Texas
After a Million Texas Kids Were Kicked Off Medicaid, Thousands More Are Still in Limbo
Nearly two out of three Texans who’ve lost Medicaid coverage since last April were children (image via Getty Images)
More than a million Texas kids in low-income families have lost their health insurance since last spring, according to state-reported data. Three out of four Medicaid recipients in Texas are children, and nearly two out of three Texans disenrolled during the post-pandemic “unwinding” process have been kids.
During the pandemic, a provision in a federal COVID relief package blocked states from kicking people off of Medicaid, even if they were no longer eligible. When that federal legislation expired in April 2023, states began reassessing people’s eligibility in a process called unwinding. It’s been chaotic in Texas with large backlogs and extremely long delays for families applying for health care or food assistance.
“Texans in need have been forced to wait several months for their SNAP and/or Medicaid applications to be processed. As a result, countless Texas families will go hungry,” stated a December letter to the Texas Health and Human Services Commission (HHSC) sent by a pair of legislative caucuses, the Texas Women’s Health Caucus and the Texas House Early Childhood Caucus.
That letter implored the agency to resolve the backlogs by this March, but they have only grown.
HHSC Spokesperson Tiffany Young told the Chronicle that staff has moved aggressively to reduce the number of applications in the queue. The good news is that the maximum wait for an application to be assigned to an eligibility worker has gone down – from 120 days in November to less than 40 days in December.
But even with reduced lead time, backlogs grew from December to January. As of Dec. 8, there were 207,465 SNAP applications and 288,939 Medicaid applications waiting to be processed. As of Jan. 26, there were 18,173 more SNAP applications and 64,604 more Medicaid applications in the backlog, per data provided by HHSC spokesperson Jennifer Ruffcorn.
Though the current eligibility crisis is acute, HHSC has chronically failed to meet federal standards for timely processing of SNAP applications since at least 2021, two years before unwinding began, according to the joint caucus letter. (Young said HHSC found no factual errors in that letter.)
Most Medicaid recipients in Texas are kids, and 65% of people kicked off Medicaid since last April were children.
Prior to unwinding, it would have been difficult to directly compare how efficiently states automatically renew coverage, but as part of the process states have reported their “ex parte” renewal rates, meaning the percentage of applications that are renewed automatically based on data. Now, it’s clear that Texas fails to renew coverage more often than any other U.S. state.
The joint caucus letter demanded an answer from HHSC on that point: Why does our system renew eligibility for so few people?
An HHSC spokesperson told the Chronicle the low renewal rate is a side effect of the state’s approach. During unwinding, Texas has reviewed applications from those most likely to no longer qualify first. “Not all states are distributing renewals in the same manner,” Young said.
But Texas is not the only state taking that approach. The research nonprofit Kaiser Family Foundation (KFF) closely tracks how states are handling unwinding and found 16 states are using a hybrid approach that involves frontloading applicants who are unlikely to qualify. KFF reports “several states will focus first on enrollees who have been flagged as potentially ineligible.”
Whatever the cause of Texas’ worst-in-the-nation ex parte renewal rate, the two caucuses want to understand it better. The December letter asked for an analysis on ex parte renewal, adding that HHSC should “quickly address the shortcomings identified in that analysis.” HHSC did not answer whether such an analysis is planned.
The letter penned by the caucuses made several other demands, some of which HHSC met. (For example, HHSC asked for an emergency waiver from the USDA to extend SNAP for people up for recertification until backlogs are eliminated – though the USDA denied that request.) One demand HHSC has so far refused sticks out: The letter called for HHSC to request a waiver from the federal Medicaid agency – Centers for Medicare & Medicaid Services (CMS) – to temporarily extend children’s Medicaid for kids in limbo during unwinding. When asked if HHSC had requested that waiver, Young said “no,” adding that HHSC “has implemented dozens of strategies to make the unwinding as smooth as possible for clients and eligibility staff.”
Where does that leave us? Lawmakers in the two caucuses want to know “the full range of investments and policy changes needed to maintain a high-performing eligibility system,” per the letter. We asked HHSC what some of those investments and policy changes might be. Young answered that the 88th Legislature approved 25% salary increases for eligibility staff, plus more than 600 temporary staff to help with unwinding. “Hiring, training and retaining staff are long-term solutions to managing workload and reducing reliance on mandatory overtime,” Young said. “However, it takes a new eligibility adviser a year to be proficient with application processing and overtime is the most readily available tool to address workload quickly.”
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DALLAS — Texas can require the Ten Commandments to be displayed in public schools, a U.S. appeals court ruled Tuesday in a victory for conservatives who have long sought to incorporate more religion into classrooms.
The 9-8 decision by the 5th U.S. Circuit Court of Appeals delivered a boost to backers of similar laws in Arkansas and Louisiana. Opponents have argued that hanging the Ten Commandments in classrooms proselytizes to students and amounts to religious indoctrination by the government.
In a lengthy majority opinion, the conservative-leaning appeals court in New Orleans rejected those arguments in Texas, saying the requirement does not step on the rights of parents or students.
“No child is made to recite the Commandments, believe them, or affirm their divine origin,” the ruling says.
The American Civil Liberties Union and other groups that challenged the Texas law on behalf of parents said in a statement that they anticipate appealing the ruling to the U.S. Supreme Court.
“The First Amendment safeguards the separation of church and state, and the freedom of families to choose how, when and if to provide their children with religious instruction. This decision tramples those rights,” they said in the statement.
The mandate is one of several fronts in Texas that opponents have fought over religion in classrooms. In 2024, the state approved optional Bible-infused curriculum for elementary schools, and a proposal set for a vote in June would add Bible stories to required reading lists in Texas classrooms.
The decision over the Ten Commandments law reverses a lower federal court ruling that had blocked about a dozen Texas school districts — including some of the state’s largest — from putting up the posters. The Texas law signed by Republican Gov. Greg Abbott took effect in September, marking the largest attempt in the nation to hang the Ten Commandments in public schools.
From the start, the law was met almost immediately by a mix of embrace and hesitation in Texas classrooms that educate the state’s 5.5 million public school students.
The mandate animated school board meetings, spun up guidance about what to say when students ask questions, and led to boxes of donated posters being dropped on the doorsteps of campuses statewide. Although the law only requires schools to hang the posters if donated, one suburban Dallas school district spent nearly $1,800 to print roughly 5,000 posters.
Texas Attorney General Ken Paxton, a Republican, called the ruling “a major victory for Texas and our moral values.”
“The Ten Commandments have had a profound impact on our nation, and it’s important that students learn from them every single day,” he said.
Tuesday’s ruling comes after the appeals court heard arguments in January in the Texas case and a similar case in Louisiana. In February, the court cleared the way for Louisiana to enforce its law requiring the display of the Ten Commandments in classrooms.
Republican Louisiana Attorney General Liz Murrill said the Texas ruling “adopted our entire legal defense” of the law in her state. In Alabama, Republican Gov. Kay Ivey also signed a similar law earlier this month.
“Our law clearly was always constitutional, and I am grateful that the Fifth Circuit has now definitively agreed with us,” Murrill said in a statement posted to social media.
Judge Stephen A. Higginson, in a dissenting opinion joined by four others on the court, wrote that the framers of the Constitution “intended disestablishment of religion, above all to prevent large religious sects from using political power to impose their religion on others.”
“Yet Texas, like Louisiana, seeks to do just that, legislating that specific, politically chosen scripture be installed in every public-school classroom,” Higginson wrote.
The law says schools must put donated posters “in a conspicuous place” and requires the writing to be a size and typeface that is visible from anywhere in a classroom to a person with “average vision.” The displays must also be 16 inches wide and 20 inches tall.
Texas’ law easily passed the GOP-controlled Legislature and Republicans, including President Donald Trump, have backed posting the Ten Commandments in classrooms.
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Associated Press writer Audrey McAvoy contributed to this report from Honolulu, Hawaii.
Texas
Glam influencer who drowned during Texas Ironman had battled flu but ignored pleas to ditch race
The glam influencer who drowned during a Texas Ironman swim had been battling the flu – but ignored pals who begged her to pull out of the brutal endurance race, according to one friend.
“She was ill before the trip, she wasn’t okay,” Luis Taveira said of close friend Mara Flávia, 38, who died during Saturday’s race in The Woodlands.
“My wife and I spoke with her to say she was too weak for this race, although a couple of days ago when we talked to her, she insisted she was okay,” Taveira said of the Brazil-born influencer, according to sports website the Spun.
“I still cannot believe what’s happened. She was ill because of the flu.”
Flávia continued “training hard” even while “weakened” by her illness, the friend said.
Just two days before the competition, Flávia shared a picture of herself in a pink swimming costume and cap sitting by the edge of a pool.
“Just another day at work,” she wrote in Portuguese.
Her Instagram account was peppered with snaps, showing her working out in a gym, by the pool, or running outdoors.
“Not every victory is photogenic, not every growth is pretty to watch. Sometimes evolving is being silent, stepping back, saying no, crying in the background, and coming back the next day more aware,” she said in one motivational post.
In others, she said that skill “only develops with hours and hours of work” and sport is “the best tool for transformation.”
The Ironman Texas competition features three legs — a 2.4-mile swim, a 112-mile bike ride, and a 26.2-mile run. The women’s event got underway just after 6:30 a.m. Saturday, with fire crews alerted around an hour later that there was a lost swimmer.
Flávia’s body was found around 9 a.m. in about 10 feet of water.
Officials have ruled her preliminary cause of death was drowning, and relatives have paid tribute.
Flávia’s sister, Melissa Araújo, said her sibling “lived life intensely” – and revealed a piece of her had vanished, People reported.
“You were always synonymous with determination, with courage — with a strength that seemed too vast to be contained within you,” she wrote on social media.
“You never did anything halfway; perhaps that is why you left such a profound mark on the lives of everyone who crossed your path.
“A piece of me is gone, and I will have to learn to live without it. And it hurts in a way I cannot even explain.
“It is a strange silence, a void I knew existed all along — as if the world itself had lost a little of its color.”
Flávia’s partner, Rodrigo Ferrari, described the swimmer as his “love” and said not waking up next to her was hard.
“Ursa, you were the best person I have ever met in my life,” he wrote in a note shared on social media.
A Brazilian fitness influencer has died after getting into difficulty during the swimming portion of an ironman event in Texas.
Mara Flavia Souza Araujo was reported as a “lost swimmer” around 7.30am at the Ironman Texas in Lake Woodlands near Houston on Saturday. According to KPRC 2 News, safety crews could not immediately locate Araujo. The 38-year-old’s body was discovered around 90 minutes later in 10ft of water by divers. She was pronounced dead on the scene.
Montgomery County Sheriff’s Department confirmed her identity in a statement to NBC on Monday.
“MCSO can confirm that Mara Flavia Souza Araujo, 38, of Brazil died while competing in the Ironman event in The Woodlands on Saturday,” the sheriff’s department told NBC News. “Preliminary investigations indicate she drowned during the swimming portion of the event.”
Araujo was an experienced triathlete and had completed at least nine ironman events since 2018. She had more than 60,000 followers on Instagram and had posted about the importance of making the most out of life in the days before her death.
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“Enjoy this ride on the bullet train that is life,” she wrote in Portuguese. “And even with the speed of the machine blurring the landscape, look out the window – for at any moment, the train will drop you off at the eternal station.”
Organizers of the race expressed their condolences on Saturday.
“We send our deepest sympathies to the family and friends of the athlete and will offer them our support as they go through this very difficult time,” race organizers said in a statement on Saturday. “Our gratitude goes out to the first responders for their assistance.”
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