No state has botched Medicaid renewals in 2023 quite like Texas. Since April, when the pandemic-era protections ensuring ongoing coverage for families on Medicaid ended, the state has removed more than 800,000 Texans–mostly children–off Medicaid due to red tape and paperwork issues, without verifying their continued eligibility. Advocates and staff at Texas Health & Human Services (HHSC) know the vast majority of these Texans are still eligible. More people have lost coverage in Texas– in total and as a percentage of Medicaid enrollment–than any other state. In this mass purging of eligible children, Texas is harming people, clinics, hospitals, schools, and businesses, and costing us billions of dollars.
Medicaid is a cornerstone of Texas’ health care system. Without Medicaid, kids miss their back-to-school physicals and mental health check-ins, and vulnerable Texans lose the 24-hour nursing assistance they need to stay alive. Without Medicaid, Texas loses billions in federal tax dollars we Texans have paid into the system. That’s right, our federal taxes pay for the vast majority of Medicaid health services in Texas. Kicking otherwise eligible people off Medicaid wastes money and lives.
What happened?
Pandemic-era protections ensured ongoing coverage for people with Medicaid. Those protections ended in April, prompting all states to begin the vital task of re-checking eligibility for everyone on Medicaid. It is both expected and appropriate for people who are no longer eligible to be removed. Texas has known for years that when the Public Health Emergency (PHE) ended, there would be a large administrative task to review the eligibility of people enrolled in Medicaid. Yet, unlike other states, Texas leaders failed to provide the appropriate budget and guidance for people and systems improvements that would have prevented the meltdown.
The staff at Texas HHSC tried their best to prepare within the people and funds allocated, but Texas’ system is melting down. And not just Medicaid but other crucial programs our federal taxes support such as SNAP, which provides nutritional food benefits to low-income Texas families. Texas’ eligibility system is now in crisis with at least 100,000 Medicaid and SNAP applications sitting untouched, some for at least six months. If you lost your job today and needed help, would you want to wait six months before hearing back from the State of Texas if you qualify for help, and even longer to receive any approved assistance?
What caused this crisis in Texas?
First, Texas has old technology and not enough people trained to help. For more than 20 years, Texas state leaders have underfunded, understaffed, and undercut the people and systems needed to effectively administer Medicaid oversight and eligibility. Despite a budget surplus, Texas state leaders have been slow to upgrade or replace aging technology or to appropriately replace and train dedicated staff who were proud to work for Texas and then left their jobs when they realized they were set up to fail, not to succeed.
Second, despite having every opportunity to prepare well, Texas leaders didn’t. Most states use data matching systems to confirm continued eligibility. For example, Arizona completes more than 60% of its Medicaid renewals with data matches. Not so in Texas which currently has the highest failure rate of data-driven Medicaid renewals in the nation. Technology-based renewals are efficient and save money, but unfortunately Texas only successfully uses data matches to expedite Medicaid renewals a mere three percent. Having the least streamlined and worst performing Medicaid IT system in the nation should be a source of profound concern for Texas leaders. If state leaders had implemented the advice of everyone from health insurers to local clinics and hospitals, we would be in a much better place today.
While the staff at HHSC is doing the best it can under these circumstances, Texas leaders are letting them and us down. Governor Abbott locked HHSC into an unrealistic process and prevented the agency from making mid-course corrections to keep more eligible people covered.
How can we fix this?
1) Hit pause on Medicaid dis-enrollments for 90 days,
2) Direct Texas HHSC to fix system errors and reduce paperwork backlogs, and
3) Update and modernize the technology and computer systems that benefit Texas families and the health care providers that serve them.
I believe Texans deserve the best, including an efficient state government with leaders who invest in smart, secure technologies and train the good people who are proud to work for the state of Texas. If you agree, tell the Governor and the Legislature to do their jobs and invest in Texas to set the standard of how smart government can be, rather than an embarrassing failure costing us lives and money.
No state has botched Medicaid renewals in 2023 quite like Texas. Since April, when the pandemic-era protections ensuring ongoing coverage for families on Medicaid ended, the state has removed more than 800,000 Texans–mostly children–off Medicaid due to red tape and paperwork issues, without verifying their continued eligibility. Advocates and staff at Texas Health & Human Services (HHSC) know the vast majority of these Texans are still eligible. More people have lost coverage in Texas– in total and as a percentage of Medicaid enrollment–than any other state. In this mass purging of eligible children, Texas is harming people, clinics, hospitals, schools, and businesses, and costing us billions of dollars.
Medicaid is a cornerstone of Texas’ health care system. Without Medicaid, kids miss their back-to-school physicals and mental health check-ins, and vulnerable Texans lose the 24-hour nursing assistance they need to stay alive. Without Medicaid, Texas loses billions in federal tax dollars we Texans have paid into the system. That’s right, our federal taxes pay for the vast majority of Medicaid health services in Texas. Kicking otherwise eligible people off Medicaid wastes money and lives.
What happened?
Pandemic-era protections ensured ongoing coverage for people with Medicaid. Those protections ended in April, prompting all states to begin the vital task of re-checking eligibility for everyone on Medicaid. It is both expected and appropriate for people who are no longer eligible to be removed. Texas has known for years that when the Public Health Emergency (PHE) ended, there would be a large administrative task to review the eligibility of people enrolled in Medicaid. Yet, unlike other states, Texas leaders failed to provide the appropriate budget and guidance for people and systems improvements that would have prevented the meltdown.
The staff at Texas HHSC tried their best to prepare within the people and funds allocated, but Texas’ system is melting down. And not just Medicaid but other crucial programs our federal taxes support such as SNAP, which provides nutritional food benefits to low-income Texas families. Texas’ eligibility system is now in crisis with at least 100,000 Medicaid and SNAP applications sitting untouched, some for at least six months. If you lost your job today and needed help, would you want to wait six months before hearing back from the State of Texas if you qualify for help, and even longer to receive any approved assistance?
What caused this crisis in Texas?
First, Texas has old technology and not enough people trained to help. For more than 20 years, Texas state leaders have underfunded, understaffed, and undercut the people and systems needed to effectively administer Medicaid oversight and eligibility. Despite a budget surplus, Texas state leaders have been slow to upgrade or replace aging technology or to appropriately replace and train dedicated staff who were proud to work for Texas and then left their jobs when they realized they were set up to fail, not to succeed.
Second, despite having every opportunity to prepare well, Texas leaders didn’t. Most states use data matching systems to confirm continued eligibility. For example, Arizona completes more than 60% of its Medicaid renewals with data matches. Not so in Texas which currently has the highest failure rate of data-driven Medicaid renewals in the nation. Technology-based renewals are efficient and save money, but unfortunately Texas only successfully uses data matches to expedite Medicaid renewals a mere three percent. Having the least streamlined and worst performing Medicaid IT system in the nation should be a source of profound concern for Texas leaders. If state leaders had implemented the advice of everyone from health insurers to local clinics and hospitals, we would be in a much better place today.
While the staff at HHSC is doing the best it can under these circumstances, Texas leaders are letting them and us down. Governor Abbott locked HHSC into an unrealistic process and prevented the agency from making mid-course corrections to keep more eligible people covered.
How can we fix this?
1) Hit pause on Medicaid dis-enrollments for 90 days,
2) Direct Texas HHSC to fix system errors and reduce paperwork backlogs, and
3) Update and modernize the technology and computer systems that benefit Texas families and the health care providers that serve them.
I believe Texans deserve the best, including an efficient state government with leaders who invest in smart, secure technologies and train the good people who are proud to work for the state of Texas. If you agree, tell the Governor and the Legislature to do their jobs and invest in Texas to set the standard of how smart government can be, rather than an embarrassing failure costing us lives and money.
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