Last year, the Children’s Defense Fund of Texas released a report called “In Harm’s Way: True Stories of the Uninsured Texas Children.” This report tells the stories of 27 families whose children had lost their health insurance.
As we enter this very difficult economic period and as the Texas Legislature comes in session in January, we must remember and remind our legislators about some facts presented in this report, which are now even worse.
Texas has the highest rate of uninsured children in the nation, with one in five children — 1.4 million — lacking coverage. Half of these children are eligible for, but not enrolled in CHIP or Medicaid. More than 80 percent of uninsured children have working parents, but they cannot afford private coverage, which costs more than $900 a month according to the Texas Department of Insurance.
As a result of cuts to its CHIP program, Texas has lost $900 million in federal matching funds that have been returned to the U.S. Treasury and spent by other states.
The report documents reasons for the sharp decline in CHIP re-enrollment: the “recertification roller coaster” and processing problems with renewing children’s coverage every six months; families who are a fraction above the income limit and no longer qualify for coverage; chronically ill children who are subject to a 90-day waiting period; and children who have become ineligible for coverage because of the asset test.
The report also highlights the difficulties that grandparents raising grandchildren and Hurricane Katrina evacuees have faced with the CHIP and Medicaid enrollment process in Texas.
The report recommends the full restoration of the Children’s Health Insurance Program and removing bureaucratic roadblocks that prevent eligible children from receiving coverage, including:
• Allowing children to re-enroll in coverage once a year instead of every six months;
• Removing the CHIP asset test;
• Eliminating the 90-day waiting period for uninsured children;
• Deducting child care and child support expenses when calculating income;
• Providing adequate reimbursement for Medicaid and CHIP providers; and
• Creating a buy-in program to allow families to purchase CHIP coverage at an affordable cast.
Unhealthy children become unhealthy adults. We can work together to have change, to have health insurance for all children and to have a healthier tomorrow.
Sally Robinson is a professor of pediatrics at UTMB Children’s Hospital, and Keith Bly is a hospitalist and assistant professor of pediatrics. This column is not intended to replace the advice of a physician. For information, contact your pediatrician. Or, contact Robinson and Bly at utmb.kids(at)utmb.edu. To view past articles, visit the UTMB Web site at http://www.utmb.edu/pedi/about/pedenews.aspx.
