Today's trip cast is brought to you by Texas State Technical Collegist Money Back Guarantee program reinforces our commitment to prepare and place highly skilled, technically competent students in the workforce. Learn more at TSTC dot DU and Austin Community Foundation mobilizes ideas and resources to address the biggest issues in Central Texas. Learn more at Austin CF dot org, slash give back. Hello, and welcome to the Texas Tribune trip Cast for July twenty eight, twenty twenty three. My name is now Matthew Watkins, Managing editor for News at the Tribune, and this week we're going to be talking about two topics. One the legal fight at the border between the Biden administration and the Abbot administration over floating buoys and other things along those lines for border security measures. And also the removal of five hundred thousand Texans from the state Medicaid rules. And we're going to start with medicaid. For three years during the coronavirus pandemic, anyone who is receiving medicaid in Texas and across the country was allowed to stay on the rules even without filing for renewal. And even if they became no longer eligible under normal circumstances. But in April that started to change, and since then Texas has removed five hundred thousand people from the rules. Since April, that means half a million people, many of them children, have lost access to help coverage. Many of them, according to experts, don't even know that their coverage is ended yet. Joining us today to discuss this is Neil and Bora, who covers disability issues for the Tribune and has been tracking this story. Hey, Neil and thinks we're joining us. Hi, thank you? All right? So I want to talk with instead of a big picture question with a sort of more narrow question and ask about one particular family that you've written about. That's the family of Jodi Whites, which lost coverage this summer. Tell me a little bit about Jody and her family and kind of what has happened to them in recent weeks and months. Yeah, So the Whitzer family in New Braunfeld, who have five kids, and their second youngest, Amelia, is a medically complex kid. She has heart defects, she has cerebral palsy and autism, and she also gets most of her food through a gastrostomy tube because she isn't able to digest through her mouth, and when they lost coverage, they lost the ability to access all of her treatments to do with every single one of her diagnoses, so that means she doesn't have access to pump bags or syringes for that tube she eats through. She doesn't have oxygen tanks anymore because the insurance company came and took that away. And she used to have a home health nurse that has been with her for the past three years, taking care of her, monitoring her vitals, even going to school with her. And this nurse is the one who caught her seizures when she started having seizures earlier this year, and now the nurse can't see her anymore, so she hasn't been able to go any follow up doctor's appointments with any specialists or any doctors, and her parents are just hoping that an emergency doesn't happen, otherwise they're going to have to go to a hospital, take on a hefty bill, hopefully if the hospital is willing to treat them without insurance. M okay, okay, So tell us a little bit about how you know this family, But also just other people who are among this five hundred thousand. How are they getting removed? What is the process the state is going through in order to do this, So the process seems to be a little bit messy. They hire on a lot more people to JHSC ahead of the beginning of this unwinding to try and handle the volume of everything that was going to happen, but it seems that some of the people they hired, according to advocacy groups, are not quite experts in all of the methods of approving and denying someone. So a lot of families have talked about getting on the phone with JHSC and being told conflicting information every time they call. People are getting removed quite a few because of pro procedural errors, so people who sent in their applications a day late, or people who weren't able to provide every piece of documentation about their jobs for the past three years, things to do with language barriers, where they got their renewal packets in the mail that were not in the language that is their primary language. Just different things like that, where people have not been contacted and didn't know to submit a renewal application and were removed as a result of that, So that a big part of it. And you know, we should step back a little bit here and make clear to be fair to the state of Texas, right, this isn't just necessarily a decision where it's like we want to kick five hundred thousand people off the rules. There was this decision made by the federal government, I believe, you know, due to the pandemic and all the challenges with communication and you know, just life challenges that were people were facing to keep people on during those times, even if they weren't necessarily kept on for those three years, we knew this was coming. It wasn't necessarily a step that you know, Texas has made this kind of dramatic decision to do so. But that being said, I mean, it sounds like what you were hearing from folks is that, you know, maybe Texas doesn't have much of a choice as to whether to go through this process, but the process itself is maybe not going as smoothly as some would have liked to have seen. Is that right. I think that's exactly right. I think there have always been issues with medicaid Texas and other states as they go through this process, but they have become much more exacerbated by the volume of work they've needed to accomplish since the federal government, you know, pulled back those restrictions. And it seems that there are issues with technology, the it system that the Commission is using. Everything seems to be a little less organized than maybe it could have been, especially as they knew it was coming. Sure. Sure, and so one thing that I'm wondering about we're trying to get an answer out, is you know, who are these five hundred thousand people. What are you hearing from the state about kind of the you know, the makeup of this group. Yeah, so the state hasn't released exact numbers on the demographics of this group yet, but according to advocacy groups and just based on what we know about who uses Medicaida and Texas, it is likely that a lot of these people are children. It's mainly kids who are on Medicaid, using Medicaid like Amelia in the Whites family, and it seems that a lot of them are losing coverage because of this removal process. Of course, the state intended to try and remove people who were ineligible. That is the intention. So kids who might have aged out of the program and are eighteen older now. But besides kids, it's also women who are either pregnant mothers who have been removed erroneously, or people who were pregnant at some point were able to get on Medicaid weren't removed until now are past their pregnancies. And lastly, there are some disabled adults who still use Medicaid as well. You had a number in your most recent story that ran today about an estimate of maybe eighty thousand people who were who were removed, but maybe shouldn't have What's what's happening with that group? Yeah, there was a letter anonymously sent to the leaders of the Health and Human Services Commission from employees, people who said they were employees, saying that eighty thousand people were removed erroneously. They didn't expand on that in the letter what that meant, and I wasn't able to get the Health and Human Services Commission to confirm or deny whether that number was true, but they did say that they were aware of some cases where people were moved erroneously. So all right, well, thank you. So then one thing I wanted to ask about this is, of course, Texas is one of a small handful of states that has not expanded Medicaid, you know, in response to the Affordable Care Act. There have been various efforts to do this over the years. Many Republican led states have chosen to do this despite kind of early resistance to the Affordable Care Act and things like that. But what that has created in Texas, you know, even before this pandemic hit and before this mass removal from the rules, was a situation where there were people who maybe aren't eligible for Medicaid but maybe didn't qualify for subsidies or couldn't afford health insurance on the Affordable Care Act market. How much is that factoring into play here? Do we know in terms of who's getting removed and who's not. I think a lot of people who are getting removed because they're now ineligible maybe because of income limits, especially seeing as Texas has some of the most strict income moments. They're definitely being told to go look at marketplace plans and things like that, and it seems like there is just going to be this big gap because Texas hasn't expanded Medicaid, There's going to be a lot of people who aren't able to afford those plans or get enough care that they need for their specific health needs under those plans, but they also won't be qualifying for Medicaid. So it is a place that people are being told to go, but it's not necessarily a place that will be helpful for them. Sure, what are you seeing from the community health clinics? I know you've spoken to some people who work in there's you know, people who are it's their jobs to help people sign up for Medicaid or kind of weave this paperwork morass, but also might be the people who need to serve the people who have lost coverage. What is the experience that they're facing. What are they telling you? Well, right now, they're saying that they've seen less of a surge of people than that you were expecting to see when people are started getting removed from Medicaid. And the reason they gave was that it seems like a lot of people still don't know that they've lost coverage, and so they are really bracing for about back to school time because they assume that is when a lot of parents are going to start coming in to get their kids, you know, routine checkups, vaccinations, things that they need before school, physical so their kids can play works, and they're going to be told when they're in the office to get services from these community health centers that they don't have insurance anymore. And of course these places are required to serve people whether or not they have insurance, and that is what is helpful about them for these people. But it is definitely going to be overwhelming for these community health centers and they are waiting for that other shoe to drop. Interesting. Yeah, I mean, you know, if you're not getting the notifications that you need to renew your application or anything like that, you might not be getting the notification that you have been dropped from the rules. And if you don't need to go to a doctor or anything like that, you might not realize until the time comes. So interesting that you know, maybe that five hundred thousand number many people will discover it later on and things like that. So let's go back to the Whites family. I mean, what are they doing? Where are they going to go from here? Yeah, so they are doing everything they can. They have reached out to their local state representatives as well as the governor's office. The mother, Jodie Whites, has reapplied for Medicaid again, hoping that her new income information is going to qualify them. She's also applied for Medicaid buy in coverage, which allows for slightly strict income limits, and other than that, she is just going back and forth with the Health and Human Services Commission. Her daughter qualifies for a Medicaid waiver program, which should guarantee coverage, but as you know, the wait lists for waiver programs are very, very long, and her daughters on a six thousand person list, so they don't think they're going to be able to get to that anytime soon. All right, well, thank you for explaining this. Let's pause and here a message from our sponsors, Texas BioMed pioneers and shares scientific breakthroughs that protect our communities. Health starts with science. Health starts at Texas BioMed. Visit tx BioMed dot org for more. And the Texas Tribune Speaker Bureau deliver Texas size insight at your next event. With the Texas Tribune Speakers Bureau. All reporters and editors are ready to bring your event to life with context and analysis. Only they can deliver book us at Texas Tribune dot org slash speakers. Okay, before we get started in our second segment, I'm joined by Matt Ewalt, our director of Events and live journalism for The Tribune. The Tribune just recently this month announced a hundred new speakers for the Texas Tribute Festival in September. Matt, what were some of the highlights of that list? So these are changemakers who are driving innovation, lawmakers making waves with new policies, and industry leaders that are pushing the state forward. Some of those highlights include Representative Adam Kenzinger renew qutour president at the University of Houston. We have the minority whip of the US House of Representatives, Katherine Clark and James Bear, Award winning Aaron Franklin, and many others. One hundred is a lot of names to announce at one time, but it's an incredible list to add to those we already had announced indeed, and it's always an exciting event, something that I really enjoy. Folks that like to hear about the topics that we talk about on the trip cast will of course hear many many of those and with from you know, moderators and panelists smarter than than the host. You'll hear on the trip pass So what do people need to know if they want to buy a ticket, participate in any kind of way. Look, it's it's going to our site tripfest dot org. And and what you'll discover there not only ways to buy tickets, finding out the kinds of discounts we have for educators and others, um you know, but it's it's an invitation to dig into our lineup of speakers. You know, numbers don't tell the whole story. It's it's thinking about the way in which these speakers are going to engage in conversation across difference, you know, with issues facing our state, in our country. I just invite people who are still looking to to look at those look at those speakers, find the names that you recognize and can't wait to hear, but also those that may be unfamiliar to you, those that are focused on issues that are important to you, or or the opportunity to dig into ideas and experiences that really challenge your own. But the website has our most up to date announcements, all sorts of information about about how these three days are going to be organized and what to expect. All right, So once again that'll be on September twenty first through twenty third. The website is ribfest dot R. Thanks a lot, ma, thank you so much. On July third, a trooper with the Texas Department of Public Safety wrote an email to a sergeant detailing a series of incidents during his work on Governor Greg Abbott's border security mission that he felt quote stepped over a line into the inhumane. He described being given orders to push people, including a four year old child, back into the Rio Grand Or. His unit received those orders as they tried to enter America. People including children and pregnant women, were getting tangled in razor wire, and migrants were getting injured as they tried to avoid barriers put in the water by the state. That letter, first reported by the Houston Chronicle, has drawn attention to the harsh tactics being used at the border. Those in particular, the border buoys being deployed in the Rio Grand have gained a lot of attention this month, as Mexico and the US government have both raised concerns about it. There's a couple lawsuits ongoing about those individual buoys, joining us to discuss this today. As Odiel Garcia, our immigration reporter who is in Eagle Pass and has just come back from the border where seeing some of these tactics in action. Thanks for joining us, Odell, Thank you so first of all, just tell us, you know, this is the first time we've talked you. You literally just got back to an Airbnb in Eagle Pass. So I'll be hearing it just as much as our listeners will as kind of what you're seeing out there today, what the what the scene is like down there. Just describe to us what stood out to you and you're reporting today, right, So I'll start off with what I saw yesterday because I was here yesterday. I went to a pecan farm that's right up against the Rio grand Um, and the owner or the owners of the that pecan farm, we're telling me that they initially had agreed to put up a fence on the river bank with the gate so they could access the river because it's it's part of their property. But thanks to escalating and DPS, National Guard began to put wire along the river bank and they shut down the gate. And even if they could could open up the gate through with the lock or with the key, there's just wire in front of that gate now. So they literally the people lost access to part of their property, and the wife has been telling me that she's been helping some of the migrants who are struggling to get up to the river bank because the wires up against the river bank and some of them are getting tangled. Some of them are struggling to get up, and she said that at one point there was there was an instance in which she yelled at DPS troopers on her property saying are you going to help? And they responded no, that they can't help, and she ended up helping the migrants and herself. She said that she was helping eight months a woman who was eight months pregnant. It's given her a lot of anxiety. She says that she goes to bed wondering, having dreams of some of these cases in which she has found herself to be a human humanitarian. So that's one scene right today. I just came back from Piedros Negatives, which is right across from Eagle Pass. I went to a shelter there where a couple hundred migrants are there. Most of them are waiting for to get an appointment with CBP, Customs and Border Protection to be able to enter the country legally. But they're getting they're growing, they're growing desperate. Some of them have been waiting there for two three months. Other people I've been waiting up to six months. I spoke to an immigration attorney who works at the shelter, and she was telling me that, you know, she tries to help as much as she can, but you know, she can only do so much because at the end of the day, the people who have the power are on the US side. It's immigration, and you know, she advises, she consults with the with the migrants, and you know she doesn't want him to cross illegally, particularly now because a lot of them are getting injured. She told me of an example of which parents with their five year old boy, their five year old son and another boy who was a little older, swam across the berber. The five year old boy got entangled in the wire, had his one of his arms all cut up, and National Guard nor DPS offered any help. They just didn't offer anything. They saw this unfold. The parents got worried and they didn't see anyone coming to the rescue, so they swam back with the boy and had to get treated at the shelter by volunteers. So you know that what's been going on. M mirants have been telling me, you know, they don't want to get tangled into the wire. But ultimately the lawyer told me, you know, this is only going to last so long, this this deterrence policy, because she's she's sensing that migrants are growing desperate and they're waiting patiently, but their patients are is going to run out pretty soon. Well, yeah, that that touches on one of the things I wanted to ask you about, because when you wrote a story about that that letter that I mentioned up at the top of this segment, you quoted Travis Constantine, a spokesman for DPS. DPS, of course, one of the main agencies and abbots kind of border security initiatives, saying you know that they were investigating that letter, but also saying, you know that troopers do everything possible to deter them, the migrants, from risking their lives in the first place. Other In other words, the idea here is is, yes, that some of these things might be dangerous and could cause harm, and the aim here is to keep them from crossing over in the first place, which can be dangerous in a lot of different ways. In the heat of Texas, and all those kinds of things. You know, it did make me think, of course, it's a dangerous journey to get to the border. And you see, you know, many of these migrants are passing through places like the Dairien Gap where there's you know, great danger to their lives and everything like that. I mean, how effective is this is this? Is this something that is actually convincing people to rethink crossing the border. Is it just kind of one more risk pilot onto many risks that they're taking to get here? Yes? And no. I think that for some it is working. Someone I spoke to a migrant at the shelter and told he told me that he had already crossed from Piedrasnegas into Eagle Pass, but he went through an area of Eagle Pass where there wasn't any wire yet he got picked up when he crossed. He got picked up by border patrol. Was eventually the ported in Mexico City and he made his way back to Piedras Negras and I asked him, are you going to try again? He said, well, now with all that wire right now, he goes, imagine getting tangled there. I don't want to go through that, but that doesn't mean that there are no migrants crossing. When I was at at the farm yesterday, I saw a group of about twenty people that included children, boys and girls ranging from anywhere from five years old to what I presume was a teenager with parents and mothers. And they couldn't get across onto the U onto the river bank because of all this wire. So there were maine to walk about three miles to the other side. There were being funnel onto the other side where there was an opening. So there are migrants crossing. And I saw, like I said, this group about twenty people crossing. I didn't get a chance to talk to them because, like I said, they're being picked up by National Guard, And so that area was closed off from me. And it's also closed off from the property owner. And that's what a noiser too, is that she can't access her own property. But the point to answer your question is yes, it is working for some. Some don't want to, as this monument told me, I don't want to cross and get injured. But at the same time, I saw a group of parents with their children crossing yesterday. And one thing you have is mentioned in your reporting is that the property owners in many cases don't have a choice here, right because Governor Abbott has invoked kind of an emergency around the border, they have the ability to place some of this wire on the property of people individuals who may not necessarily want it on their land, or in some cases have asked for it to be removed and have been denied that opportunity. One thing that I am kind of struggling to wrap my head around is how much of this is a esque elation and escalation of deterrent policies along the border, or how much of this is just renewed attention in part due to this letter, in part due to you know, just this kind of focus on Texas's politics, policies, and and things can sometimes be cyclical. How how different is it now than say it was a few months ago or years ago. Yeah, I mean, I think some of the context here is It's good to remember. Ever since Biden came into this new administration came into office, Texas Attorney General has filed a few a couple of dozen lawsuits against the Biden administration. Many of them are about attacking the Biden administration's immigration policies. So there's been an ongoing legal fight. And if you recall, this was what two years ago when Governor Abbot ordered that DPS arrest any anyone who was transporting migrants from the border into the interior. UM. The DJ sued and got an injunction on that and UH eventually that order never went into effect UM And at last last time I checked, that lawsuit is still pending UM. And this is the second time, at least the second time that the DJ has sued the UH has sued AVID or Texas over an immigration order or an immigration policy. I think what's a little different from you know, what's been going on in the past few months or even that first lawsuit I first mentioned, is that I think that letter that that DPS trooper had written and became public really put an attention, put attention on the on the human costs of what these policies are are causing. We're talking about pregnant woman. UH. There was a case of a pregnant woman having a miscarriage while she was entangled in the wire um or you know, as the email said, and pushing a group of migrants and back into the Rio Grand when she included children. UM. You know, keep in mind that earlier this year, we wrote a story about the high number of bodies being found on uh in the river, on the on the river bank of the American side and Eagle Pass and Maverick County didn't have any space for these bodies. So what they ended up doing is just burying them before they could be identified or being or contacting their family members. And so what advocates are saying now is, you know, there's already an issue of drownings happening on the Rio Grand with these booies, with with the wire and with suppulsively or migrants getting pushed back into the water. All it's going to do is cost more debts. And what I think what that email showed was, yes, it brought renewed attention, but it's it's bringing attention to the human cost of these policies. So what are Abbott and DPS saying about those concerns being raised. They denied everything that was in that in that email. They said that there was no orders to deny water, there was no orders to push migrants back, and that any migrants who are injured that they take care of them. So that's that's their stance on it. So they have opened up an investigation to find out whether these allegations are true or not right and basically whether this is a rogue employees telling them to do something against policy, which I guess, if true, is what DPS is saying what actually happened here. I mean, we've also heard from Abbott, you know, the argument of you know, this is the result of a lawless border allowed by the Biden administration and the problems that've arisen. But I mean, one thing that I think people have noted in recent weeks is, you know, many of us expected kind of a new surge of migrants to arrive at the border with the lifting of Title forty two this summer. It seems as though that that has not, at least so far happened, and that in fact, you know, encounters CBP encounters with migrants at the border have dropped sharply in the last few weeks and months. Any idea as to why that is or what's what's what's happening there? Right? The Biden administration wants to take a lot of credit for that, because they've implemented policies that they say have reduced the number of migrant apprehensions on the border. Um just to go through a few of them. They they had this app already, but they've opened up the app known as CBP one to asylum seekers to make appointments to be able to turn themselves in or make an appointment with the Customs and Border Protection officer to be able to start an asylum process. There was also they created programs for particular locations in Cubans and I believe Venezuelans, I hope I'm not mistaken to be able to apply for asylum from their home countries if as long as they have a sponsor or financial support in the US. Canada and Spain have also agreed got into a partnership with the US to be able to take in some asylum seekers from Central and South America. But there's a specific rule that the Biden administration is saying it has been the biggest, has had the biggest effect, and that is what's known as a third country rule, and what it basically says, it is telling migrants that in order to apply for asylum on the US, they need to have applied for asylum in a third country. So for example, let's say Venezuelan wants to come to the US, but on his or her way to the US. They end up in Mexico, and the rule says that they should have asked for asylum in Mexico and if they get denied, then they could ask for asylum in the US. If they don't apply for asylum in another country before coming to the to the US, they could be denied asylum in the US altogether. And keep in mind that this rule is very similar, if not exactly the same, to what the Trump administration had proposed, and that rule was struck down by a federal judge under the Trump administration, and the same judge struck down that rule under the Biden administration. The rule is still in effect on the judge has given the Biden administration two weeks, but a district judge has ruled that that rule is illegal. So, like I said, the Biden administration has credit that rule as the reason why there's a lower number of apprehensions at the border. But with it being considered illegal, you know, we could expect people. Experts are saying, well, we could expect more people to cross. And then of course we also have the deployment of these booies and the Rio grand that has been another big topic. This was an idea that was kind of floated around and discussed during the Trump administration that never ended up happening with the federal government, Abbott deciding to do it on his own, or Texas doing it on its own as well. That has of course become a source of legal conflict with the you know, and sort of a reversal, right, the federal government suing the state over immigration policies as opposed to what we have normally been seen. That lawsuit pending the government asking a judge essentially to order Texas to remove those buoys. In that document, I you know, you and I both found that interesting. Some claims from you know, diplomats in the State Department arguing that this is possibly harming relations with Mexico and possibly violating some treaties that the US has with Mexico. Did you see those buoys or where are you seeing the impact of those being on the river? Yeah, So keep in mind that the Texas Mexico border is about twelve hundred miles long. The blies only cover about a thousand feet and only from the American side. You can only see them from this private property that I mentioned earlier. From this farm, you'd have to go to the Americans sided to be able to uh see them without permits, right, without having to get onto private property. Um. Yes, so I've seen them. I didn't see anyone crossing or attempting across them. It's really easy to swim around them. Yeah, there's It doesn't have any effect other than you just have to walk a quarter of a mile left or right. Um so um, you know you brought up some of the some of the some of the characters who are against this. Um. You know, the DOJ suit. Mexican diplomats are complaining about it too. The argument that J is making is that this is a federal land, it's a federal border, and in order to have Texas to have done this, they needed the federal federal government's permission to do so. Um. And anytime the federal government does any sort of high stakes action the border, they communicated with Mexico to an extent, you know, we're going to do this or we're going to add a wall. That way, Mexico is prepared to know what's going to happen in case they need to respond to a situation with migrants. In this case, Mexico, what they're worried about is that it's going to affect the public safety and some of the migrants, and it may force some of those migrants who have to come back to Mexico, and Mexico now has to deal with those injuries to the migrants. As far as we know, that hasn't happened, but that is a concern. I think. Another concern that we haven't talked about but should be talked about is the environmental consequences of this. You know, there's the river. For a lot of people here is as their livelihood, right That's where Eagle passed, and in some cases some of the Mexican border towns get their water from. That's the water resource. Getting into the river itself is not illegal, but with so much militarization around it, it's become taboo to get into the river. I mean people go into the river to swim, to fish, to kayak, to canoe, both on the Mexican and the US side. What's illegal is stepping on the other side without permission. But the river is fair. Gaming has been used for recreational reasons, and there's wildlife there that environmentalists are concerned because there's so much wire, there's uh, these other elements there that are scaring off the wildlife, and in some cases they have to raise some of the some of what they're they're called islands in the river. They have to raise that to be able to put some of the buoys in there. And so that's what environmentalists are worried about, is it's killing off the wildlife, but it's also scaring off people who use the river for recreational reasons. Well, thank you for that explanation, thank you for joining us DL. We'll be having some dispatches on our website on this likely next week, so keep an eye on Texas Tribune dot org for that. Thank you for joining us d L. And thank you to our producer Todd and to our sponsors Texas State Technical College, Austin Community Foundation, Texas BioMed, and the Texas Tribune Speakers Bureau. We'll talk to you next week. We have a favor to ask. 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