Whistleblowers allege thousands of Texans were wrongfully denied Medicare coverage

The Texas Congressional Democratic Delegation says over half a million Texans have lost their Medicaid coverage over the past four months, and 81% of those individuals were wrongly removed.

They’re now demanding the federal government investigate and hold the state accountable for what they call grave failures.

This all unfolded after whistleblowers penned a three-page letter to the executive commissioner of the Texas Health and Human Services Commission. The letter explained how thousands of pregnant women, cancer patients and senior citizens are being denied care. The whistleblowers also stated the situation is taking a toll on their well-being and say they're “desperately seeking help that will address these issues.”

“We're always hearing about accountability for poor people. We're asking for accountability from the state of Texas,” said U.S Rep. Lloyd Doggett, D-Austin.

As part of the response to the COVID-19 pandemic, Austin said legislation was approved that gave additional federal dollars to Texas. In return the state was asked not to withdraw people from their Medicaid coverage at a time it was needed most.

“That emergency has ended, and the state has begun kicking people off Medicaid. It came to light that within the past few weeks about 100,000 of those people have been kicked off in error,” said Doggett.

This started as the state went through a redetermination process that re-accesses eligibility. Doggett feels the fallout is putting Texans’ health and finances at risk. On Tuesday he and other Democrats wrote a letter to the state calling for Medicaid redeterminations to be paused while the system is corrected.

KEYE reached out to Gov. Gregg Abbott’s office for comment. They directed us to the HHSC, who released this statement:

"Re-determining Medicaid eligibility for approximately 6 million Texans over 12 months is a massive undertaking, and HHSC has planned this unwinding effort for more than a year. We are working closely with Centers for Medicare & Medicaid Services and our partners to ensure that the redetermination process operates as smoothly as possible. Through our quality assurance process, we’ve identified and are resolving technical issues. We are aware of some Medicaid cases that were denied improperly, and we've reinstated coverage for those individuals. You can find the latest data on our End of Continuous Medicaid information page."

KEYE followed up with HHSC and asked if they could directly address the whistleblower claims.

In a separate email, the station was told “Our response below stands. Thanks.”

“Disgraceful that Greg Abbott’s administration refuses to offer a direct response to concerned state employees who are working to protect Texans’ access to health care. These courageous whistleblowers and the many patients for whom they are advocating deserve a clear response and immediate, effective action to correct the failures that have occurred. The stakes are far too high for political dodges and indifference,” said Doggett.

Doggett feels this issue is exacerbating health concerns in the state such as infant and maternal morbidity that adversely impact black women. He added it’s important this is resolved before Sept. 9 when more redetermination notices will be sent.

“There'll be some deaths by not having the coverage that's necessary. It’s time for the federal government to step in and put a stop to this and demand some accountability from the state for its failures, “said Doggett.