Senator Eliot Shapleigh - El Paso, Texas

AUSTIN, Texas — With the clock ticking, several lawmakers made a last-ditch effort Monday to heat up interest in legislation to extend children's Medicaid coverage from a six-month enrollment period to 12 months.

The Legislature wraps up its session June 1, and a Thursday deadline in the House for passage of certain bills will take many proposals out of the running.

Supporters of the Medicaid expansion called for the House Calendars Committee to place the 12-month Medicaid bill near the front of the remaining batch of bills to be considered.

"The bottom line is if this bill were to be passed and signed by the governor, approximately 250,000 more kids would have access to insurance," said Houston Democratic Rep. Sylvester Turner, who is pushing the proposal.

Texas leads the nation in uninsured children, according to a study released earlier this year.

Children enrolled in the joint state and federal Medicaid health care program now have to reapply and prove they are still eligible every six months, causing many children to lose coverage, supporters say. A family of four making less than $22,050 a year qualifies for children's Medicaid.

"It's just another bureaucratic hurdle that further impedes access to health care for these children that are most vulnerable," said Rep. Marissa Marquez, D-El Paso.

Supporters, including business groups and the Texas Hospital Association, say allowing children to have continuous access to preventive health care will keep them out of the emergency room and lower costs to the state.

But some opponents say the six-month eligibility period ensures that only the most needy children receive Medicaid, and that those who are able to pick up their health care costs do so.

"Requiring recipients to apply every six months is not an unreasonable burden, given the value of the taxpayer-funded services they receive," said Andrea Whitman, an analyst with the conservative Texas Public Policy Foundation.

Whitman also said the estimated $300 million it would cost the state to cover the 250,000 children under the expansion would be a significant burden at a time when the state needs to cut spending ahead of a projected budget shortfall in 2011.

Supporters of the expansion said the $300 million from the state will allow them to draw down roughly $500 million in federal stimulus dollars that should be used while they are available. Turner's bill hinges on the stimulus money and allows the Legislature to cut back the 12-month enrollment period in 2011.

"It makes no sense to not enroll these kids," said Rep. Elliott Naishtat, D-Austin. "If we don't do that, the kids still get sick and go to the ER, which can cost eight to 10 times as much as it would cost to have a regular primary care doctor."

The proposal won approval in a House committee late last month, but has yet to make it to a vote in the full House.

Meanwhile, bills are stacking up in the queue ahead of the Thursday deadline for House bills to get initial votes on the House floor. The 23-page schedule of bills in the House Monday was overflowing with roughly 300 measures to be addressed, many of which were rolled over from overloaded agendas the previous week.

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The 12-month Children's Medicaid bill is HB1541.