by Alberta Phillips /Austin Am-Statesman
Tuesday, June 07, 2005
(Story originally published in the Austin American-Statesman on August 25, 2004)
It's hell being poor anywhere in the United States, but in Texas, there's growing disdain for people who work every day but earn too little to afford more than the basics: food, shelter and clothing.
There is little else that can explain the Legislature's move to ax the Children's Health Insurance Program last year or the Legislative Budget Board's failure this week to restore cuts to CHIP.
CHIP was created to help low-income working families provide health insurance for their children. Most states recognize the social and economic benefits of the CHIP program and have expanded coverage for children. But in Texas, a Republican-controlled Legislature — with Gov. Rick Perry's blessing — deeply pared the CHIP program by revising eligibility requirements to push more kids off the rolls. They were very successful: Since last September when the cuts took effect, 147,000 children have been shoved off CHIP rolls. Lawmakers went further, totally eliminating dental coverage and vision screenings for all children still covered by CHIP.
Most every state wrangled with huge deficits last year, but few chose to balance their budgets by snatching CHIP coverage from children. Texas leaders weren't promoting fiscal constraint in cutting CHIP, but rather a hard-hearted philosophy that government should push away from helping needy people — even those who work every day. The state had ample money last year to maintain the CHIP program at its former level of about 507,000 children. Under new GOP policies, enrollment has declined to fewer than 360,000 children.
Some GOP leaders in Texas have falsely painted CHIP as an entitlement program for folks who are too lazy to work or who believe that government owes them a free ride. But the truth is that CHIP recipients are working families that earn too little to afford private medical coverage and too much to qualify for Medicaid. Unlike Medicaid, CHIP covers only the children in a family, and parents pay monthly premiums of up to $25 and separate fees (co-payments) for doctor visits.
At a time when private health insurance costs are soaring, CHIP offers states an affordable way to assist lower-income families. That's because for every dollar the state invests in CHIP, the federal government contributes $2.59. The bipartisan Kaiser Commission reported last month that 37 states expanded their CHIP program as Texas scaled back its program.
Without Perry's intervention earlier this month, even more children would have lost CHIP health coverage. Families that were three months or more behind on their monthly CHIP premiums had a deadline earlier this month to make at least one payment to remain in good standing.
Missing that deadline meant their children would lose CHIP coverage starting Sept. 1. Perry's intervention prevents those children from being cut from CHIP. The governor asked his health and human services commissioner to further examine the issue and look at whether restoring dental benefits could be an incentive to get families to catch up on their payments.
Those are good first steps, but with school in session the need to fully restore CHIP is more urgent. Illness, tooth decay and poor vision affect a child's school attendance and ability to learn. A healthy student has a better chance than an ailing one of succeeding in school and graduating.
Perry was right to prevent 20,000 more youngsters from losing their health coverage. The Legislative Budget Board likewise made the right move in transferring $591 million to the Medicaid and CHIP programs to cover current shortfalls that are largely the fault of budget writers who low-balled costs for those services last year.
Even so, those stop-gap measures don't go far enough. It would take less than $100 million to restore CHIP coverage for 147,000 children who need regular checkups, dental care and medicine.
Texas has the money. Now it must find the compassion.