Senator Eliot Shapleigh - El Paso, Texas

With President Obama's signature on the latest Children's Health Insurance Program (CHIP) bill and potentially billions more in Children's Medicaid funds coming with a federal stimulus package, Texas must seize an opportunity to cover more children. It's not only our 1.5 million uninsured children who stand to gain. Simple math shows all of us would be better off with these children insured.

Recent statements by the governor's office and others reported in the Express-News may have undersold the true benefits and oversold the true costs of health coverage being considered for Texas kids.

Let's start with the costs. The Texas Finish Line Campaign, led by our three organizations and endorsed by dozens of groups, support a proposal to cover children in moderate-income families with no other insurance options for their kids, using a “buy-in” model with monthly premiums that costs the state far less than the HHSC's $100 million estimate for a CHIP expansion with no monthly premiums. Asking families to significantly contribute to the CHIP premiums greatly reduces the cost to the state, allowing Texas to provide health coverage for middle income families with no other option for insuring their children at an average cost to the state of $20 per child per month.

The CHIP expansion model under consideration mimics successful models used in several states. Families earning more than 200 percent of the federal poverty level (just over $44,000 before taxes for a family of four) could “buy in” to CHIP coverage on a sliding-scale basis. The amount families pay would increase with their income. Families at the upper limit (about $66,000) would cover the state's full cost for CHIP. This model provides families with affordable health care not offered by the private market, while keeping the state's costs in check.

In terms of the benefits for Texas, we agree with the governor that reaching our lowest-income uninsured kids office should be our top priority. Other states have found that when they roll out a “welcome mat” message, offering affordable health insurance options for children at every income level — whether private coverage, a buy-in program, CHIP or Medicaid — the majority of enrollees, up to 80 percent in one state, are kids who qualified under prior law. Many families never get the message about options for their children, until word is out that there is an option for every child.

If the governor truly wants to see currently eligible, low-income children enroll, he should support cutting red tape in Children's Medicaid. Under current law, the lowest-income children, receiving Medicaid, must apply for coverage twice as often (every six months) as the more moderate-income families covered by CHIP (who apply only once a year). Moving to once-a-year applications for Medicaid is fair and would significantly cut the paperwork for an already overwhelmed system. We frequently hear from families who have repeatedly submitted Medicaid and CHIP applications only to have them lost or processed months later.

Families who can't afford or aren't offered employer-sponsored insurance still seek treatment for their children — only that treatment comes in the form of much costlier emergency-room care, often for conditions that worsened when the family couldn't afford an earlier doctor's visit. When that happens, we all pay in our local county taxes and in rising health insurance premiums.

In a time of economic instability, covering children is a great strategy for cutting costs and bringing back home to Texas federal dollars that will otherwise be spent by other states. Getting these children the health insurance coverage they need is the right and smart thing to do. The Texas Legislature and the governor must not miss this chance.

Dunkelberg is associate director of the Center for Public Policy Priorities, Garcia-Matthews is executive director of Texans Care For Children and Guerra-Cardus is director of policy for Children's Defense Fund Texas.