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Millions of Texans must reapply for Medicaid or risk losing health insurance

People at a table outside a building that says "Tarrant Area Food Bank"
Christopher Connelly
Karina Garcia, a community health worker for JPS Health Network, helps people sign up for assistance programs on the Tarrant Area Food Bank's Red Bus at the Diamond Hill Health Center in Fort Worth.

Starting this month, rules that helped Texans maintain Medicaid health insurance during the pandemic are over. Those rules expanded coverage access and allowed recipients to stay enrolled without completing an annual renewal required by federal guidelines.

That means nearly 6 million Texans who get health insurance through Medicaid will need to go through a redetermination and renewal process. Texas has added about two million people to the Medicaid program since December 2019.

It’s not clear how many people will lose access to the federal health insurance program because they are no longer eligible under Texas’ more restrictive pre-pandemic rules.

Advocates also worry about people who do qualify but can’t make it through the administrative hurdles required to stay insured.

“Those applications are not easy to complete, it can take over an hour to complete them. For many…who qualify for these benefits, English is a second language. ... That can be a barrier,” Butner said. “It’s easier to apply for these benefits online, and if they don’t have access to technology, that can also be a barrier.”

KERA News put together a guide to help Medicaid recipients understand the changes. For folks who need help with the process, the state has a tool to find an office or locate nearby community groups offering help.

On Tuesday, outreach workers from the JPS Health Network and the Tarrant Area Food Bank set up shop in the parking lot of the public hospital system’s Diamond Hill Health Center on Fort Worth’s Northside to help people sign up for assistance and start the Medicaid renewal process.

Butner expects many people who qualify could lose coverage temporarily because of issues with their paperwork. That means they’ll need help covering medical costs, and will turn to already-stressed services like the food bank.

“I’ll tell you what happens in the meantime: They run out of money for the basic living necessities like rent, utilities, gasoline for the car, and they come to the foodbank because that’s one place they can go if they can’t afford groceries,” she said.

The same is true for people disenrolled from Medicaid because they no longer qualify, even though they still earn too little to make ends meet.

Texas is one of 10 states where lawmakers have chosen to forego expanded funding and coverage authorized under the Affordable Care Act, which left about 1.7 million Texans uninsured before the pandemic.

A challenging process

Low-income families in Texas have faced a series of setbacks as the pandemic’s expanded safety net shrinks and inflation continues to eat away at earnings. In March, SNAP benefits were reduced by an average of $212 per household when pandemic-era food stamp policies ended.

Starting this month, the Texas Health and Human Services Commission began sending out renewal notices in yellow envelopes with “Action Required” printed in bright red. Those who’ve opted for paperless communications will be notified electronically.

People have 30 days to respond and complete every step of the process, or they’ll be disenrolled. If all of the paperwork and requested information is submitted within that 30-day window, coverage will continue while the state works to re-determine eligibility.

People who are determined to no longer qualify for the program will be disenrolled.

“We urge Medicaid recipients to update their information and to be on the lookout for renewal notices,” said HHS Executive Commissioner Cecile Erwin Young in a statement.

The commission plans to stagger the redeterminations over several months. It’ll take more than a year to complete the process of re-evaluating all 5.9 million Medicaid recipients, even after adding over 1,000 staffers.

Butner points out that the state is already backlogged.

“I don’t know how [the state will] process 5.9 million applications in a timely fashion without impacting people in our community,” Butner said.

Christopher Connelly is KERA's One Crisis Away Reporter, exploring life on the financial edge. Email Christopher can follow Christopher on Twitter @hithisischris.

KERA News is made possible through the generosity of our members. If you find this reporting valuable, consider making a tax-deductible gifttoday. Thank you.

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