After the expiration of a pandemic-era policy that prevented states from removing people from Medicaid, Texas has removed over half a million individuals from the program, the highest number among all states. Many affected are young mothers and children, left with limited options for affordable insurance. Medicaid enrollments surged during the pandemic, reducing the nation’s uninsured rate, but since the policy ended, over 4.5 million people nationwide have lost Medicaid coverage. Texas’ restrictive Medicaid program and procedural removals have highlighted the urgent need for healthcare reform, especially in rural areas with limited resources and technology access.
Since the end of a pandemic-era policy that prohibited states from removing individuals from Medicaid, Texas has experienced a significant decrease in Medicaid enrolments. Juliette Vasquez, a 27-year-old new mother from southwest Houston, has expressed her concerns about losing the health insurance that supported her throughout her pregnancy and the delivery of her daughter, Imani, through Medicaid. As per KFF, a health policy research organization, Texas has removed over half a million people from the program since the policy expired in April, the highest among all states. Many of those affected in Texas are young mothers like Vasquez and children who have limited options for affordable insurance.
The pandemic policy led to a surge in Medicaid enrollment, reducing the nation’s uninsured rate to a historic low. However, since its expiration, more than 4.5 million people nationwide have been removed from Medicaid, a number expected to increase. The Congressional Budget Office estimates that over 15 million people will lose Medicaid coverage, leaving more than six million uninsured.
The situation is particularly dire in Texas and nine other states that have not expanded Medicaid under the Affordable Care Act. Texas, with the highest uninsured rate in 2021, has a restrictive Medicaid program, mainly covering children, pregnant women, and people with disabilities. The unwinding of the policy has highlighted the coverage gap issue, where individuals in non-expansion states have incomes too high for Medicaid but too low for subsidized coverage through the Affordable Care Act’s marketplaces.
Many Texans are losing Medicaid due to various reasons, including changed income levels and stricter postpartum coverage cutoffs. Concerns are also raised about procedural removals, where individuals, although still eligible, lose coverage due to paperwork issues. In Texas, approximately 80 percent of the 560,000 people removed from Medicaid were dropped for procedural reasons.
Efforts to reinstate coverage are underway, but challenges persist, especially in rural areas with limited internet access and outreach facilities. Lack of resources, technology literacy, and physical impairments add to the difficulties faced by individuals attempting to re-enroll in Medicaid.
The unwinding of the pandemic policy has left vulnerable populations in Texas without essential healthcare, emphasizing the urgent need for Medicaid expansion and comprehensive healthcare reform in the state.
