Getting CHIP(ed) away


It takes a certain Ebenezer Scrooge psychology to deprive children of health care. Yet that’s exactly what the Republican leadership is doing in our state. Last month, more than 11,000 children lost their state-sponsored health insurance. That’s how many kids vanished from the rolls of the Children’s Health Insurance Program (CHIP), an immensely popular state-federal venture that provides basic health insurance to the children of families that can’t afford private plans but don’t qualify for Medicaid. Since September, when the Legislature’s punitive budget cuts from last session went into effect, CHIP enrollment has tumbled by a total of 119,000 kids or 23 percent. The Health and Human Services Commission, which operates the program, keeps a running tab of CHIP enrollment on its Web site. It used to be a point of pride, back when the program was swelling with a half-million clients. These days, as the rolls shrink each month, the enrollment counter has taken on a grim feel. As of March 1, CHIP served 388,281. As you read this, it’s probably less.

The CHIP cuts have disproportionately affected the poorest children. Of the 119,000 kids who have lost coverage, 48,000 (40 percent) are from families who earn less than the Federal Poverty Level. (That’s $18,850 a year for a family of four. Or, put another way, $13 a day per person.) What’s more, these families, who need the benefit the most, are systematically being wedged out of the program. In August of last year, kids from the poorest families in CHIP comprised 21 percent of the program; just seven months later, that number is down to 15 percent. Policymakers and the media have been slow to pick up on this trend. Those who have noticed can’t pinpoint why the reductions in CHIP coverage are booting so many of the poorest children off the program. But the consequences are clear: More of our neediest kids will eventually suffer from a preventable, chronic disease.

That wasn’t what newly empowered right-wing legislators said would happen last session when they used the $10 billion budget gap as an excuse to attack CHIP. They instituted a new asset test, forced families to re-enroll every six months (instead of yearly), and created a 90-day waiting period for new enrollees. Lawmakers cynically designed these new rules to make it more difficult for families to remain on the program. For good measure, legislators also did away with CHIP’s coverage of dentist visits, hospice care, and eyeglasses. The Republican leadership dismissed the potential impact of the cuts. They speculated that some CHIP families had dropped private health plans to mooch off the state. Exemplifying the Right’s mindset, then-Republican Party Chair Susan Weddington was quoted as saying that kids booted off CHIP would simply have to sacrifice cable TV or make do with a little less “inheritance from mom and dad.â€

A quarter of Texans already lack health insurance, the highest percentage in the nation. Now, more poor children will be denied available health care. The evidence that children with health insurance lead healthier lives is overwhelming. Insured children make more visits to doctors’ offices and receive more preventive care. One recent study found that uninsured children are six times more likely to lack a regular source of health care for such problems as viruses, infections, earaches, and asthma. When a crisis finally sets in, uninsured children end up in public emergency rooms, where medical care is at least four times more expensive, and taxpayers foot the bill. The cuts to CHIP must be undone. Not only is it the fiscally responsible approach, but we have a moral obligation, as a society, to prevent our most vulnerable children from suffering needlessly. —DM