On Tuesday, hot on the heels of the midterm elections, Rep. Joaquin Castro and 10 other Texas congressional Democrats requested a federal investigation into Texas’ Medicaid application backlog, including scrutiny of contractors involved in processing applications. In July, Texas processed just 65% of applications on time, compared with 81% a year earlier. The federal benchmark is 95%.
More than 200,000 Texans, according to the San Antonio Current, are waiting for Medicaid applications to be processed. A very sorry record, indeed.
The letters, addressed to U.S. Health and Human Services Secretary Robert F. Kennedy Jr. and Texas Health and Human Services Commissioner Stephanie Muth, cite a backlog that grew from 1,671 applications in January to 237,505 by early September. The lawmakers called for federal intervention if the problem is not adequately addressed and urged Muth to seek funding from the state’s Economic Stabilization Fund. They requested a response by November 30.
System strained?
Their concerns extend beyond waiting times. According to the lawmakers, changes associated with the One Big Beautiful Bill Act have strained HHSC’s eligibility system. Because several benefit programs share an integrated application, they warn that technical errors affecting one program can wrongly terminate coverage across others.
For Medicaid dental providers, that is a troubling prospect. A family’s coverage should not disappear because of a technical problem elsewhere in the benefits system.
State Sen. Lois Kolkhorst has defended HHSC’s efforts to prevent fraud and expressed confidence that new tools will improve processing, according to the Current article.
Double standard for Texas Medicaid agencies
Protecting public funds is a legitimate responsibility. So is ensuring that eligible families receive timely access to care. One obligation does not cancel out the other.
Imagine if Medicaid dental providers had such a backlog. What would happen to them? Medicaid providers are expected to meet deadlines, maintain documentation and comply with extensive requirements. Or else.
Families and providers should be able to expect the same timely performance from the agencies administering their coverage. Accountability works both ways.
Accountability coming?
The press release makes the changed political winds explicit. Rep. Lloyd Doggett calls for greater transparency while pointing to Governor-elect Hinojosa and a new Democratic state House majority as incoming leadership tasked with addressing the failures.
With a change in political fortunes, is that accountability finally coming?
For Medicaid dental providers, scrutiny of the program’s administration is a hopeful development. If Texas expects accountability from providers, it should demonstrate that accountability in its own performance. This demand for an investigation is definitely a step in the right direction.
The worm has plenty of reason to turn.