Texas revises Medicaid policies that denied coverage to kids of foreign parents

Texas is revising its Medicaid coverage policies after reports that U.S.-born children with lawfully present foreign parents were being barred from the program due to their sponsors' income.

Going forward, Texas' Medicaid agency will not use the income of a legal alien's sponsor to determine eligibility for that person's U.S.-born child, since that practice violates federal law, according to state officials. The sponsor's income will still be used to determine the parents' Medicaid eligibility.

Texas decided to make the change after conversations between state officials and the CMS, according to Christine Mann, spokeswoman for the Texas Health Department. "The policy change was made to align with federal requirements," she said.

Mann could not estimate how many children lost coverage under the prior policy. But the updated coverage standards could have a major impact in ensuring access to coverage.

Some 15% of Texas' residents, or 4.2 million, are native-born U.S. citizens with at least one immigrant parent, according to the American Immigration Council, a legal advocacy organization.

Advocates and legal insiders in the state say the change is also being made because of their outreach to state officials.

Roughly a year and half ago, the Center for Public Policy Priorities noticed that some children in Texas were denied coverage based on their sponsor's income.

"(It) seemed an obvious violation to many of us," said Anne Dunkelberg, associate director of the Austin, Texas-based organization.

Bernadette Segura, an attorney with Texas RioGrande Legal Aid, said her organization became aware of the policy last year when it started advocating for two U.S. citizen children, ages 7 and 4. The children's mother is a legal permanent resident.

The children were denied Medicaid coverage because their mother could not obtain information about her immigration sponsor's income, even though that information should have been irrelevant to the application, Segura said.

"The situation necessitated a clarification. … Income-eligibility requirements for citizen children of a legal immigrant parent were different from other citizen children," Segura said. "(Texas') health department was in conflict with federal law and principles of the U.S. Constitution, which require all citizens to be treated equally."