Mark, a minor living with multiple disabilities and serious health challenges, suddenly lost access to his Medicaid benefits—even after his mother, Laura, submitted all required renewal paperwork. Laura only discovered the denial when she tried to take Mark to the doctor, only to be told his coverage had been cut off. Without Medicaid, Mark’s urgent medical needs went unmet, leaving Laura desperate for help.
Throughout the pandemic, children like Mark received uninterrupted Medicaid coverage under “continuous coverage” rules. Once the federal protections ended, families were required to submit renewal applications to keep their benefits. Laura completed Mark’s renewal and submitted income verification confirming his eligibility. But the Texas Health and Human Services Commission (HHSC) failed to process the application within the required 45 days. Without issuing a proper denial notice, HHSC wrongfully terminated Mark’s benefits.
Unsure of what to do next, Laura turned to Lone Star Legal Aid (LSLA). Public Benefits Unit Staff Attorney Elizabeth Green filed an appeal, arguing that HHSC had failed to process Mark’s renewal application in a timely manner and had unlawfully terminated his coverage. Green represented Mark at a Fair Hearing before a Hearings Officer, where LSLA presented evidence of HHSC’s errors.
The Hearings Officer issued a favorable decision, reinstating Mark’s Medicaid coverage. With his benefits restored, Laura was finally able to get him the medicine and care he urgently needed.
This case is just one example of LSLA’s ongoing work to protect families who are wrongfully cut off from essential healthcare. By fighting back against systemic errors, LSLA ensures vulnerable Texans have access to the medical coverage they depend on.
*Name(s) have been changed to protect the client’s identity.
Lone Star Legal Aid (LSLA) is a 501(c)(3) nonprofit law firm focused on advocacy for low-income populations by providing free legal education, advice, and representation. LSLA serves millions of people at 125% of federal poverty guidelines, who live in 72 counties in the eastern and Gulf Coast regions of Texas, and 4 counties in Southwest Arkansas. To learn more about Lone Star Legal Aid, visit our website at www.LoneStarLegal.org.
Media contact: media@lonestarlegal.org