Houston mother Vanessa Melendez filed a new Medicaid application for pregnant women in December, only to wait until her second trimester for any response. She ultimately gave birth without insurance, highlighting a growing backlog that now affects hundreds of thousands of Texans.
Backlog numbers and recent trends
The Texas Health and Human Services Commission (HHSC) reports that in July only 65% of Medicaid applications were processed within the federal 30‑ to 45‑day window, down from 81% a year earlier. By August, 211,000 applications remained unprocessed. The same slowdown is evident in SNAP redeterminations, which fell from an 83% timely rate in January to just 28% in July – the lowest level in four years.
Legislative changes driving the slowdown
The One Big Beautiful Bill Act, enacted in July 2025, requires Medicaid recipients to reapply every six months and to demonstrate work, job‑search, or volunteer activity. While the state has not found widespread fraud, the new verification steps have added administrative burden to HHSC staff, which numbers roughly 6,000 reviewers for both Medicaid and SNAP.
State officials say the law is intended to curb fraud and improve program integrity. State Senator Lois Kolkhorst, chair of the Senate health committee, noted that “as new tools are put into practice, we will naturally begin processing these applications more efficiently and address backlogs.”
Impact on families and health providers
Families like Jessica Ballek’s feel the strain. After losing her job in December, Ballek’s Medicaid and SNAP benefits were approved quickly, but a later SNAP re‑application was delayed for months, forcing her to rely on food banks while moving to a new town for work. “My kids have been with the same pediatrician since they were born and I don’t plan on changing that,” Ballek said, adding that the lack of coverage threatens her ability to pay for care.
Hospitals and federally qualified health centers are seeing more uninsured patients. The Texas Hospital Association reports that nonprofit hospitals provided $14.9 billion in uncompensated care in 2024, and more than 5 million Texans remain uninsured – the highest number of any state.
State response and future requirements
HHSC spokesperson Jennifer Ruffcorn emphasized that the agency’s Texas Integrated Eligibility and Renewal System (TIERS) remains functional and is regularly updated to meet federal and state standards. The agency also highlighted training efforts to ensure accurate processing under the new law.
Financial penalties are looming. Starting in 2027, Texas could owe $700 million annually if SNAP error rates do not improve, with similar penalties for Medicaid slated for 2029. These incentives aim to push the agency toward faster, more accurate processing.
What’s next for Texans?
Advocates such as Diane Forester, director of health policy at Texans Care for Children, warn that the system is already under strain and that “it’s not one single cause for the entire backlog, but clearly the system is falling further behind.” Continued monitoring of processing rates and the impact of the One Big Beautiful Bill Act will be essential as the state works to balance fraud prevention with timely access to essential health and nutrition assistance.
Original reporting: Texas Tribune (HLL/CB) — read the source article.
