San Antonio U.S. Rep. Joaquin Castro and 10 other U.S. House Democrats from Texas want the federal government to investigate why more than 200,000 residents are still waiting for the state to process their Medicaid applications.
In letters sent Tuesday to U.S. Health and Human Services Secretary Robert F. Kennedy Jr. and Texas Health and Human Services Commissioner Stephanie Muth, the lawmakers called for a federal investigation into the backlog, including a review of the contractors the state uses to process applications. They urged federal intervention if the backlog isn’t cleared.
In July, Texas processed 65% of Medicaid applications on time, compared to 81% a year earlier, according to state data. That’s far short of the 95% federal requirement.
Some advocates point to the One Big Beautiful Bill Act, the 2025 federal law that introduced new Medicaid eligibility requirements, including more frequent eligibility checks and work requirements for certain recipients.
Critics argue the new requirements will place additional strain on an already overburdened system. Most of the program’s more than 3.7 million enrollees are pregnant women, children, seniors and Texans with disabilities.
“We are in a cost-of-living crisis and Republicans in Washington and Texas don’t seem to care,” Castro said in an emailed statement. “Texas’ staggering backlog in Medicaid and SNAP applications threatens to push more families into poverty. We must work to reverse the backlog, restore funding and help families in need see their doctor and put food on the table.”
Vanessa Melendez, a Houston mother pregnant with her third child, applied for Medicaid for Pregnant Women last December but didn’t receive an update until she was more than four months pregnant, the Texas Tribune reported in September. By then, she was past the first 13 weeks, when doctors typically confirm a pregnancy and run early tests.
“I’m going to have this baby, and I have no insurance,” Melendez told the Tribune. She delivered her son in July.
State Sen. Lois Kolkhorst, who chairs the Texas Senate’s health committee, said the Texas Health and Human Services Commission was taking appropriate steps to root out and prevent fraud.
“As new tools are put into practice, we will naturally begin processing these applications more efficiently and address backlogs in the program,” Kolkhorst told the Tribune in September.
Delays in application processing aren’t new for Texas.
The Texas Health and Human Services Commission has a record of missing federal deadlines of 30 to 45 days for deciding Medicaid applications, according to a September Legislative Budget Board report.
Federal regulators placed the state on corrective action plans to speed up the processing of Medicaid and SNAP applications. By late 2025, Texas was catching up, according to the Tribune. Then the new federal rules took effect, and the backlog began growing again.
Medicaid enrollment fell by 252,000, a 6% decline, in the 11 months after the law passed, according to preliminary state data reported by the Tribune. SNAP enrollment also declined by 597,000, or 17%. Children accounted for almost two-thirds of the enrollment declines.
The lawmakers asked HHS and HHSC to respond by Nov. 30. And more pressure is coming: starting in 2027, Texas could be required to pay about $700 million annually toward SNAP benefits if it doesn’t reduce its payment error rate, state officials told lawmakers in April, according to the Tribune.
A new eligibility system is in the works, but it will take years to complete.
“Nearly two years after Donald Trump promised to lower costs on day one, working families are draining their savings and taking on debt just to see a doctor or put food on the table,” said U.S. Rep. Greg Casar, a Democrat representing San Antonio and Austin, in a statement. “Now Texans are stuck in a dangerous backlog of SNAP and Medicaid applications. Donald Trump and Greg Abbott must clear it now, before more families go without care or go hungry.”
