They lost their jobs and insurance in the pandemic. Now they’re slipping through Texas’ health care safety net.

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Fort Worth resident Stevie Smith lost her health insurance March 31. Ben Torres for The Texas Tribune

Laci Crosson’s son doesn’t have pills to manage his attention deficit disorder.

Betty Canales is worried about how she’ll pay for her diabetes medication.

Stevie Smith saw a doctor after she was furloughed — and paid more than double her usual price.

With the U.S. economy flailing as the country contends with the coronavirus pandemic, more than 1 million Texans have likely suffered the double whammy of losing their jobs and their employer-based health insurance. Some have landed in the state’s patchy health care safety net, where advocates say they could be cut off from physical and mental health services while facing the economic strain of a public health crisis.

Researchers estimate that between 25 million and 43 million people in the U.S. will lose health insurance through their employers in the coming months if the unemployment rate grows to 20%. It’s already near 15%, a record high since the Great Depression.

The situation is particularly dire in Texas, where state officials have restricted access to publicly funded health insurance programs for the poor and have led the charge to toss the Affordable Care Act in court.

Already home to more than 5 million uninsured residents — or about 18% of its population, the highest uninsured rate of any state — Texas is in the minority of states that have declined to expand Medicaid coverage to people with incomes near or below the poverty line.