Bill cutting procedural roadblocks for kids with Medicaid picks up steam in Texas legislature

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AUSTIN (Nexstar) — A bill that aims to keep eligible children from getting kicked off Medicaid due to procedural roadblocks is picking up steam at the Capitol.

House Bill 290, authored by State Rep. Philip Cortez (D-San Antonio), has already passed in the House and had its first hearing in Senate committee on Friday.

Right now, Texas Health and Human Services sends requests for Medicaid eligibility verification to families within eight months of qualifying and only gives them limited time to respond.

The clock starts ticking as soon as HHSC mails the paperwork, and families only have 10 days to get the necessary documents and mail it back or lose their child’s coverage.

Dr. Lindy McGee, representing the Texas Pediatrics Society, has been fighting for the bill to help patients like hers.

“This current process is just burdensome and unnecessary at best and harmful to the child’s health and well being at worst,” Dr. McGee said. “They would qualify for Medicaid, they need Medicaid, and they need the services Medicaid offers. But because of paperwork and mail and this process, they end up losing their coverage.”

She explained many times a family doesn’t even realize they missed a deadline.

“The patients show up, they may not realize that they don’t have coverage. They may end up having to pay out of pocket, which can be extremely expensive. Or if we do catch it, it’s a missed appointment, and that they then have to try and get their coverage rescheduled appointment,” Dr. McGee said.

She explained this can lead to even more severe problems for those needing early development specialists.

“I could easily have a two-and-a-half year old come in for a checkup; I’m concerned that patient may have autism. We know that early services makes a huge difference in autism,” Dr. McGee said. “It takes a while to get into the developmental pediatrician. So I make that referral and make speech therapy referrals. But then by the time the appointment comes up the patient, the family has inadvertently lost Medicaid, and so they’re unable to get those important follow up appointments. They have to come back to see me. We start the process all over again.”

The bill also aims to knock these mid-year checkpoints from four to one.

“Ensuring that fewer of these vulnerable children cycled on and off the program or were forced to go without health insurance,” Republican Senate sponsor of the bill Lois Kolkhorst of Brenham said during Friday’s hearing.

The bill has bipartisan support, with only 16 Republican lawmakers voting it down in the 150-member House earlier this session. That opposition could be related to mere partisan policy.

“The fact that the bill has to do with Medicaid, it’s kind of a hot button issue, but the fact of the matter is, this has to do with kids covered by Medicaid and it doesn’t have anything to do with Medicaid expansion,” Katie Mitten, a health policy associate with Texans Care for Children, said.

She said she hopes the bill will continue to get support from both sides of the aisle.

“This bill is really important for making sure that kids are healthy, making sure that they’re able to go to the doctor and get any sort of care that they might need,” Mitten said.

The bill still awaits a vote in committee. If approved, it heads to the Senate floor.

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