Fixing CHIP

Today, the state of Texas took a first step in fixing a very broken Children's Health Insurance Program that has been unfairly denying health insurance to eligible children. Rule changes, bureacracy and mismanaged privatization by Accenture LLP has caused 30,000 children to be dropped from the CHIP roles since December. Today, admitting these problems, Texas Health and Human Services Commissioner Albert Hawkins granted a reprieve to 28,000 children that would have lost services in May.

CHIP is meant to provide health insurance for children of the working poor. Accenture has been wrongly disenrolling families, causing parents to wade through enormous amounts of red tape trying to keep their kids enrolled. The Texas Legislature is at fault, also. Last winter, in order to lower the number of insured children, they started requiring proof of assets tests and other unwieldy paperwork requirements. Of course, what happens is that when more and more kids are unenrolled from CHIP (down from a peak of 500,000 in 2003 to around 200,000 today) our emergency rooms become crowded with sick kids which is a ridiculously expensive way for taxpayers to pay for the health care of the children of the working poor. Consider that for every dollar the state of Texas spends on CHIP, the federal government matches it at $2.56 and reducing enrollment in CHIP really begins to make no sense at all.

Barbara Best, Texas Executive Director of the Children's Defense Fund in Houston, explains that:

The reality is that more than 36,000 children from Harris County have been dropped from the health insurance program for the working poor since cuts took effect in 2003. These cuts are due to serious processing errors since oversight of the program shifted to a private contractor and since tightened eligibility rules were passed by the 2003 Texas Legislature.

Policy changes have also contributed to the decline. While families have always had to provide proof of income to qualify for CHIP, families are now required to reapply every six months to maintain coverage, and they have to pass an assets test that prevents families with small savings accounts and second vehicles worth more than $4,650 from qualifying for CHIP. This means it is now a more burdensome process for both the state and families.

Requiring families to renew twice a year instead of once doubles the paperwork for the state and causes more children to spend months uninsured or to lose coverage altogether.

She also says that:

Maximizing CHIP enrollment is also an important strategy in reducing the number of uninsured. Texas has the highest rate of uninsured children in the nation, with nearly 1 in every 4 lacking health insurance. Almost 90 percent of uninsured children have at least one working parent, but family health coverage is often too costly — averaging more than $900 a month.

Restoring CHIP to pre-2003 levels would be a wise investment for Texas taxpayers and an important tool in ensuring the health and well-being of children from low income, working families.

This is a timely and important topic while the Legislature is meeting in special session. We learned that the state has a larger than expected surplus, a total of $8.2 billion. It would make sense to consider spending some of that surplus to restore CHIP to its 2003 levels. This ties in nicely with the education topic at hand in the special session. Sick kids are not at school. Kids who are not at school are not learning. This is a much bigger problem for our education system than many people, particularly our legislators realize.

Read more about the CHIP situation at the Houston Chronicle editorial here and the front page Chronicle article here. Also, there is a good Bay Area Houston blog post on CHIP with a Clear Lake connection.

Update: Check out this Off the Kuff post on the privitazation mess at the Texas Health and Human Services Commission involving more social service programs than just CHIP. There's good background info here on why the privitazation program was put in place to cut costs, how costs have almost certainly increased under privitazation, the questionable agenda of implementing the system and the cost to children's health.