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More than 500,000 Texans booted off Medicaid following end of COVID-era enrollment

A majority of people lost their health insurance coverage because they didn’t respond to renewal information requests in time

More than 500,000 Texans have lost Medicaid coverage since COVID-era continuous enrollment for the federal health insurance program ended in March, according to Texas Health and Human Services Commission data.

A large majority of those who lost their Medicaid coverage — nearly 405,000 — were kicked off the Medicaid rolls for procedural reasons, like failing to respond to renewal packet requests. Nearly 96,000 were disenrolled because they were no longer eligible for Medicaid or the Children’s Health Insurance Program, known as CHIP.

Public health experts have long anticipated that the end of continuous enrollment, instituted early in the pandemic, would lead to Texans losing their health insurance. Researchers estimate that as many as 1.3 million Texans would lose their Medicaid insurance as eligibility for the program is recalibrated.

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Adult Medicaid enrollees in Dallas County grew from more than 391,000 in 2020 to nearly 455,000 in 2021, according to the county’s 2022 Community Health Needs Assessment. Child enrollees jumped from 297,000 to 346,000. The county had more than 512,000 enrollees at the end of 2022.

Community stakeholders warned that many Texans could get lost in the shuffle of the renewal process. Old addresses and out-of-date contact information mean some people may not receive their renewal packet in time. Medicaid enrollees have 30 days to return updated information once that information is requested by the state.


Women, children and young adults have been most affected by the eligibility reevaluations. Many women who received Medicaid for Pregnant Women and children who have turned 19 since the start of the pandemic are now ineligible. Some families surpassed the program’s income limits, an HHSC spokesperson said.

Texas claims the most uninsured people in the country and routinely rejects Medicaid expansion offered by the federal government. The state ranked 48th for health care out of the 50 states and the District of Columbia in a June scorecard compiled by The Commonwealth Fund.

The state did expand Medicaid for new moms to a whole year after birth in June.


HHSC, which functions as the state arm of the jointly run state and federal Medicaid program, has been preparing an off-ramp from continuous enrollment since December, when a federal spending bill declared the pandemic policy would end. The agency increased its workforce to deal with huge numbers of renewal requests that will have to be processed.

Nearly 112,000 Texans maintained their Medicaid of CHIP status, according to state data. Another 173,000 are still in the renewal evaluation process. HHSC will release the next report of Medicaid enrollees in August.

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