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WHAT IS MEDICAID? Medicaid is a government-run health care policy. In Texas, eligibility requirements vary by program.
Additionally, roughly 75.9% of Texas Medicaid enrollees are chil- dren, according to the HHSC. Ezreal Garcia, public information o cer for Community Health Net- work, which is a system of health clinics located in Brazoria, Galves- ton and Harris counties, said clinic operations have been impacted by COVID-19. “We continue to work with our patients in getting them processed for recerti cation so that when that time does come, we can go ahead and process that information,” Gar- cia said. The pandemic also shined a spot- light on a debate that has been ongo- ing in Texas since 2010: whether the state should expand Medicaid to cover more people. That debate will come up again when the state Leg- islature meets in January, and some local lawmakers said they are ready for change. “We don’t have to go back to the way things were before the pan- demic,” said state Rep. Ann Johnson, D Houston. State of Medicaid The public health emergency was still in place as of May with an expi- ration date of July 15. However, the government also requires a 60-day notice before Congress can allow the emergency to expire. That notice was not given May 15, meaning the emergency is likely to be extended into October, per the Center on Bud- get and Policy Priorities, a nonparti- san 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, hit- ting 5.3 million as of March, up from 4.2 million in March 2020, according to the HHSC. In the Pearland and Friendswood area, the number of people enrolled hovered between 36,000-38,000 for both Brazoria and Galveston coun- ties prior to the pandemic in 2018 and 2019. Since then, Galveston County rolls grew to 49,000 as of the most recent con rmed data from October 2021, while Brazoria County rolls grew to 53,000. The HHSC’s preliminary data from February estimates around 55,364 Brazoria County residents and around 51,066 Galveston County res- idents are now enrolled in Medicaid.
Garcia said he does have concerns about the timeline of the recerti ca- tion process. “We’re talking about millions of Texans that have not gone through the recerti cation process, and I am con dent that the state will encoun- ter challenges with the recerti ca- tion process,” Garcia said. “That’s why we have done our due diligence to make sure that we’re educating our members and our patients.” 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 specializes in the economics of pub- lic 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 disen- rollment in that group,” Dague said. Debate over expansion 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 government with the federal gov- ernment paying 90% of the cost of health care for those insured by Med- icaid and states paying 10%, accord- ing to the KFF. When the federal government signed the A ordable Care Act into law in 2010, each U.S. state was given the option to expand Med- icaid coverage to nearly all adults with incomes up to 138% of the fed- eral poverty level, an annual income of $17,774 for an individual in 2021, according to the KFF. Texas is among 12 states in the country that have not expanded Medicaid. Of those 12 states, Texas also has set the highest bar for peo- ple to qualify based on income, only allowing people to enroll if they make less than $103 per month. Adults who do not have dependents or are not disabled do not qualify for Medicaid at all.
When the public health emer- gency 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 are to work with individuals who were not automatically re-enrolled to help them keep their coverage if they are still eligible, though a May 5 HHSC presentation on the end of continu- ous Medicaid coverage indicated that Texas plans to only use six months. According to Farah Erzouki, senior policy analyst with the CBPP, for states to be successful, they will have to focus on two key areas: streamlining the application renewal process and com- municating e ectively with enrollees. “These steps will be key to make sure people can be reached, that they know what changes are coming and they know what they need to do to keep their coverage,” Erzouki said. The CBPP recommends states 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. Texas uses those kind of renewals in less than 25% of its processes, according to data from the Kaiser Family Foundation, a non- pro t focused on health care issues. Additionally, Erzouki said it will be crucial for states to allow enrollees to renew their policies through a vari- ety of 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, accord- 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. The continued coverage require- ment in the public health emergency has been quite bene cial to those on Medicaid, Garcia said. ing to the KFF. A looming crisis Before the pandemic, individuals on Medicaid had to annually renew their policies, Garcia said, whereas those on private health insurance did not.
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 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
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 early June 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%
As a result, Texas has the highest rate of uninsured individuals of all states, according to the KFF. Nationally, about 10.9% of people are uninsured, COMMUNITY IMPACT NEWSPAPER • COMMUNITYIMPACT.COM
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