On January 31, 2020, the Federal Government declared a public health emergency (PHE) in response to the COVID-19 outbreak. In March 2020, Congress passed implemented a Medicaid continuous coverage requirement as part of the Families First Coronavirus Response Act (FFCRA). In exchange for an increase in federal Medicaid matching funds, states were required to keep Medicaid enrollees in the program until the end of the month in which the PHE ended, eliminating the need to reevaluate their eligibility and ensuring that people retained coverage during the pandemic.
The Texas Health and Human Services Commission (HHSC)—the agency responsible for administering Texas’ Medicaid programs—implemented the federal directive effective March 18, 2020. Since then, Texas has suspended most Medicaid terminations and eligibility reviews. Because of this, Medicaid recipients have not been required to annual recertify their eligibility for benefits.
However, that suspension is about to end. In December, Congress passed its year-end omnibus spending bill, which delinked the Medicaid continuous coverage requirement from the PHE. Beginning on April 1, 2023, states will resume reviewing all Medicaid enrollees’ eligibility — a process often called “unwinding” — and will begin ending coverage for those found ineligible. An estimated 3.7 million Medicaid members, or about 72% of those in the Medicaid program, will have their eligibility redetermined. Those no longer eligible could be disenrolled as soon as April 1, 2023. HHSC plans to complete all redeterminations and disenrollments within eight months.
To accomplish this unprecedented effort, HHSC is adding and training new eligibility staff. However, HHSC was already severely overworked and understaffed. As of October of 2022, HHSC had a backlog of 70,000 new Medicaid applications. Though HHSC is taking steps to address this backlog, the restart of eligibility redeterminations and reviews will only add to the delays HHSC and its constituents are experiencing.
If you are receiving Medicaid benefits, HHSC will reach out to you when it’s time to renew your coverage. Therefore, making sure that HHSC has your correct and updated contact is critical. You can report any changes at YourTexasBenefits.com, by mail, fax, calling 2-1-1 and selecting option 2.
Timely responding to renewal notices or information requests from HHSC will be imperative to ensure you keep your coverage if you are still eligible. You should be on the lookout for redetermination notices from HHSC, which will look something like this. These notices will be mailed in a yellow envelope that says “Action Required” in red, which will look like this. You will also be sent a notice electronically if have a Your Texas Benefits account and opted to go paperless. Once you turn in your renewal, HHSC will review your application and may ask for missing information or information not available from other sources. If you are still eligible, you will receive a notice from HHSC that says your Medicaid eligibility is renewed.
At Pyke & Associates, we stand ready to assist you with any responses HHSC requires. Call us at (214) 816-0133 or email us at info@dallasprobatelaw.com.
This material has been prepared for informational purposes only, and is not intended to provide, and should not be relied on for, specific tax, legal or accounting advice. We can only give specific advice upon consulting directly with you and reviewing your exact situation.
