Hundreds of thousands of low-income children keep losing basic health care in Texas. Does the governor care?
Underfunding public education is not the only way the people we call “state leaders” in Texas persistently harm thousands of children and jeopardize their futures. Another way is denying low-income children the health care they need not only for healthy lives but also for success in school.
For years, Texas has had the disgraceful distinction of being the national leader among the states in the percentage of residents without health insurance. Many of those people are children, many of school age. More than 60 percent of the students in Texas public schools are from low-income families and should be eligible for health care either though Medicaid or the Children’s Health Insurance Program (CHIP).
But the policymakers at the top of Texas’ political ladder do not make public health a priority, much like they don’t make a priority of public education. For starters, Texas is one of only 10 states that have not expanded Medicaid eligibility for poor people, even though the federal government under the Affordable Care Act, or Obamacare, would pay for most of the costs.
Instead, Texas has some of the strictest income requirements for public health care in the country and makes it difficult – through red tape and excessive paperwork requirements — for low-income people who are eligible for Medicaid to enroll in the program and stay enrolled.
The result was that nearly a million Texas children were without health insurance in 2019, shortly before the breakout of the COVID 19 pandemic, when the federal government adopted protections to help keep people enrolled in Medicaid during the health emergency. Even with those protections, though, more than 800,000 Texas children were still without health insurance in 2022.
Now that the federal government has removed the Medicaid coverage protections imposed during the pandemic, the number of Medicaid enrollments in Texas has started dropping even faster. During this so-called “unwinding” process, Texas removed some 1.7 million people statewide – many apparently who were still eligible for Medicaid – from health care coverage between April 1 and mid-December. Most of the people dropped from coverage – about one million — have been children, and the process continues.
“Texas is moving at breakneck speed to cull its Medicaid program without adequate staffing or technology to do the job right,” Every Texan, an advocacy group for low-income Texans, posted on its website. “The state has not actually determined whether a majority of the people removed were eligible or not, and more were cut off in error in apparent violation of state and federal law. While it’s both expected and appropriate for people who no longer qualify to be removed from Medicaid, Texas’ haphazard approach is certainly tossing out many eligible people too.”
Who is at fault? Ultimately, it is Gov. Greg Abbott and legislative leaders who have not made health care, even for children, a high priority, even last year, when lawmakers had a record $33 billion budget surplus, which they didn’t use to increase public education funding either.
The neglect is so bad in this state that Texas and only eight other states accounted for about 60 percent of the entire national decline in children’s Medicaid and CHIP enrollment from March through September of 2023, the federal government has reported.
President Biden’s health and human services secretary has called on Texas and these other states to take steps allowed under federal law to put and keep more eligible children in the health care programs. In other words, the Biden administration is urging Texas officials to try harder to keep children healthy.
But does Gov. Abbott really care?
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