An estimated 6.4 million people have been dis-enrolled from Medicaid nationwide since April, including more than 1.2 million children. This wave of coverage loss was triggered when the country’s pandemic-era pause on Medicaid redeterminations ended last spring, overwhelming state agencies and cutting people off from their health care.
So far, federal data suggest seven in 10 people have lost their Medicaid coverage for procedural reasons, such as missed deadlines, paperwork getting lost in the mail, or state agencies processing applications too slowly.
In those cases, state agencies claim they cannot verify whether a person still qualifies for Medicaid or if their income exceeds set limits and drops their coverage. But according to research, most people disenrolled from Medicaid for procedural reasons were still eligible.
Before Medicaid’s unwinding began, Texas already had the nation’s highest rate of uninsured people at 16.6 percent of its population, according to newly released 2022 data from the Census Bureau. During that same period, more than 6 million Texans received Medicaid.
Since April, Texas has shed roughly 900,000 people from its Medicaid rolls – more than any other state and at the highest rate nationwide. By August, roughly 95,000 of the state’s Medicaid recipients were found to have been erroneously disenrolled, including pregnant people and newborns. Children make up about 80 percent of Texans who have lost Medicaid coverage – more than anywhere else among states that have broken down disenrollment data by age. According to the state, Texas has to process millions more renewals by June.
About half of all U.S. children are covered by Medicaid or the Children’s Health Insurance Program (CHIP), and advocates say Medicaid’s unwinding has put many families in a precarious situation.
The problem of children losing their Medicaid coverage has gotten so bad nationwide that on Aug. 30, the Centers for Medicare and Medicaid Services issued a letter to all states and territories, saying they had until Sept. 13 to fix whatever systemic bugs are causing so many children and families to lose their Medicaid coverage, present preliminary findings and offer a timeline for when the state will finish assessing what’s wrong, or face consequences for being out of compliance.
In reports and statements by the Texas Health and Human Services Commission (HHSC), the state did not appear to acknowledge anything wrong with its process.
In an August dashboard report, the agency said that “procedural denials occur when HHSC does not have enough information to determine if the recipient is eligible for Medicaid coverage. In most cases, the recipient failed to return a renewal packet or provide requested information.”
Many families in Texas and elsewhere aren’t finding out they have lost their Medicaid coverage until they visit a provider for an appointment or until they try to fill a prescription or experience a medical emergency. This is leaving them exposed to being without coverage and vulnerable to medical costs they can’t afford to pay.
Guest:
Stacey Pogue is Every Texan Senior Health Analyst
"The Source" is a live call-in program airing Mondays through Thursdays from 12-1 p.m. Leave a message before the program at (210) 615-8982. During the live show, call 833-877-8255 or email thesource@tpr.org.
This interview will be recorded on Wednesday, September 27, 2023.
