Texas’ uninsured child crisis – a failure of state leadership

Recently, the Census Bureau released data showing that Texas was the state with the highest rate of uninsured children in 2023.

Texas left all other states in the dust, with 12% of children lacking health insurance. In second place was Arizona, where 7% of children were uninsured. The national average was 5%. Simply put, a childhood without health insurance is more than twice as common in Texas as in the rest of America.

These rankings are nothing new. Texas has held this embarrassing title for 15 years in a row. And each year, two out of three uninsured children in Texas are Hispanic.

Administrative hurdles and paperwork were responsible for removing more than 1.35 million eligible children from Medicaid and CHIP last year. In a September 2024 ProPublica and Texas Tribune investigation, Texas Health and Human Services acknowledged mistakes in rushing to remove children from their coverage. This is despite several warnings from federal officials and from attorneys, including us at UnidosUS.

While many states, including those led by Republican governors, have successfully reduced their uninsured child populations using federal funds, Texas does not lag behind all other states in child health.

The bureaucracy and red tape in Texas confront working families as they try to maintain Medicaid or CHIP coverage. Due to complicated paperwork, stringent eligibility checks, and inconsistent communication, many eligible children lose coverage each year. Families are often unaware that their children have lost coverage until they get to the doctor, causing confusion and hardship.

Texas has a strict eligibility verification process, which requires families to continually reapply or submit new documentation, leading to delays and denials. These requirements place an increased burden on working families, who already face significant challenges in accessing and maintaining health care coverage. This creates a cycle of children losing and regaining coverage, resulting in interrupted care and poor health outcomes.

Texas, under Governor Greg Abbott, has taken minimal action to reform these processes, instead maintaining a harsher approach that is exacerbating the problems. Abbott and lawmakers have opted not to expand 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 and economic prospects. Untreated asthma, diabetes or infections can lead to hospital admissions that could easily have been prevented with timely care.

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

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

The solutions are clear. Our September 2024 UnidosUS Poll shows that Hispanic communities want high-quality, 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 eligible children remain enrolled and those who are uninsured but eligible can access the care they need to thrive. This can be done through easier eligibility verification, better reach and removing unnecessary bureaucratic barriers.

The human price of inaction is too high. Texas cannot continue to lead the nation in uninsured children; it is a crisis that requires immediate attention. The health and future of Texas children are at stake, and it is time for Governor Abbott and the Texas Legislature to prioritize their well-being.

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

Holguín is the Texas director of UnidosUS.

This article originally appeared on Austin American-Statesman: Opinion: Uninsured child crisis – a failure of leadership in Texas