Nearly 1.7 million Texans lose Medicaid as state nears end of “unwinding”

Nearly 1.7 million Texans have lost their health insurance — the largest number of people any state has removed — in the months since Texas began peeling people from Medicaid as part of the post-pandemic “unwinding.” Around 65% of these removals occurred because of procedural reasons, according to the state.

Texas' Health and Human Services Commission has neared the end of a chaotic and overburdened process to remove people from state Medicaid insurance who became ineligible during the coronavirus pandemic. The state had not unenrolled people before this year because of federal pandemic rules, which forbid states from cutting coverage.

As a result, more than 5 million Texans had continuous access to health care throughout the pandemic through Medicaid, the joint federal-andstate-funded insurance program for low-income individuals. In Texas, the program's eligibility criteria is so restrictive, it mainly covers poor children, their mothers, and disabled and senior adults.

But the effects of speedrunning this process have reverberated: Still-eligible Texans were kicked off both in error and for procedural reasons, adding to backlogs of hundreds of thousands of Medicaid applications and pushing wait times back several months. Backlogs for SNAP food benefits applications, which the same state agency also manages, also skyrocketed because of the burden.

“The state handled this with an incredible amount of incompetence and indifference to poor people,” U.S. Rep. Lloyd Doggett, D-austin, told

The Texas Tribune. “It's really appalling.”

Doggett has repeatedly demanded for changes in the process, most recently sending a letter to the U.S. Centers for Medicare and Medicaid Services calling their scrutiny of the state “woefully inadequate.”

He said he also contacted the agency overseeing the nation's Supplemental Nutrition Assistance Program program, the U.S. Department of Agriculture, about improving the state's food benefit access during this time. He suggested pausing upcoming SNAP renewals so Texas staffers could focus on working through backlogs first.

Neither federal agency had responded to him as of Thursday morning, he said.

As of Dec. 8, there were 207,465 SNAP applications and 288,939 Medicaid applications waiting to be processed, according to HHSC spokesperson Tiffany Young.

“Nobody who watched this is surprised about the backlog. We had delays before the unwinding, and then we put a gigantic amount of work on the system that wasn't spaced in any sort of even, realistic way, that was totally front-loaded,” said Stacey Pogue, a senior policy analyst at Every Texan.

“The way the state's choosing to do this is one gigantic, long backlog. That's a choice, and it hurts people in need,” she added. “But they had other choices to take workload off the system without asking people to wait and wait and wait and wait.”

The wait time for Texans who now apply for both SNAP and Medicaid has decreased to a little over a month,