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August Johansen looks through the glass door of the birthday venue while cradling a balloon on Dec. 9, 2023. He had inoperable brain cancer and depended on Medicaid to pay for full-time home nursing care from a private agency to help his mother take care of him throughout years of health crises. But in December, he became one of 810,000 children dropped from Texas’ Medicaid program in the previous five months, but was reinstated through his mother's efforts.

Years ago, Texas hustled to get kids on state health care. Now it’s kicking them off.

Texas’ recent unwinding of Medicaid and CHIP has been criticized, dropping more than a million people eligible for the health insurance programs. Decades ago, Texas officials got kids health insurance in record time.


Erica helps August brush his hair before his birthday party on Dec. 9, 2023.
Medications and other medical supplies line a shelf in the "game room" of their home in McKinney, Texas on Dec. 9, 2023.

What was at stake in 2000

August (rirght) and his older brother Bryant (left) play a game on his toy camera on Dec. 9, 2023.
August opens his birtday presents while surrounded by friends, a few of which have similar diagnosis on Dec. 9, 2023. There are only a handful of children at his party— most are teachers, nurses and family friends who have been with Ericka and August through his treatment.

‘The environment is flipped’

August peers through the window of the birthday venue as family members arrive. There are only a handful of children at his party— most are teachers, nurses and family friends who have been with Erica and August through his treatment. In December, he became one of 810,000 children dropped from Texas’ Medicaid program but he was eventually re-enrolled.
August and Erica sit in his bedroom in McKinney, Texas Dec. 9, 2023.
August lays out photos he took while in the hospital on his bed Dec. 9, 2023.

Losing a critical function 

Erica holds August's hand as they make their way down the stairs of their Mckinney home on Dec. 9, 2023.
Erica Olenski Johansen poses for a portrait in Allen, Texas on Dec. 9, 2023.

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Health care Politics State government Greg Abbott Health And Human Services Commission Medicaid Rick Perry