Texas is four months into an ongoing process to “unwind” Medicaid continuous eligibility for the roughly 2.7 million residents who benefited from such coverage thanks to federal COVID-19
relief funding. But a recent state data report shows most of the approximately 500,000 Texans unwound so far remain eligible.
At a recent webinar hosted by the Texas Medical Association, representatives from the Texas Health and Human Services Commission (HHSC) and from Every Texan, an Austin-based nonprofit, urged physicians to share information with their patients about the
unwinding and alternative health plans.
Nancy Binford, MD, an obstetrician-gynecologist in Austin who moderated the event, welcomes their guidance.
“I’m highly concerned how we’re going to mitigate the damage of this Medicaid unwinding,” she told the virtual audience on June 20.
HHSC has a three-phase plan for redetermining Medicaid eligibility. Many enrollees will lose coverage because they no longer qualify. But, as borne out by HHSC’s data report, many will lose coverage instead because of bureaucratic barriers, such as difficulties
navigating the renewal process or address changes.
In its first monthly Medicaid enrollment report since the unwinding began, HHSC found nearly 405,000 – or 81% – of disenrolled Texans fell
into the latter camp.
Helen Kent Davis, TMA’s associate vice president of governmental affairs, said this mass loss of coverage “will impact patient care and practice viability and [will] stress the state’s safety net.” She added that TMA is working closely with HHSC to consider
interventions that might reduce the number of disenrollments which occur due to red tape.
Early reports from other states, including Florida and Arkansas, have produced similar findings, with bureaucratic barriers causing 54% and 80% of disenrollments in each state, respectively, during the first few months of the unwinding process.
Out of concern, the U.S. Department of Health and Human Services (HHS) recently urged states to do more – including partnering with local governments, community organizations, and schools – to help residents renew their Medicaid coverage, if eligible,
or find a new health plan.
“Nobody who is eligible for Medicaid or the Children’s Health Insurance Program should lose coverage simply because they changed addresses, didn’t receive a form, or didn’t have enough information about the renewal process,” HHS Secretary Xavier Becerra
said in a June 12 statement.
Rachel Patton, deputy associate commissioner of program enrollment and support for Medicaid and CHIP services for HHSC, urged physicians to talk to their patients about the unwinding process and how they can verify their eligibility, and to use HHSC’s
Ambassador Toolkit to access messaging, flyers, and social media graphics
for in-practice use.
The webinar also covered alternative coverage options, including state and federal programs that could help patients who are disenrolled from Medicaid or CHIP.
Although Texas Gov. Greg Abbott recently signed into law House Bill 12 by Rep. Toni Rose (D-Dallas), which extends postpartum Medicaid
coverage from two months to one year, its implementation timeline may not coincide with the unwinding process.
As a result, Ms. Davis says many postpartum women may need to seek alternative coverage options via state programs or the federal marketplace. At the state level, there are several women’s health programs, including Healthy Texas Women, with varying income
and age eligibility thresholds.
But Ms. Kent Davis warns “it’s not necessarily an easy handoff between Medicaid and the exchange,” underscoring the importance of navigators and physician awareness.
Fortunately, some recent policy developments have increased federal funding for navigators – community organizations that connect eligible consumers to federal marketplace health plans – and extended subsidies for the same plans.
Karla Martinez, a policy analyst at Every Texan, said patients can find local help signing up for coverage on HealthCare.gov.
She also noted that anyone who loses Medicaid or CHIP coverage between March 31, 2023, and July 31, 2024, can enroll in a health plan through HealthCare.gov thanks to a special enrollment period occasioned by the unwinding.
Find more information on TMA’s state advocacy webpage.