This is an important year for health care in the United States.

The trend toward insuring all people is growing, with Massachusetts and California taking the lead. And a key federal program, the 10-year-old Children's Health Insurance Program, is up for congressional recertification in September.
 
This program is critical for children whose families don't qualify for Medicaid but are still far too poor to afford private health care. For every dollar the state puts into the program, the federal government provides an additional $2.63.

Because Texas has not provided adequate state dollars, it has lost about $865 million in federal matching dollars. That money has gone to other states, which have used it to fully fund children's health care and, in some cases, health care for the parents.

Enrollment in the program was originally intended to hover between 700,000 and 800,000 children. It never reached that point. In 2003, about 530,000 children were enrolled. That number has dropped to 300,000 because of legislative budget cuts and a lack of outreach programs.

A pair of bills seeks to address this shortfall during the current legislative session. Sen. Leticia Van de Putte, D-San Antonio, and state Rep. Sylvester Turner, D-Houston, are pushing to increase the eligibility window from six months to a year. That would lessen the burden on poor parents, for whom reapplying every six months is difficult.

The legislation also would allow parents to deduct the costs of child care from their income and would erase the 90-day waiting period. That waiting period means newborns can't get care until they are 3 months old.

"I don't know what's wrong with Texas," said Kevin Moriarty, the CEO of Methodist Healthcare Ministries. "There's a big problem in Texas related to taking care of people."

Although it would seem that expanded health care, particularly for children, is a political no-brainer, there are still some obstacles.

During a recent televised town hall meeting on the issue, U.S. Sen. Jay Rockefeller, D-W.Va., said the national situation is different from what it was in 1997. Massive war spending bills and unnecessary tax cuts largely benefiting the wealthy have made it easier to rely on the "we can't afford it" rhetoric.

In 2007, deficits were higher than in 1997, and only 13 percent of Americans consider health care a top priority, down from 70 percent in 1997, he said.

After my last column on this topic, I received e-mail messages from people upset that I had not mentioned the financial burden that illegal immigrants place on the health care system.

It's easy to point to illegal immigrants as the source of Texas' sorry financial state. It's also easy to ignore reports, such as one issued recently by former Texas Comptroller Carole Keeton Strayhorn, that illegal immigrants actually provide a slight net gain for Texas coffers.

Nowhere is that easier to do than in the area of health care. These damn people just come here for a free ride, right? One legislator, Rep. Leo Berman of Tyler, would even like to mangle the U.S. Constitution and declare Texas-born children of illegal immigrants ineligible for just about everything.

The fact is, a person who shows up at an emergency room needing treatment cannot be turned away, regardless of immigration status. It's not a question of whether immigrants "deserve" care; it's the law. So until the laws change, it's really the difference between paying some now or paying more later.

And data are very clear on the costs of emergency treatment: It's far more expensive than preventive care.

Before we blame "illegals" for the health care crisis, it's important to note that even if noncitizens were removed from the data set, Texas would still lag far behind the rest of the country at 20 percent uninsured, according to the Center for Public Policy Priorities.

Let's stop ignoring this elephant in the living room and do something about it. We'll all be better off.

Moriarty of Methodist Healthcare Ministries put it more bluntly.

"It's stupid for Texas to continue doing what it's doing," he said. "It's morally wrong. It's ethically wrong."