren’t eligible,” according to the article.

Not only have these changes impacted families, but also the clinics and healthcare workers that are providing care.

“Across the state, some safety net clinics reported a 30% decrease in Medicaid revenue due to the unwinding,” according to the article.

Similarly, some healthcare centers have laid off staff, along with other cuts.

“I’ve had centers that are unfortunately having to cut back certain services or extended hours, like behavioral health services, dental services, just because they can’t afford to continue to offer that care,” Jana Eubank, head the Texas Association of Community Health Centers told reporters.

Additionally, some families that have lost Medicare coverage are also waiting more than a month for food assistance due to Texas having the same eligibility system to process applications for both.

“San Antonio Food Bank CEO Eric Cooper said the nonprofit was crushed by demand this summer when families faced sudden medical bills, kids were out of school and the state had a backlog of more than 277,000 food stamp applications,” the article reports.

For a complete look at the Texas impact, access article in English or Spanish.

Sharing Your Medicaid Experiences

Have you or someone you know suffered medical and financial harm while waiting for their Medicaid application to be approved?

ProPublica and The Texas Tribune want to hear from you.

“We want to show any failures to the people who are responsible for overseeing these systems — lawmakers, advocates, even the federal government — and explain where the state may be falling short of its obligations,” according to ProPublica.

People are encouraged to fill out the form if they:

• Have been waiting more than a month to hear about your Medicaid or SNAP application and have faced medical or financial consequences.
• Have worked with the state and can help us understand the reasons behind the persistent backlog, including IT glitches, staffing issues and funding shortages related to Medicaid or SNAP.
• Help people apply for benefits, or you are a health care worker or other expert with insight on this issue.

Learn more about how you can share your experiences in English and Spanish.