The Texas Health and Human Services Commission (HHSC) released data last week on Medicaid renewals through June that showed more than 1.4 million beneficiaries had their renewals initiated since April.
While HHSC plans to report renewal outcomes from its April data in August, it did report data for May and June. Of the total 785,287 Medicaid beneficiaries due for renewals in May, more than half (404,904) were terminated due to procedural reasons.
In that same month, HHSC also terminated coverage for incomplete renewals (172,960) and those determined ineligible (95,880) who were referred to the Federally Facilitated Marketplace (FFM).
HHSC told State of Reform on Wednesday it is unable to provide data on individuals who gained FFM coverage resulting from referrals.
“Individuals who are determined no longer eligible for Medicaid or CHIP are electronically transferred to the Federal Marketplace. Losing Medicaid or CHIP coverage is considered a qualifying event that allows an individual to enroll through the Marketplace and they are not limited to a specific enrollment period.”
— HHSC
HHSC reported there were no mass denials or renewals that took place in June.
The state has yet to release details about which Texans were in the first cohort of renewals and disenrollments, but healthcare advocates expressed concern over the high incidence of people losing coverage who remain eligible for Medicaid as part of the “unwinding” of pandemic-era continuous coverage rules.
There are also concerns the ex parte process in Texas, which utilizes third-party data around income and eligibility to automatically renew coverage, is not adequately converting those renewals.
Texans Care for Children (TCC), a nonprofit children’s policy organization, called on the state to transfer those determined ineligible for Medicaid to other state and marketplace programs.
“We’re deeply concerned that Texas kids who are still eligible for health insurance—either through Medicaid or another program—are losing their health coverage for bureaucratic reasons and are going to get turned away the next time they walk into a doctor’s appointment. State leaders must make sure that kids and moms who are still eligible for health insurance will be able to stay enrolled so they can go to their doctor’s appointments, keep taking their medications, and stay healthy.”
— Diana Forester, director of health policy at TCC
In the 2024-2025 budget, the Texas Legislature appropriated $111 million of the $143 million requested by the agency to support Medicaid renewal efforts this year, which is going to staffing, outreach, technology, and other forms of assistance.
HHSC told State of Reform in April that it had increased its workforce eligibility through various recruitment and retention efforts that included hiring temporary staff, utilizing overtime, and implementing flexible work schedule options.
“HHSC is leveraging all community partners to assist with outreach efforts, including collaborating with healthcare providers, community organizations, and advocacy groups to reach a wide range of individuals who may be affected by the changes.
HHSC created the Ambassador Program and Toolkit to supply outreach tools to partner organizations or ambassadors to help spread the word about the end of continuous Medicaid coverage. The Ambassador Toolkit includes publicly available information such as FAQs, talking points, flyers and social media messages for partners, providers, health plans and advocates.”
— HHSC statement from April 26th, 2023.
TCC says the Texas data shows only one percent of renewals being completed through the ex parte process. By contrast, a majority of states have been able to use the ex parte process to renew at least 25 percent of their renewals, including a quarter of states that have completed 50 percent or more of their renewals through the ex parte process.
“The high percentage of procedural denials should be setting off alarm bells. When you see this many procedural denials, it means that the process is not working properly, whether the state is sending renewal information to the wrong mailing addresses or parents are running into bureaucratic delays with the state when they try to renew their children’s health insurance.”
— Forester