Growing Medicaid Application Backlog Leaves More Texans Waiting for Health Care
Texas families depend on Medicaid health insurance for timely access to health care. Medicaid covers nearly half of all births in Texas and provides health coverage for millions of children, pregnant women, seniors, and Texans with disabilities. When someone loses a job, has a baby, or experiences another life change, they often need Medicaid coverage quickly to access doctor visits, prescriptions, prenatal care, and other essential health services.
Unfortunately, new state data published by Texans Care for Children show that the state’s Medicaid eligibility system is falling further behind. Over the past several months, the number of Medicaid applications awaiting assignment to an eligibility worker has increased dramatically, while fewer applications are being processed within federal timeliness standards.
HHSC’s monthly operational data show a sharp increase in the number of Medicaid applications sitting in the agency’s queue before an eligibility worker has even begun processing them. The backlog grew from 2,000 applications in January to 183,000 in July.
At the same time, HHSC’s performance on federal timeliness standards has declined substantially.
Federal rules require Medicaid eligibility determinations to be completed within 45 days for most applicants. Unfortunately, while the state completed 92% of applications on time in January, by July it was completing only 65% of applications within federal standards.
Without action by state leaders, these delays will continue, leaving eligible Texans waiting weeks — or even months — for the health coverage they qualify for.