Texas Medicaid, SNAP backlogs grew after natural disasters

• The natural disasters are one more wrench in a Medicaid processing system that was already overwhelmed after the pandemic, leading to more than a million Texans losing coverage for procedural reasons.

What they're saying: "If Texas leaders want to tackle the backlog to ensure kids get the health coverage they need, it's time to upgrade technology," the nonprofit Texans Care for Children wrote in a recent blog post.

• It pointed to work the state has done to address its staffing shortage, saying it's not enough.

By the numbers: Applications in the queue for the Supplemental Nutrition Assistance Program (SNAP) nearly doubled from June to August, growing from around 48,300 to about 96,600, according to data Texans Care for Children shared with Axios.

• Medicaid applications in Texas' queue grew from about 167,000 to nearly 213,000 in the same timeframe, a more than 27% increase.
• The nonprofit receives the information from the Texas Health and Human Services Commission (HHSC), which administers the benefits, as part of regular stakeholder calls.

State of play: HHSC hired 642 temporary employees to help with rechecking Medicaid eligibility and will keep them on for the next year to help with the backlogs, HHSC spokesperson Jennifer Ruffcorn tells Axios. The state increased salaries for eligibility workers.

• The agency has also decreased its eligibility worker vacancy rate from last spring, and now has 97% of its full-time positions filled.
• Texas extended by one year the Medicaid renewals for certain people who are older or have a disability, allowing the state to focus on new applications.

How it works: Texas processes Medicaid and SNAP benefits in one integrated system, Ruffcorn says. A backlog in one benefit can affect applications for the other.

• Generally, applications are processed from oldest to newest, but the state first completes renewals and priority applications (like Medicaid applications from pregnant people).

Zoom in: When asked why the backlog was growing, Ruffcorn said HHSC processed more than 350,000 replacement SNAP benefits for people in Southeast Texas affected by a deadly storm in May and Hurricane Beryl in July. There are nearly 1.6 million SNAP benefit cases statewide.

• Texas can issue replacement benefits when food purchased with SNAP benefits is destroyed by a natural disaster, per Ruffcorn.

Catch up quick: The state is under federal review for its slow processing of both SNAP and Medicaid benefits and is working with the Centers for Medicare & Medicaid Services (CMS) on improving its Medicaid backlog.

• States allowed people to keep Medicaid coverage during the pandemic regardless of eligibility. Texas began disenrollment again in April 2023.
• Texas finished rechecking this spring, and kicked more than 2 million people off the program — some of whom were likely still eligible and reapplied.
• CMS sent Texas a letter in May detailing how the state wasn't meeting federal requirements to process Medicaid applications quickly enough.
• The federal agency continues to review Texas' process and work with state officials, a CMS spokesperson confirmed to Axios.

The other side: "HHSC is taking all possible actions to provide benefits to eligible Texans as quickly as possible," Ruffcorn says. "HHSC meets with CMS on a regular basis. We will continue to discuss strategies to best serve our clients."

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).