Jae C. Hong/AP
Since Texas began checking people for Medicaid eligibility after pandemic-era coverage ended earlier this year, more than 1.4 million people across the state have lost health coverage. Nearly 60% of the people who lost coverage during the Medicaid relaxation period are children. That’s nearly 729,000 more children than the entire population of El Paso.
Health policy advocates worry that the rate of uninsured children will only rise as the state continues its Medicaid redetermination process until next summer.
“We’re back to business as usual in Texas, and Texas has become ground zero for kids losing health care during the furlough,” said Stacey Pogue, senior policy analyst for Avery Techan.
A new report from Georgetown University’s McCourt School of Public Policy shows the impact that continuous reporting has had on children during the pandemic.
From 2019 to 2022, the number of uninsured children nationally decreased from about 4.4 million children in 2019 to 3.9 million in 2022. Texas also saw a decline: About 854,000 were uninsured in 2022, which is down from nearly a million in 2019.
“This report has such a hopeful message for Texas,” Pogue said. “We don’t need to have kids going on and off coverage all the time with gaps in care.”
Six Texas regions are in the top 10 metro areas with the highest child uninsured rates, according to the report. Sherman-Denison, which is part of the larger DFV metroplex, had the third highest rate at 13.9% in 2022. The national rate was 5.1%.
Texas overall has the highest rate of uninsured children at 10.9%, more than double the national rate. A Georgetown University report found that American Indian/Alaska Native and lower-income Hispanic/Latino children were more likely to be uninsured than other groups.
“In Texas, our state leaders have unfortunately not prioritized health insurance for children,” Pogue said. “We see it in these reports year after year. Texas always comes out at the bottom, or damn near it.”
Texas is one of 10 states yet to expand Medicaid, with some of the strictest income requirements in the country. This means that most adults who lose coverage will have no other health insurance options. Multiple research studies show that if a parent is uninsured, their children are more likely to be uninsured, even if their children are eligible.
“These poor outcomes for Texas children stem from the clear fact that Texas is making it much harder than it should be for parents to keep their Medicaid-eligible children,” Pogue said.
In one study from Oregon Health and Science University, “children eligible for public insurance who had uninsured parents were fourteen times more likely to be uninsured, compared to their counterparts with insured parents.”
Both adults and children without insurance have worse health outcomes. Older adults with cardiovascular disease and diabetes became sicker, and uninsured children were more likely to be hospitalized and receive no medical treatment for chronic conditions such as asthma or diabetes.
Valerie Smith, a pediatrician in Tyler and a member of the executive board of the Texas Pediatric Society, said she has seen the impact of health insurance on her patients.
“For so many of my patients, Medicaid has been a lifeline that has kept them healthy and safe,” she said. “Basically, Medicaid is a program for children.
She is urging lawmakers to pass legislation to help Texas children access doctor appointments and manage chronic conditions.
“Every society benefits when children and families thrive and are able to address their routine preventive and emergency care needs,” Smith said. “Families deserve peace of mind that they will be able to access the care they need.”
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