Texas Has Kicked 1.3M Kids Off Medicaid, Most Often for Incomplete Applications

The state has the rest of April to process another 195,000 pending cases


Tens of thousands of Texas newborns have been kicked off Medicaid during unwinding so far (image via Getty Images)

Ninety-five thousand newborns, twice as many toddlers and preschoolers, and more than 1.3 million Texas children overall have been kicked off Medicaid since April 2023.

The latest public data from Texas Health and Human Services (HHS) shows that, in addition to those Texas kids from low-income families who have lost their health insurance, another 195,000 kids are still in limbo with pending applications.

“If you measure a society by how it treats its children, then Greg Abbott’s Texas is a massive failure,” state Rep. John Bucy wrote on X Tuesday. “This is a failure of leadership – and our kids are hurting because of it.”

So how did we get here? During the COVID-19 pandemic, a law passed by Congress blocked all states from kicking people off Medicaid, even if they became ineligible during that time. Last April, that federal legislation expired, and every state began reassessing eligibility in a process called “unwinding.”

“This is a failure of leadership – and our kids are hurting because of it.”  – State Rep. John Bucy on X

Texas’ unwinding stood out. Ours is one of just a few states that have reported disenrolling more people than they enrolled during the last year, according to the tracker maintained by research nonprofit Kaiser Family Foundation. More than half of all Texans disenrolled since last spring were children, and roughly eight out of 10 of those kids lost coverage for procedural reasons, rather than the state fnding them ineligible. That means they lost health insurance because their family had not completed every step in the renewal process on time, per the HHS March report.

Texas’ automatic renewal system may be partly responsible for high disenrollment numbers. If this data-driven computer process doesn’t find a person eligible, their application then goes to state employees for review. KFF’s tracker shows Texas fails to automatically renew people more than any other state except Pennsylvania. Automatic renewals accounted for only one in 10 Texas Medicaid enrollments approved since last spring, while most U.S. states approved the majority of applications through their automatic system. In 13 states, more than three-quarters of enrollments were approved automatically.

We’ll see how enrollment counts shift next month. Texas has until May to process the pending applications that remain.

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