Feds: Texas is too slow to process Medicaid, SNAP benefits
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Texas is not meeting federal requirements to process applications for Medicaid health insurance and food benefits quickly, officials said in letters revealed Monday.
Why it matters: Texas has kicked more than a million people off Medicaid for procedural reasons in the last year, many of whom may still be eligible for coverage. Large backlogs can lead to longer waits for people to regain coverage and access health care.
- Also, delayed Supplemental Nutrition Assistance Program (SNAP) benefits make it harder for families facing food insecurity to eat regular, healthy meals.
Threat level: If the state doesn't turn its SNAP system around, Texas could lose millions in federal funding that supports food benefits.
State of play: States paused Medicaid disenrollment during the pandemic, allowing people to keep coverage. They began disenrollment again in April 2023.
- Texas finished those checks two months ago, per the state's latest report. But the state is still processing some cases.
- As of this April, about 2.1 million Texans had lost their Medicaid coverage
— nearly 1.4 million of them for procedural reasons like outdated information, not because they were ineligible, according to the report.
Zoom in: U.S. Rep. Lloyd Doggett (D-Austin) on Monday shared letters federal agencies sent to the Texas Health and Human Services Commission (HHSC) this year about the state's inability to quickly process Medicaid and SNAP applications and monitor costs related to the state's SNAP program.
What they're saying: HHSC "is taking all possible actions to provide benefits to eligible Texans as quickly as possible," spokesperson José Andrés Araiza tells Axios.
- State and federal officials meet regularly to try and reduce the backlog, he says.
- HHSC will keep temporary staff for the next year.
Texas' Medicaid application backlog is detailed in a May 22 letter from the Centers for Medicare & Medicaid Services (CMS).
- States generally have 45 days to decide whether someone is eligible for Medicaid.
By the numbers: About 40% of the state's Medicaid applications are taking longer than that, per the most recently shared data.
The latest: In a June 3 response letter HHSC shared with Axios, the state requested the ability to temporarily renew some applications for people likely to be eligible based on their age or disability, without conducting a full renewal.
- That would extend renewals for 137,000 people this fall so the state can focus on new applications, Andrés Araiza says.
The intrigue: Problems with the state's Medicaid backlog started well before Texas began rechecking participants' eligibility in 2023, according to the May letter.
- The backlog began growing in March 2022 due to staffing shortages, per the letter.
- The state hired more people and reduced the backlog as it began its rechecks last year. But the backlog again increased.
Texas responded by hiring more staff, increasing employee training and reassigning workers from other state jobs.
- Federal officials are concerned it isn't enough, they say in the letter.
What's next: CMS will review Texas' process for determining Medicaid eligibility. Federal officials have not yet requested a corrective action plan.
Texas' backlog of SNAP cases also concerns federal officials.
- The state has reduced its SNAP backlog in 2024 from about 166,000 applications to 90,000. But it hasn't moved urgently, the U.S. Department of Agriculture (USDA) said in a letter last month.
- Only about 67% of SNAP applications meet the required processing timeline in Texas, per the letter. Federal officials want that figure to be 95%.
The state submitted prior plans to fix the problems, but federal regulators said they weren't good enough and didn't address the root causes of Texas' delays.
The bottom line: Backlogs "have a real and significant impact on eligible families who struggle to put food on the table," the USDA told Texas.
Editor's note: This story has been corrected to say states paused Medicaid disenrollment during the pandemic (not eligibility checks) and that Texas began disenrollment in April 2023 (not that it began rechecking eligibility then).