Health & Science

Some enrollees for Texas Medicaid health insurance will be ineligible for coverage under new rules

A new report from Texas A&M and the Episcopal Health Foundation shows an increase of 1.6 million Texans joining Medicaid since the beginning of the pandemic.

Miguel Gutierrez Jr / KUT
The working poor in Texas are too poor to qualify for an insurance plan at Healthcare.gov, but make too much money to qualify for Medicaid.

A federal public health emergency rule put in place during the beginning of the pandemic in 2020 that prevented Texas residents from being dropped from Medicaid will expire in April.

About 1.6 million Texans joined the state Medicaid program during the pandemic. This increased enrollment to more than 5 million. Those who applied were allowed to stay on Medicaid and exempted from completing what used to be routine renewal paperwork based on eligibility and income.

Those enrolled in Medicaid are primarily low-income children, pregnant women, and parents of dependent children. According to a report from researchers at Texas A&M and the Episcopal Health Foundation, some enrollees could be dropped when the emergency rule expires.

Laura Dague is an associate professor of public service and administration at the Bush School of Government and Public Service at Texas A&M. Through her research, she found that children would be the largest group to potentially lose health insurance. If someone's circumstances have changed since they applied for Medicaid because they now have a bigger family in the household or because their income has increased, they could be at risk of being dropped.

In those cases, Dague said Texans may need to find other forms of coverage. As an alternative to Medicaid, she said parents whose children will no longer qualify might be able to apply to the CHIP program.

"CHIP is for kids who have slightly higher income than for Medicaid," Dague said. "If someone is still a child and income is still fairly low, they could qualify for CHIP and the state would help them understand that."

Dague also said adults who will no longer be eligible have more options for health insurance because of the Affordable Care Act (ACA). The ACA can potentially provide families who saw modest increases in their income a low or no-cost insurance.

"It was harder essentially to get family coverage through marketplaces, but now even if a parent has coverage for themselves at their job, they might be able to get a subsidized plan for their kid," Dague said.

Even so, Dague's research shows that many women and young adults may fall into the health insurance "coverage gap." This gap happens when incomes are too high for Medicaid, but too low to qualify for a federal subsidy to buy ACA health insurance.

The president and CEO of the Episcopal Health Foundation, Dr. Ann Barnes, said in a statement that there will be many who lose their health insurance and will not have guidance for other options.

"There needs to be increased awareness of how the end of this public health emergency could contribute to the health insurance coverage gap in Texas," Barnes said.

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