Child enrollment in Texas Medicaid grew by 26.4% during the pandemic


Boram Kim


Texas ranked 10th among states for child enrollment growth in Medicaid and CHIP during the pandemic, according to a report released by the Georgetown University Center for Children and Families this month. 


Stay one step ahead. Join our email list for the latest news.



Texas had the largest child population among the states with the highest growth at nearly 4.2 million children, with more than 870,000 children enrolling between February 2020 and August 2022.

Prior to that period, Texas had the highest child uninsured rate at 12.7%. 

Texas will maintain 12 months of continuous coverage eligibility for all children under 19 years of age in CHIP only and multi-year continuous eligibility for young children starting Jan. 2024.

The Georgetown Institute of Health Policy (GIHP) estimates that as many as 6.7 million children across the US are at risk of losing coverage during the unwinding. It warns that while the vast majority of them remain eligible for Medicaid, the likelihood of losing coverage is high due to “bureaucratic snafus.”

“The uninsured rate for children could easily more than double if states have inadequate staffing levels and overwhelmed call centers and do not take the time and care needed to properly conduct eligibility checks after the federal protections lift,” GIHP said in its findings. 

As part of the PHE unwinding, Texas can end Medicaid continuous coverage on April 1st and initiate redeterminations. Last year, the Health and Human Services Commission (HHSC) was experiencing delays in processing Medicaid and other public benefits due to staffing shortages. 

During the Texas Senate Committee on Finance meeting last week, HHSC Commissioner Cecile Young said addressing the agency’s workforce needs remains its top priority. 

“Another challenge we face is the unwinding of continuous Medicaid coverage,” Young said. “Congress enacted the requirement for continuous coverage effective March 31st. Now HHSC will have to redetermine the eligibility of 5.6 million Texans currently enrolled in Medicaid.

This is a massive undertaking that requires agency-wide focus and attention and we are working on several fronts to make the transition as seamless as possible.”

HHSC reported during the hearing that its eligibility staff had been on mandatory overtime every month last year due to personnel shortages before diverting state funding to salary increases and hiring efforts over the interim. Those efforts have seen some positive returns to stabilize the workforce charged with handling redeterminations, but shortages remain, according to HHSC officials.