After the end of a pandemic-era policy, 1.7 million Texans have lost access to Medicaid. For health insurance agents and brokers, that could open enormous opportunities to enroll uninsured consumers in the Health Insurance Marketplace.
Based on normal qualifying conditions for Medicaid, most of these consumers likely would be eligible for $0 premium plans.
According to the Kaiser Family Foundation, 1.7 million Texans who were allowed to remain on Medicaid during and after Covid-19 have now been removed from their plans. The Kaiser Family Foundation estimates 1 million of the newly uninsured are children.
While it appears most of the people who lost Medicaid are still eligible for the federal and state program, there’s an enormous delay in Texas to get people re-enrolled, which means a policy under the Affordable Care Act could be their best option.
Under federal rules, the Public Health Emergency declared in March 2020 gave Medicaid recipients continuous coverage without the need for renewal. But as that federal order expired at the end of March 2023, more than 12 million people across the nation have lost health coverage.
According to data from KFF, more than 70% of people who lost health coverage through Medicaid were removed for procedural reasons. In many cases, Medicaid recipients said they didn’t know where to sign up for renewals.
One of the largest problems in Texas is the state’s ability to handle consumers who are still eligible for Medicaid but do not currently have health insurance.
Stacey Pogue, who works with an organization called Every Texan, told Texas Public Radio that the reason Texans who may be eligible for Medicaid can’t get renewed is because of the tremendous backlog of applications that have not been processed by the state. She said that, as of November, there were still 48,000 applications that have been stuck in the renewal phase since March 2023 and even earlier.
While many of the people removed from Medicaid are simply waiting to get through the state system, Every Texan also estimates that nearly 33% of those removed from the program are, indeed, ineligible for Medicaid.
In an article for Axios, Texas Health and Human Services Commission spokesperson Tiffany Young said renewing Medicaid recipients “is a massive undertaking.”
In order to receive Medicaid in Texas, a 4-person household must have an annual income less than $59,400. A single individual must have income below $28,869. That means many of those who received Medicaid in the past would also qualify for plans under the Health Insurance Marketplace, where there are income minimums based on household size.
