AUSTIN (Nexstar) — Concerned employees at the Texas Health and Human Services Commission say Texans are at risk of losing their health insurance due to understaffing, insufficient technology, and “disheartening and unacceptable” leadership, according to an internal email shared with Nexstar.

“These issues are escalating rapidly, and the agency is facing significant risks, including the potential termination of Medicaid coverage for countless individuals and the potential loss of billions of dollars in federal funding,” the group of anonymous employees told Executive Commissioner Cecile Young in a July 25 email.

The concerns stem from changes in Medicaid policies that the employees say have stressed the state system and overburdened their workload.

On April 1, the federal government ended its “continuous coverage provision,” which prevented states from unenrolling Medicaid recipients during the COVID-19 pandemic. That meant Texas needed to review its enrollees — about 6 million people — to determine which are still eligible for coverage.

Since May, about 500,000 Texans have lost Medicaid coverage due to the changes. But about 80,000 people were kicked off of coverage by mistake, HHSC employees say, including “several thousand” pregnant and elderly people.

“The concerning part was that many of these individuals did not receive any notice of denial, leaving them unaware of their coverage termination until their social benefits were reduced,” they wrote. “We fear that the problems experienced during the first round [of case reviews] in April may recur, leaving thousands of individuals without coverage and placing a heavy burden on our team to resolve the issues manually. How many more thousands will lose coverage?”

The commission told Nexstar they are aware some Medicaid were denied improperly, and they are working to restore coverage as soon as possible. They have offered the employees “an opportunity to work through their concerns.”

“Redetermining Medicaid eligibility for approximately 6 million Texans over 12 months is a massive undertaking and HHSC has planned this unwinding effort for more than a year,” HSSC Press Officer Tiffany Young said. “We are working closely with Centers for Medicare & Medicaid Services (CMS) and our partners to ensure that the redetermination process operates as smoothly as possible. Through our quality assurance process, we’ve identified and are resolving technical issues.”

State Senator Nathan Johnson, D-Dallas, said the state did not prepare for the anticipated workload.

“It’s alarming and it shouldn’t have happened. And it’s the result of, frankly, poor planning and execution by the state,” he said. “We’ve known for at least a year and a half that this day was going to come and for us not have the IT resources or the human resources to accommodate it is just really poor government.”

The state is providing information and resources to Texans on Medicaid at StayCoveredTX.com