Support HHSC's Funding Request: Make the Medicaid Enrollment System Work for Families

It’s Time to Finally Bring the State’s Health and Human Services IT System into the 21st Century

Support HHSC’s Exceptional Item #2: 
A Request to the Legislature for One-Time Funding to Make TIERS Work for Families

For years, the state has used a clunky, inefficient, outdated system to process applications and renewals for SNAP and Medicaid health insurance:

  • The system over-relies on expensive manual processes and underutilizes technology.

  • When families submit online applications and renewal forms for Children’s Medicaid, HHSC staff must manually re-enter the data into the system.

HHSC data show the results are unacceptable:

  • According to HHSC, “Since 2019, Texas has not consistently met federal timeliness standards for SNAP, Medicaid, CHIP, and TANF eligibility determinations.”

  • During 50 of the 60 months from 2019 to 2023, Texas failed to meet national standards for processing Medicaid applications on time.

  • There has been a backlog of more than 200,000 unprocessed Medicaid applications for 7 of the last 10 months in 2024.

  • In December 2023, parents waited an average of 41 days for a Medicaid eligibility determination — with some waiting over 160 days.

  • It currently takes years to update the system to implement changes passed by the Legislature.

State leaders should ensure children who are eligible for health insurance can actually sign up. Otherwise, children will miss check-ups, medications, support for mental health challenges, and more.

The state has invested in hiring more eligibility staff and paying overtime, but the problem persists — underscoring the need to improve technology. After the Legislature provided funding in 2023, HHSC onboarded more than 2,100 eligibility workers and maintains a 97 percent fill rate for full-time positions.

Please support Exceptional Item #2 in HHSC’s budget request. It will equip HHSC to improve the integrated eligibility system (TIERS), YourTexasBenefits.com, and the Your Texas Benefits mobile app and improve efficiency by maximizing the use of verified data.

Cover Texas NowMedicaid, State Policy