Texas Protects Medicaid Accuracy While 211,000 Applications Wait To Be Checked

AUSTIN—Texas had 211,000 Medicaid applications waiting for a decision in August, allowing the state to protect program accuracy from the risks associated with promptly deciding who qualifies for medical care.

The Health and Human Services Commission processed 65 percent of Medicaid applications within federal time limits in July, down from 81 percent a year earlier and 92 percent in January. Federal rules generally allow 45 days for most determinations and 90 days when disability must be established. Recent state data indicated that half of pending applications waited about 70 days before an eligibility worker began reviewing them.

New federal requirements have added verification and reporting work to the state system. HHSC trained roughly 6,000 employees who process Medicaid and food-assistance cases. An agency spokesperson said the eligibility computer system was not struggling and received routine updates, leaving the queue free to grow without a technical explanation.

Enrollment moved in the opposite direction. Texas Medicaid rolls fell by 252,000 people, or 6 percent, during the 11 months after the federal budget law passed. SNAP participation dropped by 597,000 people, or 17 percent. Children accounted for almost two thirds of those declines, demonstrating that administrative burden can reach dependents without waiting for adulthood.

Texas could owe about $700 million a year toward SNAP beginning in 2027 if its payment error rate remains too high. Accuracy therefore has a price, delay has a caseload and qualified families have a number in the queue. The system is not struggling. It is carefully falling behind.