Forty-two days ago, the Texas House overwhelmingly gave final approval to changes in the Children's Health Insurance Program that sponsors say could add 100,000 children to the rolls.

Soon after, the proposal was referred to the Senate Finance Committee, but it has not been scheduled for a public hearing. With the May 28 finale of the legislative session approaching, advocates for children are worried that time is running out for lawmakers to increase enrollment in the program, which serves working families that cannot pay for private health insurance.

"I'm deeply concerned about the delay," said Barbara Best, Texas executive director of the Children's Defense Fund. "We're dealing with an absolute crisis. We can't afford to wait anymore."

But Lt. Gov. David Dewhurst, who presides over the Senate, said Tuesday: "Time has not run out, and we're going to have a proposal" on CHIP in the Senate.

The House plan would let more children into the program by easing enrollment restrictions put in place during a budget crunch in 2003. That year, more than 500,000 children were enrolled in CHIP. Now, 306,000 children are in the program.

The bill's author, Rep. Sylvester Turner, D-Houston, has a plan to persuade the Senate to approve the changes. He wants to bring uninsured children to the Capitol, possibly later this week.

"It's easy to say 'no' to another politician," Turner said. "Let them look at children with no insurance."

North Dallas mother Jennifer Roper's three children are uninsured, she said. They have been approved for CHIP, but because of a 90-day waiting period, the coverage has not started. Meanwhile, 3-year-old Emilija has a cough that is getting worse, Roper said. She said she is worried that her daughter is getting bronchitis, but the family cannot afford medical tests.

Turner's bill would eliminate the 90-day waiting period for uninsured children. It would also allow families to apply for the program once a year rather than every six months.

The changes are expected to cost about $78 million over two years. The House version of the budget includes money for the CHIP changes; the Senate version does not.

Senate Finance Committee Chairman Steve Ogden, R-Bryan, said Tuesday that his panel will not consider the CHIP proposal until House and Senate leaders finish negotiating the final version of the state budget. That work could wrap up this week, he said.

Advocates for CHIP families say that increasing the enrollment period to 12 months is important because every time families have to reapply, some drop out of the program. Sometimes that is because of application processing errors; in other cases, it is because submitting an application can be a hassle, Best said.

"These are busy parents who are trying to manage their finances on very limited incomes," Best said.

The 12-month enrollment provision could be changed in the Senate.

Dewhurst has proposed having families apply once a year but electronically verifying the eligibility of families in the highest income bracket after six months. A family of four can earn up to $41,300 a year and still qualify for CHIP.

"You want to make sure it's the eligible children who get the benefit," Dewhurst spokesman Rich Parsons said.

Dewhurst's proposal is a change from his earlier opposition to the 12-month enrollment period. In January, he said, "I don't think most people in Texas have a lot of sympathy for someone that can't fill out a two-page application every six months."

It's still unclear how Dewhurst's proposed income checks would work or who — a private company or the state — would conduct them.

Turner said Dewhurst's proposal could work "as long as we don't reduce the number of kids that would be covered" under House Bill 109.

Some House Democrats fought to ease CHIP enrollment restrictions enough to get 200,000 additional children into the program. By not claiming its full federal CHIP allotment, Texas has forfeited more than $900 million, said Rep. Garnet Coleman, D-Houston.

But Turner said that a bill adding 100,000 children to CHIP was more likely to pass.

There are about 1.4 million uninsured Texas children. About half are eligible for — but are not enrolled in — CHIP or children's Medicaid, according to Children's Defense Fund Texas.

"In the legislative process, I've learned to be patient," Turner said. "It's one thing for us to be patient, but for the children, it can be highly detrimental to their health."

What is CHIP?

• The program is designed for families that earn too much money to qualify for children's Medicaid, which provides free health insurance.
  

• Enrollment fees, which vary according to a family's income, are $50 or less for six months. The fee covers all children in the family.
  

• Co-payments for most doctor visits and prescription drugs range from $3 to $10.
  

• Coverage includes checkups, immunizations, dental cleanings and fillings, hospital care, X-rays and lab tests, mental health care, eye exams and glasses, and prescription drugs.
  

Highlights of House Bill 109

• Allows families to stay in CHIP for 12 months at a time rather than having to reapply every six months.
  

• Eliminates a 90-day waiting period for uninsured children.
  

• Allows families to deduct child care costs when determining eligibility.
  

Source: Texas Health and Human Services Commission