Commentary: Children left uninsured

Recent data by the Census Bureau show that Texas continues to lead the nation in the number of children without health insurance. In fact, Texas has held this shameful title for 15 years straight. Two out of every three children in Texas who lost healthcare coverage between 2022-23 were Hispanic. The percentage of uninsured children in Texas is more than double the national average. Administrative hurdles and paperwork are responsible for removing more than 1.35 million eligible children from Medicaid and CHIP last year. In a September 2024 ProPublica/Texas Tribune investigation, the Texas Health and Human Services Department acknowledged their errors in rushing to remove children from their coverage. This is despite several warnings from federal officials and from advocates including us at UnidosUS.

These alarming statistics mean many children in Texas go without critical preventative care, risking long-term health problems and even life-threatening complications from otherwise treatable conditions. While many states, including those led by Republican governors, have successfully reduced their uninsured child populations by leveraging federal funds, Texas has not and continues to lag behind all other states in protecting the health of its children.

Texas’ bureaucracy and red tape confront working families when trying to maintain Medicaid or CHIP coverage. Due to complicated paperwork, tough eligibility checks and inconsistent communication, many eligible children get removed from coverage each year. Families are often unaware that their children have lost coverage until they are already in the doctor’s office, creating confusion and hardship.

Texas has a harsh eligibility verification process that forces families to constantly reapply or submit new documentation. These requirements put more burden on working families who already face significant challenges to access and maintain health coverage. In some cases, families must submit paperwork multiple times, leading to delays and denials. This creates a cycle where children lose and regain coverage, resulting in interrupted care and poor health outcomes.

Texas, under Gov. Greg Abbott’s leadership, has taken minimal action to reform these processes, instead maintaining a tougher approach that only adds to the problem. Gov. Abbott and legislators have chosen not to extend Medicaid for low-income Texans or to fully use available federal funds allocated in 2021 to modernize the state’s health care system.

Children without health insurance are less likely to receive necessary vaccinations, preventive care or treatment for chronic conditions. They are more likely to miss school due to illness, which affects their long-term educational outcomes and economic prospects. Untreated asthma, diabetes or infections can lead to hospitalizations that could have been easily prevented with timely care. For example, a young Texas boy with a rare heart condition was unnecessarily removed from coverage, which resulted in his parents needing to find $6,000 for life-saving medication and unable to pay for a necessary ultrasound.

Additionally, a lack of routine doctor visits means that many developmental and mental health issues go undiagnosed, compounding the challenges these children face.

Despite these alarming trends, the Texas government fails to act. The state has refused to invest in solutions that could reverse this trend, such as simplifying Medicaid/CHIP renewal processes, expanding outreach to families, and improving communication from state agencies. Gov. Abbott has largely ignored calls for change, leaving thousands of children to face the harsh realities of being uninsured. This lack of action shows a disturbing disregard for the health and future of Texas’ children.

The solutions and needs are clear. Our September 2024 UnidosUS Latino Issue Polling for Texas shows that Hispanic communities want quality and affordable health care. Medicaid and CHIP can ease the financial burden on working families. Texas must reform its administrative processes for Medicaid and CHIP to ensure that children who are eligible remain enrolled and those who are uninsured but eligible can access the care they need to thrive. This can be done through simpler eligibility verification, better outreach and removing unnecessary bureaucratic barriers.

The human cost of inaction is too great. Texas cannot continue to lead the nation in uninsured children — it’s a crisis that demands immediate attention. The health and future of Texas’ children are at stake, and it’s time for Gov. Abbott and the Texas Legislature to prioritize their well-being.

The longer Texas delays addressing this issue, the more children will suffer. They are waiting for the leadership they deserve.

Eric Holguin is Texas state director of UnidosUS.