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WHAT IS MEDICAID? Medicaid is a government-run health care policy. In Texas, eligibility requirements vary by program.
Medicaid will have their eligibility redetermined once the emergency ends, according to the Texas Health and Human Services Commission. About 75.9% of Texas Medicaid enrollees are children, according to the HHSC. According to census data released in March, Texas has a disproportion- ate rate of uninsured individuals com- pared to the national average. In 2020, the national uninsured rate fell to 8.7% from 15% in 2013. According to U.S. Census Bureau American Com- munity Survey results, Texas’ unin- sured rate was double the national average at 17.3%. Carol Paret, Memorial Hermann’s senior vice president and chief com- munity health o cer, said ending the extension would increase Texas’ num- ber of uninsured individuals. Memorial Hermann opened its Sugar Land hospi- tal in 2006. “Texas already has one of the high- est numbers of uninsured in the coun- try,” she said. “When you have so many people in your community that don’t have access to care, it impacts health overall.” The pandemic also shined a light on a debate that has been ongoing since 2010: whether Texas should expand Medicaid coverage. That debate will come up again when the state Legis- lature meets in January. Some local lawmakers said they support reform for better health care access—but think expansion is unsustainable. “When Medicaid has been expanded in other states, the cost burden has been so great it hasn’t been sustain- able or bene cial to their health care program,” Republican state Rep. Jacey Jetton said. “Last session, we worked on legislation to continue to provide better access to a ordable health care through open market concepts in areas of telehealth medicine, expanded broadband and increased exibility to who can administer vaccines. We will continue to push for reforms for better health care access and a ordability for all Texans.” State of Medicaid The public health emergency was still in place as of May with an expira- tion date of July 15. However, the gov- ernment also requires a 60-day notice before Congress can allow the emer- gency to expire. That notice was not given May 15, meaning the emergency is likely to be extended into October, according to the Center on Budget
and Policy Priorities, a nonpartisan research institute that analyzes federal and state budget policies. Since the emergency was declared, Medicaid enrollment has increased to its highest mark ever in Texas, hitting 5.2 million as of February, up from 4.2 million in March 2020, according to the HHSC. The number of people enrolled hovered around 66,000 for Fort Bend County prior to the pandemic in 2019. Since then, Fort Bend County enroll- ment grew to more than 96,000 as of the most recent con rmed data from October 2021. HHSC’s preliminary data from February estimates around 100,813 Fort Bend County residents are now enrolled in Medicaid. When the public health emergency ends, a portion of Medicaid enrollees will have their coverage automatically renewed if they are deemed eligible. There will also be an unwinding period of up to 12 months during which states will work with individuals who were not automatically re-enrolled to help them keep their coverage if they are still eligible, though Texas plans to only use six of those months, HHSC o cials said. For states to be successful, they will have to focus on two key areas, said Farah Erzouki, senior policy analyst with the CBPP: streamlining the appli- cation renewal process and communi- cating e ectively with enrollees. The CBPP recommends states “BECAUSE OF TEXAS’ ELIGIBILITY RULES, ALMOST ALL MEDICAID BENEFICIARIES ARE KIDS. … I THINK WE WILL SEE THE MOST
methods, including online, by phone, by fax, by mail and in person. Texas is among the 33 states to allow renewals by all ve methods, according to the Kaiser Family Foundation. A looming crisis There is no estimation from the HHSC at this time for how many peo- ple could be determined ineligible and unenrolled as part of that pro- cess, HHSC Press O cer Kelli Weldon said. O cials will get a better idea of that number after they conduct a full analysis during the unwinding period, she said. In an emailed statement, Jacque- lyn Minter, Fort Bend County’s health and human services director, recom- mended Medicaid enrollees update their information on www.yourtexas- bene ts.com and return requests for information as soon as possible. Children are most at risk of being unenrolled when the public health emergency ends, said Laura Dague, associate professor with the Texas A&M University Public Service and Administration Department who spe- cializes in the economics of public health insurance. “The vast majority—and that means, of course, the people who kind of stayed on [Medicaid] longer than expected—are low-income kids. I think we will see the most disenrollment in that group,” Dague said. Paret said unenrollment can have a domino e ect on students’ health and school attendance, exacerbating the health care gap for future generations. “Our belief is the No. 1 way that you improve health is [breaking] the pov- erty cycle,” she said. “You can break the poverty cycle through education—but kids can’t be educated unless they’re Certain population groups are required to be covered by Medicaid under federal law, including people who are below a certain income level and are also pregnant, are children, have a disability or are over age 65. The health care policy is jointly funded by states and the federal gov- ernment with the federal government paying 90% of the cost of health care for those insured by Medicaid and states paying 10%, according to the KFF. When the federal government signed the A ordable Care Act into law in 2010, each U.S. state was given the healthy and in school.” Debate over expansion
WHO QUALIFIES IN TEXAS?
Children from low-income families, determined based on monthly household income and size: To obtain Children’s Medicaid, a two-person household must make less per month than $2 ,034
$3,083 And a four-person household must make less than INCOME REQUIREMENTS VARY FOR OTHER GROUPS:
Pregnant Responsible for child age 18 or younger
Have a disability or a family member in the household with a disability Blind
Age 65 or older
All adults with incomes up to 138% OF THE FEDERAL POVERTY LEVEL THE FOLLOWING INDIVIDUALS MAY BE ELIGIBLE IN OTHER STATES BUT NOT IN TEXAS Individuals receiving HOME AND COMMUNITY BASED SERVICES CHILDREN IN FOSTER CARE who are not otherwise eligible
More than 5.3 MILLION people were enrolled in Medicaid statewide as of March.
Up from 4.2 MILLION in March 2020
DISENROLLMENT IN THAT GROUP.” LAURA DAGUE, TEXAS A&M UNIVERSITY ASSOCIATE
of Medicaid enrollees in Texas are children.
73%
SOURCES: TEXAS HEALTH AND HUMAN SERVICES COMMISSION, U.S. CENTERS FOR MEDICARE AND MEDICAID SERVICES COMMUNITY IMPACT NEWSPAPER There is NO ESTIMATION as of mid-May of how many people will be determined ineligible. State o cials said they will conduct a full redetermination during the unwinding period. or 3.7 MILLION Texans, will need to have their Medicaid eligibility redetermined when the public health emergency ends, according to May 5 estimates. 70%
PROFESSOR, PUBLIC SERVICE AND ADMINISTRATION DEPARTMENT
increase capacity for renewals that are determined using electronic data matches, which will help avoid hav- ing to rely on enrollees to complete a renewal form or submit documenta- tion, Erzouki said. Additionally, Erzouki said it will be crucial for states to allow enrollees to renew their policies through a variety of
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COMMUNITY IMPACT NEWSPAPER • COMMUNITYIMPACT.COM
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