Texas children still in peril when it comes to getting healthcare

Texas’ recent “unwinding” of Medicaid enrollment after three years of automatically renewing individuals’ coverage during the pandemic has widened the cracks in the system into a chasm.

As a result, the state’s children have become especially vulnerable to losing health coverage.

About 600,000 Medicaid recipients under 65 in Texas have been unenrolled from the program since June, and 81% percent of those are children, according to state-by-state data tracking reported at the end of August by KFF, an independent health policy research group.

Texas’ culling of the Medicaid rolls started in June in an effort to drop people who became ineligible for Medicaid during the pandemic’s automatic renewal period.

It’s unclear how many of those hundreds of thousands of kids dropped from the rolls actually should be eligible for Medicaid. Critics say Texas’ data, some of which is compiled by outside parties, is riddled with errors.

Nonprofit children’s policy group Texans Care for Children questions the validity of Texas’ system for determining who to drop from rolls. It also questions the state’s effectiveness at turning its data into proper renewals instead of just booting people from their coverage.

“We’re deeply concerned that Texas kids who are still eligible for health insurance — either through Medicaid or another program — are losing their health coverage for bureaucratic reasons and are going to get turned away the next time they walk into a doctor’s appointment,” Diana Forester, Texans Care for Children’s health policy director, said in a statement.

Theoretically, if a child in Texas doesn’t meet Medicaid’s household income guidelines, they could be eligible for the broader Children’s Health Insurance Program (CHIP). But, in reality, parents have been left scrambling to renew or find alternatives in a hard-to-navigate system.

KFF reports that the number of non-renewals in Texas could be far greater as a percentage of the total Medicaid rolls than other states. While other states staggered their decisions to drop individuals from the rolls based on their renewal dates, Texas targeted the people officials thought were most likely to be ineligible.

In a statement released in April as the state prepared to dump people from the Medicaid rolls, the Texas Health and Human Services Commission said it was adding staff, including temporary workers, and “leveraging all community partners to assist with outreach efforts.”

It’s still an open question as to whether Texas’ outreach was sufficient. And the implications are huge.

The U.S. Centers for Medicare and Medicaid Services report that as of May, 5.66 million Texas children were enrolled in Medicaid and 302,110 in CHIP.

In 2019, the year before pandemic protocols froze the need to reenroll in Medicaid, Texas had nearly 1 million uninsured children. By 2021 the number of uninsured had shrunk by 65,000 to 930,000, according to an analysis of state data by the Georgetown University Center for Children & Families.

Even before Texas began jettisoning people from the Medicaid rolls in recent months, Texas had the nation’s highest rate of uninsured children: 11.8%.

“State leaders must make sure that kids and moms who are still eligible for health insurance will be able to stay enrolled so they can go to their doctor’s appointments, keep taking their medications and stay healthy,” Texans Care for Children’s Forester said.

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This article appears in Sep 6-19, 2023.