Juliette Vasquez recently gave birth to her daughter, Imani, with the help of Medicaid. She expressed her fear of going without health insurance, as Medicaid helped cover her prenatal care and delivery. Since the lifting of a policy that prevented states from removing people from Medicaid during the pandemic in exchange for federal funding, over half a million people in Texas have lost their coverage, the highest number reported by any state. Many of those affected are young mothers like Ms. Vasquez or children who have limited options for obtaining affordable insurance. Ms. Vasquez emphasized the importance of health insurance as a new parent, as she needs to stay healthy while breastfeeding and have access to a doctor when needed.
During the pandemic, Medicaid enrollment reached record levels, and the uninsured rate in the country dropped to a record low. However, since the unwinding of the policy, over 4.5 million people have been dropped from Medicaid nationwide. The Congressional Budget Office estimates that over 15 million people will lose Medicaid coverage in the next year and a half, with over six million becoming uninsured. While some individuals lose coverage due to no longer meeting eligibility criteria, others are dropped for procedural reasons, indicating that they still qualify for the program.
This situation is particularly problematic in states like Texas, which have not expanded Medicaid under the Affordable Care Act. Texas has the highest uninsured rate in the country and a more restrictive Medicaid program that primarily covers children, pregnant women, and people with disabilities. The unwinding of Medicaid has highlighted the coverage gap issue, where people in non-expansion states have incomes that are too high for Medicaid but too low for subsidized coverage through the Affordable Care Act marketplaces. This gap has left many poor parents uninsured and with no alternative options.
In Texas, nearly six million people were enrolled in Medicaid at the start of the unwinding, but that number has significantly decreased. Many parents whose children suddenly lost Medicaid coverage are panicking, as they want their children to receive required immunizations and annual exams. Besides not meeting eligibility criteria, other reasons for losing Medicaid coverage include earning too much income and aging out of the program. New mothers like Ms. Vasquez are also losing coverage due to a stricter cutoff two months after giving birth, although legislation has been signed extending postpartum coverage to a year.
Health experts are concerned about procedural reasons for losing Medicaid coverage, as many individuals may still qualify for the program. In Texas, about 80% of the 560,000 people removed from Medicaid were dropped for procedural reasons. The state claims to have prioritized eligibility checks for those most likely to no longer be eligible, using various tactics such as text messages, robocalls, and community events to reach people. However, outreach efforts remain challenging, particularly in rural areas where residents may lack internet access or nearby health department offices for in-person assistance.
The problem is compounded by the difficulties faced by those who need to renew their coverage but do not have access to online or phone enrollment options. Some parents have had to attend events held by the state at locations like the Houston Food Bank to seek help with enrollment. These events can be emotional, with parents concerned about losing coverage for their children, particularly if therapy is required. The experience of Mario Delgado, who suddenly lost coverage with his wife, highlights the struggle to afford healthcare when disabled and unable to work. Despite the difficulties, there have been success stories, like Mr. Delgado being able to re-enroll in Medicaid.
In conclusion, the unwinding of the policy that prevented states from removing people from Medicaid during the pandemic has had significant consequences in Texas, where over half a million people have lost their coverage. The situation is particularly alarming for young mothers and children who have limited options for affordable insurance. The coverage gap issue is also evident, leaving some individuals with incomes that make them ineligible for Medicaid but unable to afford coverage through the Affordable Care Act marketplaces. Procedural reasons for losing coverage have also impacted many people who may still qualify for Medicaid. The challenges faced in reaching and assisting those at risk of losing coverage, particularly in rural areas, highlight the need for improved outreach efforts and policy reform to ensure access to healthcare for all.