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The disaster of Texas Medicaid disenrollments

On Behalf of | Sep 21, 2023 | CMS Conditions of Participation, Health Law Attorneys

The state of Texas is unenrolling Medicaid recipients faster than any other in the United States, and some of these recipients include eligible children and adults living with serious medical conditions that require life-saving treatment and medications. Patients and their loved ones are scrambling and trying to figure out how to meet complex medical needs while fighting to have their only lifeline to affordable healthcare restored to them.

Disenrollment statistics

The statistics of Medicaid disenrollment are staggering. Since April, the Texas disenrollment rate was 72%. Over 600,000 Medicaid recipients have lost their coverage, and the state will continue to remove people from the program until reaching pre-pandemic levels, not considering that the pandemic has changed life in significant ways for many.

Texas has the highest number of uninsured residents in the nation. Many individuals work essential but low-wage jobs that do not offer benefits that include health insurance. These low-wage workers fall through the cracks because they will no longer qualify for Medicaid under current Texas Medicaid law, and they cannot afford to purchase a health insurance plan on the marketplace.

What is being done?

As the COVID emergency declarations are ending, nonprofit organizations are trying to pick up the slack and help those who can qualify for Texas Medicaid with redeterminations. For those who do not qualify, nonprofit organizations are offering health services on a sliding fee scale that depends on income. While there is bipartisan support in the Texas state legislature for narrowly expanding Medicaid for new mothers up to 12 months, Republican lawmakers in Texas continue to resist expanding Medicaid under the Affordable Care Act.

These disenrollments are also impacting those who are currently eligible under current Texas Medicaid law. According to the Children’s Defense Fund, 81% of these individuals were removed from Medicaid because of bureaucratic reasons before their eligibility could truly be determined. The process clearly needs work, and lawmakers must make improvements quickly to avoid devastating consequences.