Looming end of federal pandemic emergency threatens to shake Texas’ Medicaid safety net, advocates say

to accelerate their removal faster than required by the federal government — and with limited resources — has advocates worried that millions more could lose coverage due to administrative glitches even if they do qualify.

If they can’t get it right, access to health care for the state’s most vulnerable residents — pregnant women, children, older adults and disabled adults — is at stake, said Tricia Brooks, research professor at the Georgetown University McCourt School of Public Policy’s Center for Children and Families.“However this turns out, it’s really the state’s responsibility,” Brooks said.

As Texans lost their jobs — along with their employer insurance or the ability to pay out of pocket — enrollment in Texas Medicaid programs jumped from 3.8 million in February 2020, a number that had been dropping in recent years, to about 5.1 million in December 2021, according to the Texas Health and Human Services Commission.

Texas HHSC, tasked with handling the influx, anticipates a “large volume of work” and “potential strain on the eligibility system” when the process of dismantling the PHE begins, according to plans the agency released in March.The volume of work involved in the process, state officials say, is comparable to the launching of the massive Affordable Care Act, which overhauled health insurance and delivery systems on a state and national scale.

“Allowing people who are ineligible for Medicaid to continue to receive benefits hurts the patients who truly deserve to be on the program,” said Balat, who directs the Right on Healthcare initiative at the right-leaning Texas Public Policy Foundation. “Texas can and should make the transition as soft as possible … But if someone is no longer eligible for Medicaid, they should not continue to take critical resources away from those for whom they were intended.

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