On the Cutting Edge

In the aftermath of severe legislative budget cuts to Medicaid and the Children’s Health Insurance Program (CHIP), depriving hundreds of thousands of Texans of their medical coverage, the state agency responsible for helping low-income parents find jobs is attempting to make matters worse. Texas already leads the nation in the percentage (24.7%) of residents without health insurance. Now the Texas Workforce Commission seeks to redefine the word “work,†placing thousands of moms on public assistance at risk of losing their health care benefits.

In a recent statement, Governor Perry called the 78th Session the “most successful session in decades.†He went on to say that the budget was balanced without raising taxes and that legislation was passed that would “improve Texans’ access to health care.†Improve access to health care? Nothing could be further from the truth.

As a result of budgetary cuts last session, there will be 166,897 fewer Texas children eligible to receive health coverage through CHIP. There will be 8,144 fewer low-income pregnant women eligible to receive prenatal care and 9,959 fewer medically needy adults eligible to receive health care through Medicaid. Nearly 340,000 low-income, Medicaid-eligible children will be deprived of this benefit. In addition, every one of the 830,000 adults on Medicaid in Texas has lost coverage for mental health services, hearing aids, eyeglasses, and podiatry care. Over three-fourths of these individuals are elderly or disabled.

As if this wasn’t enough, the Texas Workforce Commission wants to carry these draconian measures one step further. Through a proposed rule change that is being challenged in Washington, D.C., at least 2,235 additional low-income parents could end up losing their Medicaid health coverage. This may not sound like a lot of people, but the negative impact it would have on the lives of these individuals and their families is huge.

According to federal law, states are authorized to terminate Medicaid benefits for a parent receiving Temporary Assistance for Needy Families (TANF) if the person refuses to work or won’t cooperate with child support enforcement. The Texas Workforce Commission proposes to cut off Medicaid for low-income parents on TANF for reasons that have nothing to do with whether the parent is complying with these requirements or not. Thus, if a child on welfare isn’t receiving all of his immunizations in a timely manner, or doesn’t get regularly scheduled medical check-ups, or isn’t attending school every day, his parents could be denied their health coverage.

The parents impacted would be TANF recipients who are working and cooperating with the state’s child support collection efforts, per federal law. They would be parents who are struggling to maintain employment, usually in minimum-wage or low paying jobs, in addition to meeting the needs of their families. They would be parents who are trying to educate or train themselves in hopes of one day being free of government assistance and self-sufficient. To strip these parents of medical coverage makes no sense. The proposed rule directly contradicts policies that would help to ensure that low-income Texans are healthy, able to work and capable of being productive citizens.

The commission proposal wasn’t part of the savings assumed in the budget the Legislature passed and isn’t needed to maintain a balanced budget for the state. This is simply one more attempt by our new leadership to punish low-income individuals by depriving them of health benefits they’re entitled to, as long as they comply with federal requirements regarding work activities and child support enforcement. By redefining “work†to include ensuring that children attend school or receive immunizations according to a specified schedule, the Texas Workforce Commission would not only violate federal law, it would exacerbate Texas’ abysmal health insurance status and guarantee that we remain the nation’s leader in the percentage of residents without coverage.

State Rep. Elliott Naishtat is from Austin (Dist. 49) and has been a member of the Texas House of Representatives since 1991.