Millions of Texans Will No Longer Have Health Insurance

Ethel Ruano reapplied for Medicaid coverage in May, something she hadn’t done in three years. Ruano said she earns $360 to $400 per week cleaning houses part-time in Fort Worth. Her family consists of her husband and three children. Her 16-year-old son was on Medicaid during the pandemic, but he must now be reevaluated for coverage.

The COVID-19 pandemic was deemed a public health emergency in March 2020, and actions were taken to assist struggling Americans. The Families First Coronavirus Response Act prohibited states from removing people from Medicaid during the pandemic, regardless of eligibility status.

Nationwide, approximately four million Americans have been kicked off Medicaid since the end of a pandemic-era guarantee that those with the safety-net health care would be able to keep it. Enrollment in Texas Medicaid surged by 1.6 million people, or 41%, during the first month of the Act’s implementation. Over 5.9 million Texans had enrolled in Medicaid three years later. That’s two million more than at the start of the pandemic.

It is estimated that 50,000 people will lose Medicaid coverage in Dallas County. In addition to 15,000 people in Denton County. 18,000 people in Collin County, and 50,000 people in Tarrant County will lose their health insurance coverage.

Texas began its unwinding process in April 2023. Hundreds of thousands of Texans have been kicked off Medicaid since then.

Ruano has not been informed whether she is eligible for coverage. When she originally filed for Medicaid in May, she said a Texas Health and Human Services official informed her she wouldn’t know if she was eligible until July. Texas must complete the unwinding of ineligible participation by May 2024.

The Texas Health and Human Services Commission (HHSC) has hired about 1,000 people as a result of the increased number of cases since April 2022.

In Texas, most of those who have been removed from Medicaid in recent months are ineligible because they either turned 19 during the pandemic, their family’s income increased, or it has been more than two months since they gave birth.

According to KFF, the majority of those in the U.S have been removed rom Medicaid for reasons unrelated to whether they are eligible for the program. Three-fourths have been eliminated due to bureaucratic reasons. Such “procedural” cutoffs — caused by renewal notices not arriving at the correct addresses, beneficiaries not understanding the notices, or a variety of state agency errors and logjams — were a risk that federal health officials had warned states about for months as they coached states on how best to carry out the unwinding.

Medicaid is a lifeline for millions of Americans. People may remain uninsured if they lose their coverage. Many people simply cannot afford health insurance. In some cases not having healthcare coverage can even be fatal. Everyone should have access to affordable healthcare.


Goldstein , Amy. “Nearly 4 Million in U.S. Cut from Medicaid, Most for Paperwork Reasons.” The Washington Post, 28 July 2023,

Farris, Gloria. “More than 670,000 Texans Lose Medicaid Coverage as the State Unwinds Continuous Enrollment.” Texas Standard, 31 July 2023,

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