40 Groups Urge Strategic Improvements to TX Health Programs

Forty Texas organizations — including members of the Children’s Health Coverage Coalition, Texas Women’s Healthcare Coalition, and Cover Texas Now — recently sent a letter to top officials at the Texas Health and Human Services Commission (HHSC) thanking them for their tireless efforts during the COVID-19 pandemic, while urging the agency to implement strategic improvements in three key areas.

By taking the proposed steps during the coming weeks and months, state officials would ensure that Texans can better access and utilize state health programs under the system in place during the federal Public Health Emergency (PHE) and ensure that the state is better prepared when the PHE comes to an end. Under federal rules in place during the PHE to address challenges related to the pandemic, Texans who are enrolled in Medicaid remain enrolled in those programs rather than facing the usual barriers to maintaining health coverage. The federal government extended the PHE until January 20, 2021. Many observers expect the PHE to be extended beyond that date.

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These steps are particularly urgent in light of the state’s high uninsured rate. Texas already had the highest uninsured rate in the nation before the pandemic, and hundreds of thousands of more Texans have become uninsured this year as they lose job-based health coverage amid the nationwide employment crisis.

The letter urges state officials to: 

  1. Take specific steps to improve the administrative renewal process for Medicaid and CHIP. Administrative renewal is intended to be an efficient, automated process for keeping eligible Texans’ enrolled in their current health program when it is time to renew their enrollment. Because of inefficiencies in the current administrative renewal process, HHSC staff is forced to manually enroll many clients, creating delays for clients and a backlog of work for state staff. The letter notes that it will be particularly important for the state to improve the administrative renewal process before ending auto-enrollment of women into Health Texas Women (HTW) from Medicaid for Pregnant Women.

  2. Improve instructions sent to clients about renewing during and after the PHE. While Texans cannot be disenrolled from Medicaid during the PHE, the state is still asking them to renew their coverage to prevent a backlog of renewals when the PHE ends. Community-based organizations that assist Texans with health coverage enrollment have reported several examples, outlined in the letter, of Texans receiving contradictory and/or confusing information about these renewals.

  3. Build the provider network for new Healthy Texas Women (HTW) Plus benefits. Texas does not provide a comprehensive health insurance option to most low-income women unless they are pregnant, but the state does offer access to an important, narrow set of services through HTW. The state recently added new services through the announcement of the HTW Plus program. To ensure HTW Plus is able to serve Texas women when they transition from Medicaid for Pregnant women to HTW after the PHE, the state must recruit providers to offer the HTW Plus services.

These proposed administrative steps are in addition to and distinct from the legislative proposals to reduce the state’s uninsured rate by expanding Medicaid eligibility (to include low-wage women for a full year after childbirth or to include low-wage adults more broadly); boost outreach to Texans about insurance options; and to provide 12 straight months of Medicaid coverage to eligible children rather than conducting inaccurate mid-year eligibility checks.

The letter to HHSC provides further information on the three proposed administrative steps outlined above. Additionally, Every Texan provided greater details on administrative renewal challenges and recommendations in an accompanying memo.