Despite what seems like an unrelenting flow of disagreements on political and public policy issues, it is important we come together to solve important problems — especially when it involves the most vulnerable among the next generation.
While our organizations, the Texas Public Policy Foundation and Texans Care for Children, do not always agree on every policy issue, we do strive to collaborate on policy solutions where we can. In this case, we agree that the Texas Legislature has a unique opportunity to fix unintended bureaucratic barriers in Medicaid that are hurting the children for whom much of the program was intended.
In 2019, approximately 400,000 Texas children were eligible for Medicaid but were not covered. We believe it’s because the eligibility system itself is to blame. It’s understaffed, it’s difficult to navigate, and there are unintended bureaucratic barriers that make it difficult for parents to sign up their children.
There are in-person barriers. Applications or renewals are inaccessible for many working parents because field offices are not open on weekends or evenings, or were permanently closed during the pandemic.
There are online barriers. For example, if you forget your password for the YourTexasBenefits.com website (and who doesn’t?), you can’t retrieve it or reset it online. You have to call 2-1-1 — during business hours.
Oh, and that’s a problem too. Wait times on hold with 2-1-1 are typically 45 minutes — and often more than an hour — which is longer than the standard lunch break. This leads to parents having to hang up when their lunch break is over, often the only time they can call during the day. Even when parents do get connected, their call is dropped altogether.
Even when families overcome these barriers, there are system problems that can get their application delayed or dropped. The Texas Health and Human Services Commission has lost about 1,000 eligibility workers, contributing to long delays in processing applications.
There needs to be more urgency from the Texas Legislature in helping eligible children.
What can be done? First, the Legislature needs to revitalize the state’s health coverage education, outreach and application assistance efforts, including state funding for community-based organizations, such as food banks or local health centers, to conduct outreach and provide application assistance to families with eligible children.
The Legislature can provide funding to HHSC to update eligibility and enrollment technology, including investing in 2-1-1 call centers and modernizing YourTexasBenefits website and app so Texans can reset their passwords. And the Legislature can provide funding to reduce the significant number of HHSC eligibility worker vacancies.
Next, Texas can leverage SNAP enrollment as an indicator of Medicaid or CHIP eligibility under the Express Lane Eligibility option that is used in Alabama, South Carolina, Iowa and Louisiana, among other states. HHSC would use already-verified information — such as income, household size, and other factors of eligibility — from the SNAP program to simplify health coverage enrollment.
We have other suggestions, too. But we have something else: hope, and a high level of confidence that Texas lawmakers can come together and improve the system — because they’ve done it before.
In the 2021 regular session, lawmakers passed important bills on telemedicine, children’s health coverage, and extended Medicaid eligibility to new mothers for six months after childbirth. Building off of these accomplishments, lawmakers have already signaled that their priorities next session include ensuring that eligible children can enroll in Medicaid health insurance and addressing maternal health by allowing new mothers to keep health coverage for 12 months postpartum.
The Texas Legislature needs to put politics aside and ensure that the tens of thousands of Texas children who are already eligible for Medicaid can enroll in health coverage and stay covered. And that’s good for all of us.