More than 2 million people have been removed from Texas' Medicaid program since federal pandemic-era coverage protections were lifted last April, new state data shows.

The big picture: That's the most of any state and nearly equivalent to all of Houston — Texas' most populous city, with 2.3 million residents — losing coverage in less than a year.

Zoom in: More than 16.4 million people have lost Medicaid coverage nationwide since eligibility checks, which were put on hold during the pandemic, resumed last spring, according to health policy research nonprofit KFF.

• Texas is the second-most populous state and has long had the country's highest uninsured rate, so it's perhaps not surprising that it leads the U.S. in disenrollments.
• But it also has the highest rate of people removed from Medicaid since last year, with 61% of enrollees losing coverage, per KFF.
• Over half of disenrolled Texans, 1.3 million, lost coverage because of procedural issues like failing to return paperwork, not because they were determined ineligible.

Reality check: The latest figures indicate that Texas Medicaid is now roughly back to pre-pandemic enrollment levels.

• However, the state hasn't completed reviewing eligibility for every enrollee, so more people are likely to lose coverage.

What they're saying: Texas is "taking all possible actions to provide benefits to eligible Texans as quickly as possible" and working closely with the federal government on ensuring "that the redetermination process operates as smoothly as possible," Thomas Vazquez, a spokesperson for the Texas health department, told Axios in an email.

What's next: It's not yet clear how many people losing Medicaid have found coverage elsewhere.

• Some likely wound up in the Affordable Care Act insurance marketplaces. Texas was among the states that saw the biggest surge in marketplace sign-ups this year.