Sign up for The Brief, the Texas Tribune’s daily newspaper that keeps readers up to date with the most essential Texas news.
Nearly 1.7 million Texans have lost their health insurance, the largest number of people dropped by any state in the months since Texas began removing people from Medicaid as part of post-pandemic relief Is. According to the state, about 65% of these removals occurred for procedural reasons.
The Texas Health and Human Services Commission is nearing the end of a chaotic and overburdened process of removing people who became ineligible during the coronavirus pandemic from state Medicaid insurance. The state had not disenrolled people before this year because of federal pandemic rules that prevent states from cutting coverage.
As a result, more than 5 million Texans received continued access to health care during the pandemic through Medicaid, the joint federal and state-funded insurance program for low-income individuals. In Texas, the program’s eligibility criteria are so restrictive, it primarily includes poor children, pregnant and postpartum mothers, and disabled and senior adults.
But the effects of speeding up the process have come to light again: Still-eligible Texans were excluded by mistake and for procedural reasons, increasing a backlog of hundreds of thousands of Medicaid applications and pushing back wait times by several months. . The backlog for SNAP food benefit applications, which is also managed by the same state agency, also skyrocketed due to the burden.
U.S. Rep. Lloyd Doggett, D-Austin, told The Texas Tribune that the state handled it with incredible incompetence and indifference to poor people. This is really scary.
Doggett has repeatedly called for changes to the process, most recently sending a letter to the U.S. Centers for Medicare & Medicaid Services calling their investigation of the state grossly inadequate.
He said he also contacted the U.S. Department of Agriculture, the agency that oversees the nation’s Supplemental Nutrition Assistance Program, to improve the state’s food benefit access during this time. He suggested pausing upcoming SNAP renewals so Texas workers could focus on working through the backlog first.
As of Thursday morning, he said, no federal agency had responded to him.
As of December 8, there were 207,465 SNAP applications and 288,939 Medicaid applications waiting to be processed, according to HHSC spokesperson Tiffany Young.
No one watching this is surprised about the backlog. We had delays before closing, and then we did an enormous amount of work on a system that didn’t have any kind of equitable, realistic way in place that was completely front-end,” said Stacey Pogue, a senior policy analyst at Everywhere. Was loaded. Texan.
The way the state has chosen to do this is to create a very large, long backlog. “It is a choice and it hurts people in need,” he said. But they had other options to remove the workload from the system without asking people to wait and wait, wait and wait.
For Texans who now apply for both SNAP and Medicaid, the wait time has dropped to slightly less than a month, Doggett said, because they have to wait for their Medicaid application first. Young said a special team processes joint applications at the same time. That’s less than the five-month waiting period implemented in early December, Young said.
HHSC spokeswoman Jennifer Ruffcorn said that as of October 2023, some applications previously submitted to the queue had been sitting there for four months.
HHSC is shifting 250 eligibility staff from other priority projects to focus on processing applications requesting SNAP and other benefits, Ruffcorn said in a statement. Additionally, within the next five months, HHSC will send 600 of our new employees to Medicaid training. It will also increase our ability to process more SNAP and Medicaid joint applications.
For those who do not have food, even a month is a very long time. Even before the holidays arrived, food banks were beginning to feel the strain.
“It’s a difficult time, it’s kind of a perfect storm,” Celia Cole, CEO of the nonprofit Feeding Texas, said earlier this fall. Food banks are seeing high demand. They’re struggling to get food in and out the door, and it’s costing more to do so.
And for those who do not have health insurance coverage, options remain limited, often leaving them either incurring thousands of dollars of medical debt or turning to federally qualified health centers that provide medical care regardless of insurance. It is necessary to provide.
It’s sad to think that children aren’t able to get their tests or medications because their Medicaid application is gathering dust in a state office, Diana Forrester, health policy director at Texas Care for Children, said in a news release Thursday.
Some of the solutions proposed by the state have been disappointing. In an email sent by HHSC pleased to be received by Doggett’s office to its employees, leaders suggested employees participate in the “6 Days of My Service Challenge,” where they work overtime by either extending time every day or coming in on Saturdays. do.
The email included a prize lottery for employees who worked more than 15 hours of overtime that week.
Pogue said of the email that there are other avenues besides asking overworked employees to do more work. Of all the solutions to choose from, this is only the last solution on the list.
Texas has also made limited use of an automated eligibility check system, which uses previously collected data such as pay stubs as well as federally provided data about people’s work. According to state numbers, only 6% of Medicaid renewals came through the automated system.
Throughout the process, advocates like Pogue have fallen on deaf ears calls for a pause so that HHSC staff can clear the backlog before sending more qualified people to the back of the line.
Now that the state has worked through most of its groups of people trying to renew, one million people have had their coverage renewed, advocates say the state has an opportunity to fix the system. Is.
What can Texas lawmakers hope to know? What kind of system do we want? How difficult should it be to go through the Medicaid renewal process? How do we staff our systems to process the paperwork? Pogue said. Now it’s not about how we will relax. It’s: How do we run the Medicaid program?
Karen Brooks Harper contributed to this report.
Neelam Bohra is the 2023-24 New York Times Disability Reporting Fellow, based at The Texas Tribune through a partnership with The New York Times and the National Center on Disability and Journalism, based at the Walter Cronkite School of Journalism and Mass Communication. Arizona State University.
Disclosure: Every Texan, Feeding Texas, Texas Cares for Children and The New York Times have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Is funded by. Financial supporters have no role in Tribune’s journalism. Find their full list here.