Hundreds of thousands of Texans could lose their insurance when the public health emergency ends

The pandemic had a small silver lining. But one of them was a federal emergency program that automatically renewed Medicaid coverage for people who qualified. It’s unclear when the program will expire, but health advocates worry that people could be kicked off their health insurance without realizing it.

The end date is a bit of a moving target. When the state of emergency was declared two years ago, automatic renewals were put into effect for 90 days. Since then, the federal government has renewed the program in 90-day increments.

The feds say states will get 60 days notice once the decision is made to end the program. The last 90-day period is due to expire soon, but the program is expected to be renewed again.

Advocates are urging states not to wait for the inevitable notification that the program is ending, but to start contacting Medicaid recipients now. People covered by Medicaid may need to update their contact information so they can be notified if they lose eligibility for Medicaid, which primarily covers low-income families, and be given the opportunity to find other options, such as Affordable Care Act plans.

“It’s hard to create a sense of urgency when there’s no set expiration date,” said Diana Forrester, director of health policy at Texans Care for Children, a nonprofit that advocates for the well-being of Texas children and families.

In the spring, the federal government said states must determine who is still eligible for Medicaid and who is not, and then begin notifying people who lose their coverage. In April, Texas unveiled a plan to update Medicaid recipients’ eligibility status and notify everyone within six months. The Texas Department of Health and Human Services estimates it needs to review the eligibility of about 3.7 million people.

“It’s an ambitious plan under the best of circumstances,” Forrester said, “and it’s not the best of circumstances.”

Once the public health emergency ends, hundreds of thousands of Texans will no longer be eligible for the program. In Texas, the program primarily covers children, pregnant women and people with disabilities. Individuals must earn less than $26,900 per year to qualify.

Advocates predict that the biggest groups of people who will lose coverage will be women who were pregnant in March 2020 and then had children, children who age out of the program and those whose incomes have decreased. increased in the last two years.

Because there has been no need to renew individuals in the past two years, Texas Health and Human Services expects many of the addresses it has on file to be out of date. The agency expects to receive a high rate of return mail during the contact process.

For that reason, the outreach process needs to start now, Forester said, especially as Texas Health and Human Services grapples with staffing shortages. During the pandemic, the department had to close eligibility offices that enroll people, and some have not reopened. People who call 211, the state’s social services hotline, to renew report being put on hold for about an hour, Forrester said.

“We need to use this time to reach out aggressively so it’s not up to the member to understand the complexity of the situation,” Forrester said.

Texas has the highest uninsured rate in the country, and has for years. About one in six Texans are without health insurance, according to census data. Researchers say increased benefits from the pandemic, such as automatic enrollment and marketplace subsidies of Affordable Care Act plans, have helped reduce the uninsured rate in Texas. But that won’t be confirmed until the Census releases data in the fall.

The low uninsured rate likely won’t last. After the public health emergency ends, it’s possible that eligible children and their families could be inadvertently kicked off Medicaid, said Joanne Alker, executive director of the Center for Children and Families at Georgetown University. She worries that many eligible families won’t be properly notified because of contact information that hasn’t been updated or simply problems in an overloaded system.

“They could potentially lose the coverage they’re responsible for,” Alker said. “I am very worried about the children and families in Texas right now.”

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