Texas needs to ensure it helps parents track renewal applications to the state's low-cost health insurance program for children.
The state also needs to improve the way a private contractor handles incomplete files for CHIP enrollment.
That's according to a study by a children's health-policy institute at the University of Florida.
It surveyed 500 families that renewed their enrollment in the Texas program, and 500 families that didn't.
The study found one-fourth of the families that didn't renew their coverage mistakenly thought their children were still enrolled in the Children's Health Insurance Program. Nearly half the non-renewing families said the process was unnecessarily difficult.