The Texas Health and Human Services Commission, or HHSC, asked state lawmakers for additional funding to address a growing backlog of applications for the Supplemental Nutrition Assistance Program, or SNAP, and Medicaid.
As of late August, more than 210,000 Texans are waiting for their Medicaid application to be processed – and more than 150,000 are waiting for an eligibility worker to review their SNAP application. Last week, HHSC submitted its budget request to the state legislature asking for funding to make more than 640 temporary eligibility workers permanent employees.
Diana Forester, director of health policy at the advocacy organization Texans Care for Children, said the positions are set to expire at the end of the current fiscal year, meaning the state could lose hundreds of workers by August 2027.
"Without these workers, I don't see a way for them to be able to get through [the backlog] in any kind of meaningful way, which means people don't have insurance that they're eligible for," she said. "They don't have access to food through SNAP that they are eligible for. It just means that families are stuck waiting too long for healthcare and food."
HHSC did not respond to KERA's request for comment prior to publication.
In its legislative appropriations request submitted last Friday, the agency said there has been a significant increase in "eligibility actions" since 2017, and it needs more resources to meet state and federal timeliness standards.
The 642 temporary positions were approved for the past two state budget cycles to deal with the increased workload that followed the end of the COVID-19 public health emergency, when the state had to review more than four million enrollees within a year – known as the Medicaid unwinding.
HHSC said application volume has decreased since the end of the public health emergency, but the workload for eligibility workers hasn't returned to pre-public health emergency levels. The agency said there's been an increase of more than 16% in application volume across all programs.
Despite the increase, HHSC said in its request that staffing for eligibility has grown by only about 10% since 2019 – a result of the temporary workers provided by the state in 2023.
Forester said she's worried about what would happen if HHSC isn't able to convert those jobs into permanent positions.
"The thing about temporary positions is if you have people leave those positions and there's only a few months left, are you going to repost for them?" she said. "Then, are people going to apply for temporary jobs or are they going to be more tempted to do something that's permanent."
HHSC has been able to utilize temporary overtime to work through extreme backlogs, according to Forester, who worked at the agency for more than a decade before starting at Texans Care for Children.
"But that's not sustainable," she said. "You actually need people that are trained and know how to work these applications."
Forester said Texas' eligibility technology system is outdated – something the agency is already working to address.
"But in the short-term – the next like eight years – we have to work with what we have, which is these very manual heavy systems," Forester said. "The only way to really work through a backlog is just to have more workers."
HHSC prepares for higher SNAP costs in request
Texas has been preparing for significant changes to SNAP funding since the federal tax and spending bill was signed into law in 2025.
The bill lowered the federal government's contribution to cover the administrative costs of the program from 50% to just 25%. That makes Texas responsible for an additional $117 million annually, according to state officials.
Forester said state officials and lawmakers already knew HHSC was going to have to make this request.
"We'll be watching to see which source of funding the legislature uses to pay the state's share," Forester said. "Fortunately, the state revenue continues to come in really strongly and the state has a huge rainy-day fund. The legislature has different ways it can pay for this cost share. It's just a matter of which pool of money they're going to pull from."
Federal lawmakers also approved changes to the SNAP program that would make states responsible for covering a percentage of the benefits costs of the program based on payment error rates.
Texas could be responsible for covering more than $700 million in benefits costs if it doesn't improve the accuracy of its program. In order to avoid paying for part of the program, Texas would need an accuracy rate of 94%, but in fiscal year 2025, the state's rate was 91%.
HHSC said its SNAP payment accuracy hasn't met federal standards since 2019.
"Federal policy changes to shift SNAP benefit costs to states puts even more emphasis on the need for tenured staff and maintaining timely work," the agency said in its request.
Forester said there wasn't a placeholder for the potential cost associated with Texas' error rate.
"We don't know the final number year, but that was interesting that it's not a specific ask," she said. "HHSC has done a really good job in interim hearings articulating that this is going to be something the state has to pay and educating lawmakers about this – like showing them the potential, what we expect could be our payment error rate."
The additional cost wouldn't go into effect until next fiscal year, which Forester said means it needs to be considered as part of the budget lawmakers will be working on in 2027.
She said advocates are keeping a close eye on how the state chooses to address it.
"I just thought since it was a known expected cost, it might be articulated somewhere in there," Forester said. "But I don't think it's alarming yet."
Abigail Ruhman is KERA's health reporter. Got a tip? Email Abigail at aruhman@kera.org.
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