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CHIP Expansion in Texas Highlights Continued State Health Coverage Advances

Texas has both the highest rate and the greatest number of uninsured children of any state.  21.8% of all kids in the state, representing over 1.5 million children, lack health coverage.  This is more more than the entire populations of 14 different US States.  Addressing this problem, Texas lawmakers are poised to take a large and bi-partisan bite out of the number of uninsured children.  HB 2962, sponsored by Rep. Garnet Colemanwill expand the state's CHIP program to an additional 80,000 children.  The bill, which passed the House 87 to 55 and is on to the Senate, will create sliding scale premiums for children in families with incomes between 200% and 300% of federal poverty (premiums will not exceed 5% of net family income) and a full-cost buy-in option for children in families between 300% and 400% of poverty.  The full cost buy-in option will be available to children who had lost CHIP coverage because growth in family income made them ineligible and who do not have access to employer coverage. 

Additional Provisions to Ensure Access and Outreach: The bill authorizes additional financial exclusions in determining eligibility, including child support payments and assets in college savings plans so that parents are not penalized for investing in their child's future education.  Additionally, the bill will improve outreach and education to help ensure more eligible children are enrolled. Lastly, the legislation requires the State to take any actions necessary to qualify the state for the temporary increase in federal Medicaid funding available through the stimulus package.  Currently, Texas receives $2.65 from the federal government for every state dollar it spends on children's health care.  Unfortunately, the state has turned away over $1 billion in federal matching funds because of its relatively meager CHIP program.  Texas has the 4th lowest rate of children covered by employer-based insurance, which makes this initiative and the creation of a more robust CHIP program absolutely vital to improving options for coverage for all children in the state.

Other States Act on Kids Health Care: Despite state budget deficits, caused in large part by the economic downturn, many states have acted this year to expand and improve state health care programs for kids.  In fact, the economic downturn and rising unemployment means that now is precisely the time when state's need to step in and ensure access to coverage for children and families.  State CHIP expansions include:

  • Iowa lawmakers approved a $7.5 million CHIP expansion that proponents say will extend coverage to 53,000 uninsured kids and fulfill the legislature's multi-year commitment to ensure all Iowan children have health coverage (SF 389)
  • Montana lawmakers pushed back a conservative effort to phase in a voter-approved expansion of CHIP and progressives were able to achieve full implementation of the plan to insure 30,000 additional kids. 
  • Washington legislators passed HB 2128 to confirm the state's goal of ensuring all kids have health coverage by 2010.  The measure officially named the state's kids program, Apple Health for Kids.  Its new provisions streamline enrollment measures (of the 75,000 uninsured children in WA, almost half are eligible but don't know it), take advantage of the federal re-authorization of the State Children's Health Insurance Program, and modify some requirements for a twin program that will start by 2010 allowing families above 300% of poverty to buy Apple Health coverage for their children.
  • Kansas lawmakers approved a budget that increases funding for CHIP and expands coverage to children in families with incomes up to 250% of poverty. 
  • Arkansas lawmakers enacted an expansion of ARkids, from 200% to 250% of poverty, enabling the CHIP program to cover an additional 8,000 children.
  • In related action, New Jersey, which has CHIP eligibility to 350% of poverty, is mailing a new one-page application to families who indicated on the state tax return that they have children who are likely eligible for coverage.  The state's goal is to cover an additional 350,000 uninsured kids.  

These actions highlight that despite the economic crisis, many state leaders recognize that investing in the health of our children is key to the long-term economic and social prosperity of our country.

Resources:
www.statehealthfacts.org - Health Insurance Coverage of Children 0-18
Progressive States Network - SCHIP "Down Payment" on Health Care Reform Is Signed Into Law
Progressive States Network - Covering All Kids: CHIP Reauthorization, Economic Recovery and Immigrant Children's Health Care Coverage