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Weekly Brief, February 28th, 2023
Focus: Healthcare
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Now is the Time for Medicaid Expansion
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The 88th Legislative Session provides another opportunity for lawmakers to improve the health of our state by adopting Medicaid expansion. Medicaid expansion is one of the most important policies that the legislature could enact to expand healthcare coverage and improve outcomes across the state. Texas continues to have the largest number of uninsured Americans with 5.2 million or 18% of the population lacking access to affordable health insurance. Yet Texas remains one of 11 states that has refused to expand Medicaid coverage. Medicaid Expansion would allow an estimated 1.4 million Texans or 34% of the uninsured population to access coverage. This includes 771,000 Texans who are currently in the coverage gap (those whose income is too high to qualify for Medicaid, but is too low to access marketplace subsidies).
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In addition to ensuring that more Texans have access to health insurance, Medicaid expansion is both popular and makes fiscal sense. A recent survey from the Episcopal Health Foundation (EHF) found that 69% of Texans want the state to expand Medicaid. A 2020 report from EHF found that the state would see a $54 million dollar annual surplus if Medicaid was expanded. With the federal government responsible for 90% of costs, Texas’ contribution would only be 10% or $650 million. The state currently spends $704 million on Medicaid programs, which means that we could both save money and provide more than a million people with health insurance. In addition, Medicaid Expansion has strong financial
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benefits for providers. A recent Kaiser Family Foundation report found that Medicaid expansion lowers the costs associated with uncompensated care, improves hospitals’ overall revenue and reduces hospital closures. A Commonwealth Fund report found that Medicaid expansion would create 298,900 new jobs in Texas across a number of different sectors including healthcare, construction, and retail.
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A number of full Medicaid Expansion bills have been filed this session. In the House, two bills, HB 132 from Representative Bucy and HB 512 from Representative Bernal, have been referred to the House Select Committee on Healthcare reform. In the Senate, SB 39 from Senator Zaffirini, SB 71 from Senators Johnson and Blanco, SB 125 from Senators Alvarado, Blanco,Eckhardt, Gutierrez, Menéndez and Whitmire, and SB 671 from Senator West, have all been referred to the Health & Human Services Committee. CCPPI will continue to track these bills as they move through committee.
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Call to Action 
#SickOfItTexas has put together a comprehensive guide to contacting your representatives to advocate for Medicaid Expansion. The guide includes a script you can use and an easy way to look up your state representative’s phone number.
On March 2nd, #SickOfItTX will be holding a People’s Hearing for Medicaid Expansion. This is an opportunity for people to tell their healthcare stories and how Medicaid expansion is needed in the state of Texas. For more details on how you can participate, click on the link above.
The Texas Civil Rights Project will be holding a Legislative Training Session on February 28th to learn more about the legislative process and identify opportunities to take action. You can register for the event here.
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Update on extending Postpartum Medicaid Coverage
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On February 23rd, House Speaker Dade Phelan released a few of his legislative priorities, which included extending postpartum Medicaid for 12 months. Representative Toni Rose is leading the efforts in the House with HB 12. Representative Rose was the author of last session’s HB 133 extending postpartum Medicaid for 12 months, which passed the House, but was cut to 6 months in the Senate. The fate of HB 133 is currently in limbo as the Biden administration denied the state’s application for a 1115 waiver finding it was not approvable in its current form. With the upcoming Medicaid wind-down, it is critical that the legislature act to ensure that pregnant women are covered beyond 60 days.
CCPPI is a member of the Harris County Medicaid Expansion Coalition, which recently testified in favor of extending postpartum Medicaid for twelve months. Hunter Ryan spoke on behalf of the coalition at the Senate Finance Hearing on February 21st. His written testimony, with CCPPI's signature, can be found here.
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Medicaid Continuous Enrollment ends March 31st, 2023
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On March 31st, 2023, the continuous Medicaid enrollment provision will be ending. The requirement was created through the enactment of the Families First Coronavirus Response Act (FFCRA), which mandated that states keep people continuously enrolled in exchange for enhanced federal funding. The requirement was to remain in place through the end of the declared public health emergency. The Consolidated Appropriations Act passed at the end of December, delinked the continuous coverage requirement from the public health emergency and set March 31st, 2023 as the end of the program. This means that as of April 1st, 2023, states can begin the disenrollment process.
The continuous enrollment provision, which required states to maintain coverage for most Medicaid recipients and barred terminations, saw Medicaid enrollment grow to 91.3 million in October 2022. The Kaiser Family Foundation estimates that between 5.3 and 14.2 million people might lose coverage during the twelve months that states have to review eligibility. This is slightly less than the estimate of 15 million people from the Department of Health and Human Services (HHS). There is fear that, due to staffing shortages in state Medicaid offices, many enrollees will lose coverage for administrative reasons. An article from the Center on Budget and Policy Priorities reports that, “...64 percent of Latino enrollees, over half of Asian/Native Hawaiian/Pacific Islander enrollees, nearly 40 percent of Black enrollees, and nearly half of multiracial and other non-white enrollees who will lose Medicaid coverage during unwinding are predicted to lose coverage through administrative churning even though they’ll still be eligible.”
In Texas, Medicaid enrollment grew by approximately 1.3 million, almost a million of whom were children and 256,000 were pregnant women. A recent study found that postpartum women with continuous Medicaid were 50% more likely to seek preventative care. It is not yet known how many enrollees in Texas will lose coverage during the wind-down, but an estimate from the Health and Human Services Commission (HHSC) found that 2.97 million new and extended enrollees would need to have their eligibility re-assessed. There is concern that staffing shortages at HHSC (the agency is down more than 300 “eligibility advisors”) may slow down the process of reviewing applications. Given the data that many of those that lost eligibility will do so due to administrative errors, this may increase the possibility of people losing coverage even though they are eligible.
Call to Action
#SickOfItTexas as a guide to the changing Medicaid rules that can be found here. The HHSC website has additional FAQs and information on how to manage eligibility.
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Days of Action
The Transgender Education Network of Texas (TENT) will be holding its Trans Advocacy day on March 8th, at the Capitol. For more information and to sign up, click here.
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A donation would help the Center for Civic & Public Policy Improvement continue to fight for justice through our policy, advocacy, and community work. Our work contributes to the development and promotion of affordable housing, equitable education opportunities, access to quality healthcare, and reforms to the criminal justice system.
Click here to make a donation.
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Check out our social media pages & website below for updates on CCPPI’s work, local advocacy efforts, opportunities to take action, and stories on the topics of housing, healthcare, education, and criminal justice and safety.
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The Center for Civic and Public Policy Improvement is a non-profit organization dedicated to advancing policies that promote human, civic, social, and economic justice, and to taking the necessary action to affect progress in all areas of civic improvement throughout the culturally diverse communities in the Southern United States.
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