AUSTIN (KXAN) — Whistleblowers reached out directly to Texas Gov. Greg Abbott this week, escalating their continued concerns about denials and delays in getting Texans critical medical support and food assistance.

The anonymous Texas Health and Human Services employees sent the letter to the governor on Tuesday — marking their third outcry about issues with the agency’s systems, staffing and leadership which, they say, contributed to tens of thousands of people erroneously losing Medicaid coverage earlier this year.

“Regrettably, it appears that the full extent of these challenges may not have been adequately conveyed by our leadership, hence our decision to provide you with this comprehensive overview,” the whistleblowers stated in the letter to the governor.

KXAN reached out to the governor’s office for comment and is waiting to hear back.

Whistleblowers first flagged these concerns in an internal email to leadership in July. At the time, the Health and Human Services Commission (HHSC) confirmed technical issues occurred while the agency reviewed the eligibility of its roughly six million Medicaid enrollees, in order to come into compliance with new federal guidelines.

At the time, a spokesperson for the agency called the year-long process a “massive undertaking” and acknowledged the internal issues resulted in improper denials, including “several thousand” pregnant and elderly people being kicked off coverage. The spokesperson also said it was working to restore coverage to those erroneously removed “as soon as possible.”

By August, the agency reported all but a couple thousand people out of the nearly 100,000 affected, had their coverage restored.

In their latest letter, the whistleblowers expressed concerns about the transparency and accuracy of some of the agency’s public responses on these issues. They also criticized the agency’s approach and timing of these the coverage redeterminations, claiming they were “directed to follow the quickest path, even at the expense of potentially jeopardizing the well-being of innocent individuals by depriving them of necessary medical services.”

They ultimately called on the resignation or reassignment of certain top agency leadership over “the creation of a toxic work environment, staff members experiencing burnout, and the overarching demoralization instigated by the leadership.”

KXAN reached out to HHSC regarding the most recent allegations, and a spokesperson for the agency said they were looking into it. We will update this article when additional information is available.

U.S. Representative Lloyd Doggett, D-Texas, published the letter on Wednesday, as he and other lawmakers continue their calls on federal regulators to intervene.

In a letter signed by the entire Texas Democratic delegation, lawmakers asked the Centers for Medicare and Medicaid to pause terminations of people’s coverage until it can complete an audit of the Texas system.

“There is no reason why thousands of additional pregnant women, children, individuals with disabilities should be denied access to a family physician, until we’re sure these problems are corrected,” Doggett said.

The whistleblowers’ latest letter also alleges they identified cases where potentially eligible non-citizens and even former foster care children were denied coverage, before they received a comprehensive review.

Additionally, they provided an update on the length of time it takes the agency to process applications for food assistance applications — noting it surpassed 100 days and saying the “situation has continued to deteriorate” since their last outcry.

“This means that once someone applies for food assistance, it just sits in our system for over three months before anyone even looks at it,” the letter reads.

It goes on to address the governor directly, saying, “The health and well-being of innocent Texans hang in the balance, and it is crucial that you take decisive, corrective actions.”