Senator Eliot Shapleigh - El Paso, Texas

AUSTIN, May 6 – Legislation marked as priority legislation by advocates of expanded state health insurance for children was approved on Wednesday by the Texas Senate.

Senate Bill 841 by Sen. Kip Averitt, R-Waco, creates a buy-in option for participation in the state’s Children’s Health Insurance Program for families that earn up to 300 percent, or three times, the federal poverty level. This would impact a family of four earning up to $66,000.

“These are folks who work hard at their jobs, pay taxes and do the best they can but simply cannot afford the high cost of health insurance,” Averitt said.

Current eligibility is limited to families that earn up to two times the poverty level - or about $44,000 for a family of four.

The bill also allows families that earn above the current limit to pay a premium and other related fees to access coverage. It passed on a 29-2 vote, with Sens. Jane Nelson, R-Lewisville and Robert Nichols, R-Jacksonville, voting against.

The Senate vote came just hours after the Texas Finish Line Campaign held a Webinar and teleconference urging constituents and lawmakers to make a final push for expanded coverage of children’s health insurance and modifications to the state’s Medicaid program.

“(The budget) conference committee is meeting right now and making decisions on what they are going to spend in the budget in the next two years,” said Anne Dunkelberg, the associate director for the Center for Public Policy Priorities.

“They went into the budget with some high marks for having funded the existing Medicaid and CHIP programs but what we don’t know at this point is what the compromised budget will look like in terms of preserving some of the funds that were put in to the House budget but not necessarily on the Senate.”

Dunkelberg said Averitt’s bill would pave the way for coverage of more than 80,000 additional children through the program, which she said is even more pressing during the current economic downturn.

“Families that are having a hard time making their mortgage payment or their rent payment are going to have an even harder time accessing health care for their children,” she said.

Dunkelberg said it was only appropriate the state expand the coverage if, through premium payments, parents are contributing to help pay the costs of the program.

“To the extent that you actually have the parents making larger contributions to the funding of the program, then we are asking the state legislature to contribute,” she said.

The bill was not greeted with unanimous applause, however, and some see a reformed private health care industry as the better solution.

"Rather than expand taxpayer-funded programs, our legislators’ time would be better spent on developing reforms that would make private insurance a more attractive and accessible option for Texans,” said Andrea Whitman, a health care policy analyst with the Texas Public Policy Foundation, in a statement released just moments after the Senate vote.

Whitman said CHIP was created to help the state’s working poor and increasing eligibility “morphs the program into an expensive entitlement for the middle class.”

“Why would we consider expanding CHIP when we still aren’t enrolling more than 170,000 children already eligible under the current guidelines,” Whitman stated.

According to the Greater Houston Partnership, however, more uninsured children translates into higher premiums for even those who can afford private health insurance.

“Private health premiums also rise to cover the cost (of the uninsured),” said Elaine Barber, said Greater Houston Partnership’s vice-president. “Thirteen percent is added to premiums to cover the cost. As health costs continue to rise to cover this expense, fewer small businesses can afford to provide health coverage for an employee, which then creates a vicious cycle.”

Barber added that property taxes for businesses would continue to increase to help repay hospitals for services rendered to the uninsured.

Because of the federal match per state dollar used in CHIP ($1.50) and Medicaid (almost $2.00) programs and because the they are about 30 percent less expensive than private health insurance, Barber called the programs “bargains” for the state. To participate in the programs, she added, keeps tax dollars spent by Texans in the state.

“We only get it back if our state leaders decide to invest in these programs, otherwise we are donating these dollars to other states which are more than happy to spend the monies they receive that should have appropriately been coming to Texas,” she said.

Barber said business leaders have a vested interest in expanding coverage for reasons that might be less about health and more about money.

“You should know that business leaders know that Texas must reduce our state’s number of uninsured children not because it’s the right thing to do but because it strengthens our state economy,” she said.

Dunkelberg and the Finish Line Campaign are also urging revisions to the current children’s Medicaid program, which requires participants to re-enroll in the program every six months.

“One of the issues that we are very concerned about is that fact that our Medicaid system has been unable to keep up with the demands, not just from children, but from women and Texans with disabilities and also the folks that are seeking nutrition assistance in this hard time,” said Dunkelberg. She is urging support for state Rep. Sylvester Turner’s House bill 1541, which would expand the enrollment period to a year.

“Since we have nearly two million children in any month on Texas Medicaid, if we go to a 12-month renewal cycle for them we will be taking two million complicated renewal processes off the work load of this staff and it will enable us to get a system that can actually serve all the Texans who need help,” she said.

Turner’s bill was voted out of the House Committee on Human Services and should see floor action soon.