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Texas should do more for children without insurance
June 16, 2009

Can we please stop pretending that helping working parents provide health insurance for their children is a ruse for enacting an unwarranted middle-class entitlement?

Written by Editorial , Star-Telegram

Can we please stop pretending that helping working parents provide health insurance for their children is a ruse for enacting an unwarranted middle-class entitlement?

The arguments against increasing access to Texas’ Children’s Health Insurance Program have included claims that it would entice parents away from private insurance providers and get away from the mission of aiding the neediest families.

Even though legislation to expand the program won several rounds of approval in both the Senate and the House during this year’s session, the bills ultimately died for lack of time.

Gov. Rick Perry didn’t help by sending signals that he didn’t want to see a CHIP expansion bill on his desk.

The derailment happened even though Republican and Democratic lawmakers worked diligently to produce a plan backed by a broad coalition of groups. They ranged from the Arlington and Fort Worth Chambers of Commerce to Big Brothers Big Sisters, from the Texas Catholic Conference to the Texas Medical Association.

This wasn’t a handout.

It was a way to dent Texas’ number of uninsured children: 1.4 million.

CHIP, which is a federal-state partnership to insure children whose families fall in the gap between Medicaid and private health insurance, did start out with the goal of insuring the neediest kids. But need continues to grow.

Texas CHIP currently covers children in families making up to 200 percent of the federal poverty level, which is $44,100 for a family of four.

About 481,000 children are enrolled, although many more are thought to be eligible.

But some children get kicked off CHIP when their parents get small raises, even though the gains aren’t nearly enough to purchase private healthcare premiums.

Only half of Texas employers offer their workers healthcare benefits to begin with. And only a fraction pay premiums for dependents, according to the Austin-based Center for Public Policy Priorities.

Families between 200 and 300 percent of the poverty level — now $44,100 to $66,540 for a family of four — are among those who most need assistance in obtaining insurance for their children.

In Texas, about 516,000 uninsured children live in families with incomes above 200 percent of the poverty level and no access to affordable insurance, according to the Senate Research Center.

Sen. Kip Averitt, R-Waco, and Rep. Garnet Coleman, D-Houston, filed similar CHIP expansion proposals, with Averitt’s moving forward but then stalling largely because of House Democrats’ delay to kill the voter ID bill.

The most important feature of Averitt’s bill would have let families making up to $66,540 for a family of four enroll their children in CHIP and pay monthly premiums based on their income, ranging from $90 to $125 a month.

Other CHIP enrollees pay an annual fee of up to $50 per family, depending on income, and they make co-payments of $3 to $10 for doctor visits and prescription drugs.

To avoid luring parents who have other options, CHIP won’t enroll children until they’ve been uninsured for three months. Averitt’s bill has a six-month waiting period for families in the 200-300 percent of poverty level range.

It’s estimated that up to 80,000 children over two years would get healthcare coverage under the expansion. That means healthier kids. Fewer expensive emergency room visits. And more federal dollars toward a healthier Texas: For every dollar spent on CHIP, 28 cents from the state is matched by 72 cents from the federal government.

If Perry intends to call a special session to address vital business the Legislature didn’t finish, expanding CHIP should be on that list.

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