Medicaid renewal in Texas — how to keep coverage
The number
Texas Medicaid redetermines eligibility at least once every 12 months under 42 CFR 435.916. During the 2023+ unwinding, roughly 69% of disenrollments in Texas were procedural — missing paperwork, not confirmed ineligibility.
How to keep your coverage at renewal
Texas Medicaid is federally required (42 CFR 435.916) to redetermine eligibility for every enrollee at least once every 12 months. For most MAGI-category enrollees (children, pregnant women, parents, expansion adults), the state must first attempt an ex parte renewal — pulling current income data from the state's workforce and tax databases — and only contact you if that data doesn't confirm continued eligibility.
What you need to do: make sure the state has your current mailing address, phone number, and email. Log in to https://yourtexasbenefits.hhs.texas.gov/ and update your contact information the moment it changes. Watch for a renewal packet from the state Medicaid agency (sometimes titled "notice of redetermination" or "request for information"). You have at least 30 days to respond under federal rules, and the state must provide a 90-day reconsideration period if you miss the deadline.
The 2023+ unwinding: when the COVID-19 public health emergency ended March 2023, states resumed annual redeterminations that had been paused since 2020. More than 25 million Americans nationally were disenrolled during the first 18 months of unwinding, and 69% of those disenrollments were for procedural reasons — missing paperwork, returned mail, incorrect contact information — rather than confirmed income above the limit. Black and Latino enrollees had higher procedural-termination rates than white enrollees in nearly every state that publishes the breakdown.
If your coverage was terminated and you believe it shouldn't have been: you can appeal within the state-specified window (usually 60 or 90 days). The appeal triggers continuation of coverage while it's pending. You can also reapply at any time — there's no waiting period. Texas has the lowest parent-income Medicaid cap in the country: 15% of the federal poverty line — roughly $3,900 annual income for a family of three. Texas finally extended postpartum coverage to 12 months in March 2024 under HB 12 (2023), after CMS repeatedly denied earlier waiver requests. An estimated 1.5 million Texans remain in the coverage gap.
For Black families
Black enrollees in Texas faced high procedural-termination rates during the 2023 unwinding, when states resumed annual redeterminations that had been suspended during COVID-19. If your Texas Medicaid coverage was terminated for paperwork reasons (not income), you can appeal and request a retroactive reinstatement. Texas has the lowest parent-income Medicaid cap in the country: 15% of the federal poverty line — roughly $3,900 annual income for a family of three. Texas finally extended postpartum coverage to 12 months in March 2024 under HB 12 (2023), after CMS repeatedly denied earlier waiver requests. An estimated 1.5 million Texans remain in the coverage gap.
Where to get help in Texas
- Federally Qualified Health Centers in Texas: every FQHC accepts Medicaid, charges on a sliding scale for the uninsured, and has certified application counselors who can help you apply or renew. See our FQHC directory for this state at /clinics/tx/.
- Medicaid-accepting providers in Texas: our provider directory lets you filter to providers in this state. See /providers/tx/.
- State health profile for Texas: for state-level health outcomes context (maternal mortality, infant mortality, life expectancy, uninsured rate) by race, see /health/texas/.
- Texas Medicaid consumer help line: 1-800-252-8263 for application help, renewal questions, and general Medicaid inquiries. Ask for an interpreter if you need one; language access is required under Title VI of the Civil Rights Act.
- Find a Navigator: federally funded Navigators help with Medicaid + ACA marketplace applications and are free. Find one via localhelp.healthcare.gov.
References & primary sources
- Texas Medicaid, state Medicaid portal: https://www.hhs.texas.gov/services/health/medicaid-chip.
- KFF State Health Facts: kff.org/statedata. Medicaid income eligibility + enrollment.
- Medicaid.gov: medicaid.gov. Federal program guidance + state plan amendments.
- CMS Medicaid + CHIP Unwinding Dashboard: medicaid.gov/unwinding.
Data refreshed: