Texas says it needs 12 months to properly reverify everyone receiving Medicaid
The Texas Health and Human Service Commission reiterated Friday that it needs 12 months to properly reverify six million people on Medicaid in the Lone Star State.
The commission emphasized the need to take a year in response to an American-Statesman story about problems with the unwinding of Medicaid in Texas, determining whether people remain eligible for the program after the end of the pandemic health emergency. Advocacy organizations and a group of whistleblowers at the commission have said that the state is trying to reverify people too quickly, even in as little as six months for those who received continuous coverage during pandemic. The HHSC says that is simply not true.
"We are initiating renewals for the maintained population, or those who maintained coverage because of continuous Medicaid, within the first 6 months, but we still must redetermine the entire Medicaid population through normal renewals (about half of the Medicaid population) that will be initiated throughout the 12 months," Tiffany Young, a public information officer for the commission, said via email.
How is the reverification process working?
Medicaid is medical insurance available for pregnant women, children and people with disabilities who make below a certain income. For a family of four in Texas, their income has to be less than $3,083 a month. For a pregnant woman with a family of four it is less than $4,579 a month.
Beginning in April, all states have had to reverify recipients who had continuous coverage during the pandemic. That continuous coverage has ended. Medicaid recipients have to supply information such as current income to maintain coverage, or they'll be dropped from Medicaid.
The state is verifying people who had continuous coverage in three cohorts:
The first cohort began with the people most likely to no longer qualify because they have aged out or are no longer pregnant or had a child age of out of Medicaid.
The second cohort included people who were likely to transition to a different kind of coverage.
The third cohort is anyone who wasn't in the first two cohorts, such as children on Medicaid, older adults and people with a disability.
From April 1 to July 31, the state has initiated the process of reverifying 2.5 million Texans, or about 42% of people currently on Medicaid, according to the state's dashboard. That included the first cohort.
In that first cohort, 242,717 people were approved; 616,554 people were denied. Of those denied coverage, 490,723 people were denied for procedural reasons; 125,831 were denied because they were determined ineligible, according to the state dashboard.
The results from the second cohort are expected to be released this month.
The state began to verify the third cohort this month.
Since Aug. 10, Texas sent out 1,472,661 renewal forms by mail and 1,089,848 renewal forms by Your Texas Benefits app and website as well as 736,625 text messages, 202,828 emails and 951,616 robocalls.
The additional almost 3.5 million others will be done by July 2024, the state said. Many of those people were not part of continuous coverage and are part of the normal annual reverification process.
The number of initial denials, especially the procedural denials, has drawn the attention of advocacy groups, a group of whistleblowers at the commission, U.S. representatives from Texas and the Centers for Medicare and Medicaid Services, which oversees the states' Medicaid programs.
"We've had concerns about it throughout," said U.S. Rep. Lloyd Doggett, of the process of the state is taking to reverify people.
Texas is not alone in its Medicaid reverification problems.
Parents who qualify for Medicaid should not have their minor children denied coverage. Instead, through the ex parte system, which uses available data, the children should be automatically reverified. Texas only had about 20,000 people verified through the ex parte system in the first cohort, according to the state dashboard.
If states can determine eligibility for one household member, they should be able to verify eligibility for the rest of the household members and not remove an individual family member from coverage.
CMS told states in the Aug. 30 letter to pause procedural terminations if the ex parte system is not working until the state can ensure that the technical systems are working and people who qualify are not disenrolled. They also have to reinstate coverage for anyone who was disenrolled because they could not verify an individual's coverage in a household that did qualify for coverage.
The Aug. 30 letter from CMS tells states to fix the systems and processes. They should either identify who was affected by being disenrolled when their family members qualified and re-enroll them, or they should suspend the renewal process until the systems and processes are fixed.
States can also waive the requirement to redetermine eligibility for these folks for an additional 12 months.
CMS is also reviewing any additional strategy a state might have.
This article originally appeared on Austin American-Statesman: Texas Medicaid renewals to take a year to properly reverify recipients
