Medicaid Unwinding in Texas: What You Need to Know If You Lose Coverage
Key takeaways:
Medicaid renewals in Texas are changing because of the end of the COVID-19 public health emergency (PHE) on May 11, 2023. This will lead to a loss of coverage through a process called unwinding.
During the PHE, Medicaid renewals were automatic and enrollees had continuous coverage. As part of the unwinding process, automatic renewals for Medicaid and Children’s Health Insurance Program (CHIP) coverage, or children’s Medicaid, stopped nationwide on March 31, 2023.
If you live in Texas and need to complete a new Medicaid application or renewal form, the state’s Health and Human Services Commission (HHSC) will attempt to reach you, so be sure the agency has your current contact information. If you can’t be reached or no longer qualify for Medicaid, you could lose coverage as early as June 1, 2023.
The U.S. Department of Health and Human Services declared a public health emergency (PHE) for COVID-19 in January 2020, which was renewed a dozen times through February 2023.
During the COVID-19 PHE, Medicaid enrollees were able to keep their health insurance coverage without eligibility reviews until March 31, 2023. That’s because states and territories were required to provide continuous coverage during this period.
But the PHE is ending on May 11, 2023, along with automatic renewals for Medicaid enrollees. In Texas, this means an estimated 550,000 to 700,000 people — mostly children — may lose Medicaid or Children’s Health Insurance Program (CHIP) coverage, according to a report by Texas A&M University researchers that was prepared for the Episcopal Health Foundation.
Prescription Savings Are Just the Beginning
See what other benefits you qualify for—from cashback cards to cheaper insurance.
Texas is reviewing Medicaid and CHIP enrollees to determine who is eligible to continue enrollment. This process is called redetermination. If you or your family members no longer qualify for Medicaid or CHIP, you could lose coverage as early as June 1, 2023.
Here’s how to prepare for Medicaid changes in Texas and what to do if you lose your coverage.
Why is Medicaid changing nationwide?
After the PHE ends, COVID will remain a public health priority — just not an emergency. As part of this process, Medicaid renewals will no longer be automatic. This is being referred to as the unwinding of Medicaid, and millions of people nationwide risk losing Medicaid coverage.
The unwinding will affect Medicaid in every state, the District of Columbia, and five U.S. territories.
What’s happening with Medicaid renewal in Texas?
The Texas Health and Human Services Commission (HHSC) oversees Medicaid in the Lone Star State. The HHSC plans to review about 5.9 million Medicaid cases through May 2024 and has added 1,000 staff members to get the job done. As mentioned, researchers estimate that as many as 700,000 people in the state could lose Medicaid or CHIP coverage due to the unwinding process. Most of them will be children, but pregnant women and young adults are also at a high risk of losing coverage.
The state is working with partner organizations to get the word out that renewals are resuming through a campaign called “Don’t Wait — Respond and Update!” And a website called Stay Covered Texas has been designed as a statewide resource targeted to the 2.7 million Texas women and children enrolled in Medicaid.
Read more like this
Explore these related articles, suggested for readers like you.
If you live in Texas and are enrolled in Medicaid, it’s important that the HHSC has your correct contact information. Texas started the redetermination process on April 1, 2023 and the HHSC will reach out when it’s your turn to renew. You can update your contact information through the Your Texas Benefits online portal. If you don’t already have one, create an account online or through the mobile app.
You should look for renewal notices from the HHSC and respond to any request from the agency. You may receive a yellow envelope with “action required” written on it in red in the mail. Or you may be sent an electronic notice if you have opted to go paperless.
When it’s time to renew your Medicaid coverage, you will find a “yes” marked in the “Time to Renew” column in the detail area of your account on Your Texas Benefits. If you respond to a renewal request by the indicated deadline, you will continue to have coverage until your eligibility is reviewed and a decision is made.
If you need to reach the Texas Medicaid office by phone, call 211 from inside the state or 877-541-7905, select a language, and press 2.
What should I do if I lose my Medicaid coverage in Texas?
Through May 2024, the HHSC will review eligibility for all Medicaid enrollees in the state. In order to receive Medicaid in Texas, you must meet the following criteria:
You are a Texas resident.
You are a U.S. citizen, permanent resident, or legal resident.
You need assistance with access to healthcare or insurance coverage.
Your annual household income before taxes are withheld meets the limit for your household size.
And you are one of the following:
Currently pregnant
Responsible for the care of a child who is 18 years old or younger
Blind
65 years old or older (and meet certain criteria)
Person with a disability or a household member who has a qualifying disability
If you no longer meet the eligibility guidelines, your Medicaid coverage won’t be renewed. However, your application will automatically be evaluated for HHSC alternatives. Click on the following links to learn about eligibility for these programs and how to apply for:
Family planning program called Healthy Texas Women
If you lose coverage but believe you still qualify, you should reapply for Medicaid in Texas. You may be uninsured for a while if you reapply for Medicaid and need to wait to be approved again. In that case, you may want to look into free and low-cost healthcare options. You can also use free GoodRx coupons to save on your prescription medications.
You should see if you qualify for coverage elsewhere if you don’t plan to reapply for Medicaid and aren’t eligible for another government healthcare program. Depending on your circumstances, you may be able to find health insurance with one of these options:
Affordable Care Act (ACA) marketplace: Through the ACA exchange, you may be able to find coverage for $10 or less per month if you qualify for a premium subsidy. If you lose your Medicaid coverage, you’ll be able to get an ACA plan during an unwinding special enrollment period from March 31, 2023 to July 31, 2024. During this time, you can purchase an insurance plan on the ACA marketplace.
Employer plan: You may want to take advantage of employer-sponsored healthcare if you have a job that offers health insurance benefits.
Medicare: If you have a qualifying disability or condition — such as end-stage renal disease or ALS (amyotrophic lateral sclerosis), commonly referred to as Lou Gehrig’s disease — you can enroll in Medicare at any age.
Partner’s plan: If you have a spouse or domestic partner who has insurance, you may be able to join their plan during an open enrollment or special enrollment period.
Special plans: Short-term insurance can be a great choice if you anticipate a better option, like job-based health insurance, to be available soon. You may also consider alternative and limited-benefit plans, such as fixed indemnity, accident, cost-sharing, and catastrophic insurance plans.
Student health plan: If you’re enrolled in a college or university, you may be eligible for a campus health plan.
U.S. Department of Veterans Affairs (VA): If you are an active-duty service member or a veteran, you may qualify for TRICARE coverage or VA benefits and services.
Texas Medicaid resources
Here are some sites where you can learn more about Medicaid in Texas and upcoming changes related to the end of the PHE:
Texas Medicaid office: The Texas HHSC oversees Medicaid in the state.
Texas Medicaid self-service portal: You can log in to your Medicaid account 24/7 through Your Texas Benefits to update your contact information — including your mailing address and phone number — and learn more about Medicaid and CHIP renewal.
Texas Medicaid unwinding FAQ: The Texas HHSC has prepared a document that provides answers to frequently asked questions about the end of continuous Medicaid coverage.
Stay Covered Texas: This website is a targeted resource for the 2.7 million Texas women and children enrolled in Medicaid.
The bottom line
Automatic Medicaid renewals stopped nationwide on March 31, 2023 because of the upcoming end of the COVID-19 public health emergency (PHE).
Through May 2024, Texas will spend a year reviewing Medicaid eligibility for enrollees. During that time, Texas residents will be contacted either by mail or through the Your Texas Benefits portal about renewal reviews. So it’s important to update your information in the portal to receive any notifications.
If you lose your Medicaid coverage, you may still qualify for health insurance through another provider. Your options may include ACA marketplace plans, Medicare, or job-based insurance.
Why trust our experts?
References
Administration for Strategic Preparedness and Response. (2020). Determination that a public health emergency exists.
Administration for Strategic Preparedness and Response. (2023). Renewal of determination that a public health emergency exists.
Dague, L., et al. (2023). What happens to Texans’ insurance coverage when Medicaid and marketplace pandemic-era policies end? Episcopal Health Foundation.
Episcopal Health Foundation. (2023). New report: 700,000 Texans – mostly children – could lose Medicaid health insurance as federal pandemic public health emergency rule ends.
Medicaid.gov. (n.d.). Unwinding and returning to regular operations after COVID-19.
Stay Covered Texas. (n.d.). Medicaid rules are changing.
Texas Health and Human Services. (n.d.). Medicaid and CHIP.
Texas Health and Human Services. (n.d.). Renew your benefits.
Texas Health and Human Services. (2023). Ending continuous Medicaid coverage.
Texas Health and Human Services. (2023). End of continuous Medicaid coverage FAQ.
Tolbert, J., et al. (2023). 10 things to know about the unwinding of the Medicaid continuous enrollment provision. Kaiser Family Foundation.
Young, C. E. (2023). HHSC resumes Medicaid eligibility redeterminations as continuous coverage requirement ends.
