Since Texas began checking people’s eligibility for Medicaid after pandemic-era protections ended earlier this year, more than 1.4 million people statewide have lost health care coverage. Almost 60% of people who lost coverage during the Medicaid unwinding period are kids. That’s close to 729,000 children—more than the entire population of El Paso.
Health policy advocates are concerned the rate of uninsured kids is only going to grow as the state continues the Medicaid redetermination process through next summer.
“We’re back to business as usual in Texas, and Texas has become ground zero for children losing health coverage during unwinding,” said Stacey Pogue, senior policy analyst for Every Texan.
A new report from Georgetown University’s McCourt School of Public Policy shows the impact that continued coverage had for kids during the pandemic.
From 2019 to 2022, the number of uninsured kids nationally decreased from about 4.4 million kids in 2019 to 3.9 million in 2022. Texas also saw a decline: about 854,000 were uninsured in 2022, down from nearly a million in 2019.
“This report has such a hopeful message for Texas,” Pogue said. “We don’t have to have kids turning on and off coverage all the time with gaps in care.”
Six regions in Texas are in the top 10 metro areas with the highest uninsured rates for kids, according to the report. Sherman-Denison, which is a part of the larger DFW metroplex, had the third-highest rate at 13.9% in 2022. The national rate was 5.1%.
Texas overall has the highest uninsured rate for children – 10.9%, more than double the national rate. The Georgetown University report found lower-income American Indian/Alaska Native and Hispanic/Latino children were more likely to be uninsured than other groups.
“In Texas, our state leaders sadly have not prioritized health insurance coverage for kids,” Pogue said. “We see it in these reports year after year. Texas always shows up at the bottom, or darn close to it.”
Texas is one of 10 states that has yet to expand Medicaid, with some of the strictest income requirements in the nation. That means most adults who lose coverage won’t have other health insurance options. Multiple research studies show if a parent is uninsured, there’s a higher likelihood their kids will be uninsured, even if their kids are eligible.
“These bad outcomes for Texas kids all flow from the plain fact that Texas makes it far harder than it needs to be for parents to keep their eligible kids in Medicaid,” said Pogue.
In one study from Oregon Health and Science University, “children eligible for public insurance who had uninsured parents were fourteen times more likely to be uninsured, compared to their counterparts with insured parents.”
Both adults and kids without insurance have worse health outcomes. Older adults with cardiovascular disease and diabetes got sicker, and kids without insurance were more likely to be hospitalized and not receive medical treatment for chronic illnesses like asthma or diabetes.
Valerie Smith, a pediatrician in Tyler and a member of the Texas Pediatric Society executive board, said she’s seen the impact of health insurance coverage with her own patients.
“For so many of my patients, Medicaid has been a lifeline that’s allowed them to stay healthy and safe,” she said. “At its core, Medicaid is a children’s program.”
She urges lawmakers to pass legislation that will help Texas kids access doctor’s appointments and manage chronic conditions.
“All of society benefits when children and families are thriving and able to get their routine preventive and urgent care needs addressed,” Smith said. “Families deserve peace of mind that they’ll be able to access the care they need.”
Got a tip? Email Elena Rivera at erivera@kera.org
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