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After a Million Texas Kids Were Kicked Off Medicaid, Thousands More Are Still in Limbo

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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.

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“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.)

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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.”

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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.”

Got something to say? The Chronicle welcomes opinion pieces on any topic from the community. Submit yours now at austinchronicle.com/opinion.

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Texas needs at least $174 billion to avoid water crisis, state says

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Texas needs at least 4 billion to avoid water crisis, state says


AUSTIN (Texas Tribune) — Texas communities will need to spend $174 billion in the next 50 years to avert a severe water crisis, a new state analysis revealed Thursday. That’s more than double the $80 billion projected four years ago, when the Texas Water Development Board last passed a state water plan.

The three-member board presiding over the agency authorized the highly anticipated draft blueprint Thursday, the first administrative step toward adopting the water development board’s plans for the next 50 years. The plan, released every five years, encompasses the projects that 16 regional water planning groups in Texas said are the most urgent, water development board officials said. 

The board’s latest estimates come as the state’s water supply faces numerous threats. Growing communities across Texas are scrambling to secure water, keep up with construction costs and cope with a yearslong drought. This week, Corpus Christi officials said the city may be just months away from declaring a water emergency. Meanwhile, other rural cities by the Coastal Bend are rapidly drilling wells to avoid a crisis. Residents in North Texas have also been bracing for groundwater shortages.

In an effort to restrain the crisis, lawmakers last year called an election in which voters approved a $20 billion boost for communities to use on water-related expenses. The water development board’s estimate shows that what lawmakers proposed on the ballot falls dramatically short of the needed cash, experts said.

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“What this number tells me at the end of the day is if we don’t get serious about (funding water projects), there are going to be serious consequences for Texas,” said Perry Fowler, executive director of the Texas Water Infrastructure Network. “Even with the billion-dollar-a-year plan kicking in, it’s not going to be enough to offset the costs of the projects that are going to have to be executed.”

The new estimate accounts for 3,000 projects, from regional infrastructure upgrades to smaller endeavors such as drilling new water wells. Texas’ water supplies are expected to drop by roughly 10% between 2030 and 2080, according to the water plan. In that same time frame, the maximum amount of water communities can draw is also expected to decline by 9%.

The 80-page plan notes approximately 6,700 recommended strategies that would add water to the state’s dwindling portfolio. The recommendations — which are not accounted for in the cost — include developing new supplies from aquifer storage and recovery, brackish groundwater, desalination and recycled water. It also calls for water conservation.

The report suggested that if Texas does not implement the plans and recommendations, the state is one severe drought away from an estimated $91 billion in economic damages in 2030.

The state’s plan attributes a variety of reasons for the bigger price tag, such as higher costs of construction due to inflation, impacts of the COVID-19 pandemic on supply chains, and a growing backlog of water supply projects.

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“There’s a plan that can meet our needs,” said Matt Nelson, deputy executive administrator for the Office of Planning at the water development board, adding that they take their cues from the regional planning groups. “These are local projects that folks need to implement; they’re needed regardless of how they’re funded. It’s important to remember these are not top-down projects or state projects.”

Experts told The Texas Tribune that the board’s estimate is only a fraction of what Texas communities will need to ensure they have water in 50 years’ time, saying growth and development are outpacing the state’s ability to keep up.

“This is a bigger water plan in terms of volume strategies and capital costs compared to anything we’ve ever seen before,” said Jeremy Mazur, the director of infrastructure and natural resources policy at think tank Texas 2036.

Mazur suggested that the $174 billion only covers water supply projects and does not account for updating aging infrastructure, adding that the actual price could amount to a quarter of a trillion dollars.

“There’s a substantial magnitude with regard to the capital investment needed to both fix our aging and current systems and potentially develop the water infrastructure, water supply projects that we need.“

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The report largely confirmed what many water experts have warned regarding threats to the state’s water supply, said Sarah Kirkle, director of policy at the Texas Water Association.

“Population growth, extreme weather, and economic development needs are all increasing demands on our infrastructure, and the state is going to need more water, sooner,” Kirkle said. “This is all while water projects are becoming more costly and complex because the easiest and cheapest local projects have already been developed.”

Fowler, with the infrastructure network, said he expects the Texas Legislature to take up the issue next year, when lawmakers meet for the 90th legislative session. He said the state should take a bigger role in ensuring that communities can afford their respective water projects.

“It’s going to have to be a top-down priority, there’s no way around it,” he said. “The challenges are so immense that it’s going to take all hands on deck.”

Texas residents have until the end of May to comment on the proposal. Water development board officials must adopt it by January 2027.

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Alejandra Martinez contributed to this story.

This article originally appeared in The Texas Tribune at www.texastribune.org. The Texas Tribune is a nonprofit, nonpartisan media organization that informs Texans – and engages with them – about public policy, politics, government and statewide issues.



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Co‑worker confesses to killing missing North Texas man and stealing his car, police say

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Co‑worker confesses to killing missing North Texas man and stealing his car, police say



A North Texas man reported missing earlier this week was found dead Friday, and police say a co‑worker has confessed to fatally shooting him and stealing his car.

The suspect, Gregory D. Lewis, 34, remains in custody and faces a forthcoming capital murder charge, according to the Fort Worth Police Department. 

Lewis is accused of killing 31‑year‑old Thomas King, who had been last seen in his Taco Casa work uniform. King was reported missing on Tuesday after failing to return home Monday from the fast‑food restaurant in the 1100 block of Bridgewood Drive.

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Car found at Arlington motel 

Police said King’s car was found at the Quality Inn on I‑20 in Arlington, and surveillance video showed Lewis arriving in King’s vehicle shortly after King left work. 

Detectives identified the man in the video and arrested him on unrelated charges.

  Gregory D. Lewis, 34

Tarrant County Jail

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Body discovered on Fort Worth’s East Side 

King’s body was located on Friday in an open field on Fort Worth’s East Side, authorities said. 

According to police, Lewis confessed to shooting the victim and stealing his car. 

Medical examiner review pending 

The Tarrant County Medical Examiner will determine the cause of death. 

CBS News Texas has reached out to Taco Casa for comment.

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Exclusive | Mexican mayor urged relatives in US to vote for Texas Dem for Congress who would ‘take care’ of their city

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Exclusive | Mexican mayor urged relatives in US to vote for Texas Dem for Congress who would ‘take care’ of their city


WASHINGTON — A Mexican mayor earlier this month urged her constituents to get their relatives in Texas to vote for House Democratic candidate Bobby Pulido because he would “take care” of their city if elected to Congress.

“We need to get out the vote for him,” said Patricia Frinee Cantú Garza, mayor of General Bravo in Nuevo León, less than two hours from the US border, in a recent Spanish-speaking Facebook reel,which The Post reviewed and translated.

“Talk to your families in the United States. Make sure they go vote,” Garza added, noting that she would be presenting the keys to the city to Pulido, a two-time Latin Grammy winner, on April 3.

A Mexican mayor earlier this month urged residents of her municipality to get their relatives in Texas to vote for House Democratic candidate Bobby Pulido because he would “take care” of their city if elected to Congress. Politigranja/ Facebook

“When he becomes a congressman,” she also said, “we want him to take care of Bravo.”

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The city ceremony celebrating Pulido in General Bravo never received enough funding and was cancelled, the Mexican outlet El Norte reported.

Pulido has headlined concerts in General Bravo as recently as November 2023. Local officials promoted the show and the current mayor and her husband, then-mayor Edgar Cantu Fernandez, appeared.

“Bobby doesn’t know the mayor and has never met her,” a Pulido campaign spokesperson said in a statement. “He declined the invitation, didn’t attend the event, and isn’t responsible for unsolicited comments made by other people.”

Bradley Smith, a former chairman of the Federal Election Commission, said the statements wouldn’t pose legal or ethical issues for Pulido — but that the remarks may have a political cost, given the focus on foreign involvement in US elections in recent years.

“Bobby doesn’t know the mayor and has never met her,” a Pulido campaign spokesperson said in a statement. Bobby Pulido for Texas

“If you were making financial contributions, that would be a different thing, but just to exhort people to vote,” Smith said, “I don’t think that’s going to be a problem for them.”

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Jessica Furst Johnson, a partner at the Republican-aligned campaign finance and election law firm Lex Politica, noted that event appeared to function as an in-kind contribution to Pulido’s campaign but it would be difficult to determine without “more details.”

Congressional Republicans have thus far failed to pass a bill this session aimed at beefing up identification requirements for voters when registering, though many have said laws as currently written are too lax and could lead to non-citizens casting ballots.

State investigations and audits have shown in recent years that thousands of non-citizens ended up being registered, but few have ever illegally voted. Those who have are federally prosecuted.

Pulido has headlined concerts in General Bravo in the city as recently as November 2023, which local officials promoted and where the now-mayor and her husband, then-mayor Edgar Cantu Fernandez appeared. Obtained by NY Post
Pulido is challenging incumbent GOP Rep. Monica De La Cruz in the Texas district this November and has faced questions from the press about his ties to Mexico, where he has said he maintains a home for parts of the year. CQ-Roll Call, Inc via Getty Images

Pulido is challenging incumbent GOP Rep. Monica De La Cruz in the Texas district this November and has faced questions from the press about his ties to Mexico, where he has said he maintains a home for parts of the year.

The Latino music star admitted to splitting time with his family between there and Texas just two years before launching his campaign, telling a YouTube show in a 2023 interview that he’s a “summer Mexican” but “winter Texan.”

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“We live on the border,” he has also said. “My wife and I have a house in Mexico. So, we travel there, and we spend time over there.”

“Bobby lives in his family home in Edinburg, Texas, where he was born, raised, and is raising his own family,” the Pulido campaign rep noted. Getty Images

There was no indication of a current mortgage on a property either there or in the US, according to financial disclosures that Pulido filed April 15 with the House. Those filings also revealed he holds a checking account at a Mexican bank.

“Bobby lives in his family home in Edinburg, Texas, where he was born, raised, and is raising his own family,” the Pulido campaign rep noted. “He is in complete compliance with all House disclosure rules — the property you are referencing is not his primary residence so is not required to be listed.”



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