The first data released indicate that the state’s Medicaid unwinding of pandemic continuous coverage is likely disenrolling many eligible Texans. The 81% of over 500,000 Texans removed from Medicaid in June was not due to ineligibility. Rather, they lost coverage due to “procedural” red tape. This includes things like Medicaid sending their paperwork to an old address, confusing paperwork with multiple deadlines or not in the family’s language, or the family not completing all required steps. Of states that have reported unwinding data thus far, 71% of disenrollments on average were due to procedural reasons, and Texas’ rate of denials is even worse than this shameful national average. A major factor in this high procedural cut-off rate is that HHSC renewed coverage using data-driven tools (also known as “administrative” or “ex parte” renewal) for less than 1% of the more than 785,000 Texas Medicaid enrollees notified in April they needed to renew. In comparison, Arizona reports 62% of their first round of unwinding renewals were successfully completed administratively. This initial data from HHSC is limited and does not show how many of those who lost coverage were children, low-income seniors, or individuals with disabilities. All of these groups are likely to remain eligible for Medicaid, yet are at risk of losing their coverage due to bureaucratic hurdles. Options for People Who Lost Medicaid Getting Back on Medicaid Families may lose coverage because the state couldn’t find them or they missed a deadline – even though they might still be eligible. Families may also be incorrectly denied due to immigration status, income, or other errors. To get these cases corrected, please escalate them through Every Texan or the Office of the Ombudsman. If the case still can’t get corrected, families have the right to a fair hearing. 90-Day Reconsideration Period If a person is denied Medicaid because they didn’t submit their renewal or needed information, the client has a 90-day window to send the renewal or missing information after losing coverage. Unfortunately, the renewal link on YourTexasBenefits.com is currently not active during the 90-day reconsideration period. To submit information to complete a renewal after a denial, you can help clients during this time period by calling 2-1-1 Option 2 or completing a paper application and either faxing, mailing, or bringing it into a local HHSC office. Other Health Care Options People who lost Medicaid may have other options for health coverage like HealthCare.Gov or through an employer. Unfortunately, some people may newly find themselves in the Medicaid coverage gap, making too little for help paying for health insurance through HealthCare.Gov or too much for Medicaid. To learn more about other health coverage or access options, check out this TOED or resource hub. What’s Next for Medicaid Unwinding in Texas? As of now, Texas is sticking to the current self-imposed timeline and initiated Cohort 2 in July. Renewal packets for moms who are over six months postpartum and people who are likely to be eligible for another type of coverage have been sent this month. Texas HHSC’s plan is to initiate 3.3 million renewals from July through September. |
