More than 2 million Texans have lost Medicaid coverage since continuous enrollment ended last April, according to the latest data from the Texas Health and Human Services Commission.
COVID-era protections through the public health emergency (PHE) meant people had continuous Medicaid coverage from 2020 to 2023. But the federal government ended this PHE provision on March 31, 2023, meaning every state had to redetermine whether people were still eligible for coverage.
“I think a lot of our fears came true through this process,” said Diana Forester, the director of health policy for Texans Care for Children.
About 65% of people disenrolled were children, the highest percentage in the country. Many of the people who lost coverage were disenrolled due to procedural reasons. Forester said she thinks about it as “you timed out.”
“Maybe you didn't get your notice in time, or you weren’t able to get your documents uploaded or submitted in time,” she said. “You timed out and then they just cut you off.”
She said it’s especially concerning because many people “encountered a barrier in trying to respond” and didn’t find out they had lost coverage until they were at an appointment with a pediatrician or a doctor.
Forester said she’s especially concerned with the number of kids who lost coverage, as Texas already has the highest rate of uninsured children in the United States.
A Texas School Readiness Dashboard from Texans Care for Children shows “nearly 200,000 Texas children under age 6 are uninsured,” and the state’s rate of uninsured children is a little over 10%, double the national average.
“Those kids are missing checkups, medications and mental health treatment,” Forester said. “We know those gaps in coverage are really detrimental to the overall health of kids. It keeps them from being able to go to school and be able to learn.”
She said the organization’s focus in the upcoming legislative session will be on reducing barriers for families to access health insurance they’re qualified for.
“How do we make our programs work better?” Forester said. “The ones that we have right now, let's make them work more efficiently.”
A new survey from KFF also highlighted people’s challenges with the unwinding process and the impact it had on health insurance retention. Nationally, a little over 20% of people disenrolled from Medicaid sometime in 2023 are still uninsured.
More than half of people who lost coverage “skipped or delayed needed health care when attempting to renew.”
“When you have a change in your health coverage like that, it really does add additional worry and concern about your health status,” said Lunna Lopes, a senior survey analyst for KFF.
People who were disenrolled from Medicaid said cost was the main reason why they could not access another kind of health insurance, and Lopes said even people with other forms of coverage were “finding it difficult to afford monthly premiums and out of pocket costs.”
Lopes said the survey findings showcase the complexity of the renewal process for some people, and the need for more support “for these programs that are really important for people's lives, especially when it comes to health insurance.”
Elena Rivera is KERA’s health reporter. Got a tip? Email Elena at erivera@kera.org
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