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WHAT IS MEDICAID? Medicaid is a government-run health care policy. In Texas, eligibility requirements vary by program.
enrollees are children, according to the HHSC. Ezreal Garcia, public information o cer for Community Health Network, which is a system of health clinics with a Katy location, 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 pro- cess that information,” Garcia said. According to census data released in March, Texas has a higher rate of uninsured individuals compared to the national average. In 2020, the national uninsured rate fell to 8.7% from 15% in 2013. According to the U.S. Census Bureau American Community Survey, Texas’ uninsured rate was 17.3%— about double the national average. 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 has operated in the Katy area for more than two decades. “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.” State of Medicaid The public health emergency was still in place as of June 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, the HHSC said enrollment has increased to its highest mark ever in Texas, hitting 5.3 million in March, up from 4.2 million in March 2020. 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. Harris County’s rolls grew from the high 600,000s in 2019 to 898,567 as of October 2021 data. The HHSC’s preliminary data from February estimates around
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 cation process,” Garcia said. “That’s why we have done our due diligence to make sure that we’re educating our members and our patients.” In an emailed statement, Jacquelyn Minter, Fort Bend County’s health and human services director, recommended Medicaid enrollees update their information on www.yourtexasbene 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 specializes 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 policy is jointly funded by states and the federal government 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. healthy and in school.” Debate over expansion When the federal government signed the A ordable Care Act into law in 2010, each U.S. state was given the option to expand Medicaid coverage to nearly all adults with incomes up to 138% of the federal poverty level, an annual income of $17,774 for an indi- vidual in 2021, according to the KFF. Texas is among 12 states that have not expanded Medicaid. Of those 12
100,813 Fort Bend County residents are now enrolled in Medicaid, with 932,000 enrollees in Harris County. 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 a May 5 HHSC presentation on the end of continu- ous Medicaid coverage indicated that Texas plans to use six months. 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 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 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, according to the Kaiser Family Foundation. A looming crisis There is no estimation from the HHSC yet for how many people could be determined ineligible and unen- rolled as part of that process, HHSC Press O cer Kelli Weldon said. O - cials will get a better idea of the num- ber after they conduct an 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. Before the pandemic, individuals on Medicaid had to annually renew their policies, Garcia said, whereas those on private health insurance did not. “The certi cation process is annual for Medicaid, so they have to go through the eligibility process all over again,” Garcia said. “They can just go for the recerti cation, which is not as lengthy as it would be for rst-time applicants.” Garcia said he does have concerns about recerti cation. “We’re talking about millions of
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 mid-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%
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COMMUNITY IMPACT NEWSPAPER • COMMUNITYIMPACT.COM
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