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Texas, The Epicenter Of Medicaid Losses

Since the end of a pandemic-era policy that barred states from removing people from Medicaid, Texas has dropped over half a million people from the program, more than any other state.

Juliette Vasquez gave birth to her daughter in June with the help of Medicaid, which she said had covered the prenatal medications and checkups that kept her pregnancy on track.

But as she cradled her daughter, Imani, in southwest Houston one afternoon this month, she described her fear of going without the health insurance that helped her deliver her baby.

This month, Ms. Vasquez, 27, joined the growing ranks of Americans whose lives have been disrupted by the unwinding of a policy that barred states from removing people from Medicaid during the coronavirus pandemic in exchange for additional federal funding.

Since the policy lifted at the beginning of April, over half a million people in Texas have been dropped from the program, more than any other state has reported removing so far, according to KFF, a health policy research organization. Health experts and state advocacy groups say that many of those in Texas who have lost coverage are young mothers like Ms. Vasquez or children who have few alternatives, if any, for obtaining affordable insurance.

Ms. Vasquez said that she needed to stay healthy while breastfeeding and be able to see a doctor if she falls ill. “When you are taking care of someone else, it’s very different,” she said of needing health insurance as a new parent.

Enrollment in Medicaid, a joint federal-state health insurance program for low-income people, soared to record levels while the pandemic-era policy was in place, and the nation’s uninsured rate fell to a record low early this year. But since the so-called unwinding began, states have reported dropping more than 4.5 million people from Medicaid, according to KFF.

That number will climb in the coming months. The Congressional Budget Office has estimated that more than 15 million people will be dropped from Medicaid over a year and a half and that more than six million of them will end up uninsured.

While some people like Ms. Vasquez are losing their coverage because they no longer meet the eligibility criteria, many others are being dropped for procedural reasons, suggesting that some people may be losing their insurance even though they still qualify for it.

The upheaval is especially acute in Texas and nine other states that have not adopted the Affordable Care Act’s expansion of Medicaid, all of which have state governments either partly or fully controlled by Republicans. Under the health law, states can expand their Medicaid programs to cover adults who earn up to 138 percent of the federal poverty level, or about $41,000 for a family of four.


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