One-third of Texans who signed up for Medicaid last March have since lost coverage after a pandemic-era expansion of the federal health insurance program ended.
More than 2 million Texans have been stripped of Medicaid over the past 13 months, and an additional 2.1 million Medicaid recipients have had their coverage renewed, according to the latest report. KFF data. In Texas, approximately 6 million people were enrolled in Medicaid and the Children’s Health Insurance Plan as of March 31, 2023.
As of March 11, the Texas Health and Human Services Commission still had about 300,000 redeterminations to initiate, meaning that number could increase in the coming months. Once the state requests the information, the recipient must return her renewal packet within 30 days.
The Texas Health and Human Services Commission said the numbers are in line with projections before the mitigation. The state has until May 31 to complete the redetermination.
“We expect enrollment numbers to continue to fluctuate as we complete the redetermination process, complete pending applications, and evaluate the impact of the 12-month postpartum coverage extension,” HHSC spokeswoman Jennifer Ruffkorn said in a statement. “I am doing so,” he said. “We will continue to process applications as quickly as possible to serve all eligible Texans.”
More than 65% of Texans who lost insurance had their coverage terminated for procedural reasons, such as not returning renewal packet requests. Texas falls somewhere in the middle of states based on procedural termination. Of the people whose registrations were canceled in Nevada and Utah, 92% in each state were due to procedural reasons.
As part of Medicaid eligibility redetermination, states first attempt to renew beneficiaries through what is known as a “unilateral” process or use existing data sources, such as state wage databases, to access continued eligibility. need to do it. According to the report, only 10% of Texans who had Medicaid insurance as of May 1 were renewed through the unilateral process. KFF data.
That number is higher than researchers estimated before the country began relaxing Medicaid policies introduced during the coronavirus pandemic. According to one study, Texas is one of only eight states with more people expected to lose their health insurance. New report by Urban Research Institute.
The total number of dropouts from Texas’ Medicaid and Children’s Health Insurance Programs from April to November 2023 accounted for 117% of the more than 1.2 million dropouts predicted by the Urban Institute. Based on this prediction, the socio-economic policy think tank 2022 surveyregarding pre-pandemic enrollment trends.
Disenrollment among children was 178% of initial predictions, but disenrollment among nonelderly adults was lower than expected, at only 74% of predictions.
Texas already has the highest uninsured rate of any state in the nation and routinely rejects federal proposals to expand Medicaid. Vivian Ho, a professor of health services research at Baylor College of Medicine in Houston, said access to insurance, especially for children, can impact a person’s long-term health and success.
“This impacts the long-term development and learning ability of these children,” said Ho, who was not connected to the Urban Institute report. “If you have asthma and can’t get treatment because you don’t have health insurance, you’ll miss more days of school and you won’t be able to get treatment.”
Disenrollment rates tend to correlate with how states have addressed continued coverage expansion, said Matthew Buttgens, a senior fellow at the Urban Institute Health Policy Center and a co-author of the report. said.
States that prioritized processing people most likely to be ineligible for Medicaid, including Texas, had higher drop rates. The number of federal exemptions each state applied for also correlated with the number of disenrollments.
Waivers provided by the Centers for Medicaid and Medicare Services allow states to update beneficiaries based on eligibility in other federal programs or partner with outside organizations to update contact information. became.
Texas took four. By comparison, Indiana and Tennessee each received 15 exemptions. The average net disenrollment for states that implemented four or fewer waivers was nearly 116% of expected disenrollment, according to the report.
The study notes that states that took less than 12 months to complete deregistration had higher percentages of predictions on average compared to states that took 12 to 14 months. Texas took 14 months.
Buettgens said the high rate of child disenrollment in some states requires further evaluation.
“There is no dispute that the number of eligible children has decreased significantly compared to before. [the pandemic]. “Especially when it’s like 178% of our forecast,” he said. “There is no evidence that the number of eligible children has changed significantly. Therefore, it strongly suggests that there may be a problem with eligible children being disenrolled.”
Relaxing Medicaid policies during the coronavirus era has been difficult, and Texas health officials have had to hire staff to obtain up-to-date contact information for people who moved during the pandemic. State and local agencies have run awareness campaigns warning people on Medicaid that they need to apply for renewal after March 31, 2023.
A state may deem you ineligible for Medicaid for a variety of reasons, including exceeding the program’s income limits. Many women who received prenatal Medicaid have since expired from the program, and some children who have turned 19 since the pandemic began have been disqualified from coverage.
Starting March 1, Texas expanded Medicaid coverage for new mothers through the first year of life. new federal guidelines The law enacted this year also requires children on Medicaid or CHIP to remain eligible for 12 months, even if their circumstances change.
