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Congress: Renew CHIP Funding NOW!

Post author By admin
Post date October 17, 2017

While Congress members were focused on legislation to repeal the Affordable Care Act (ACA) and cut Medicaid, they irresponsibly let federal funding for the Children’s Health Insurance Program (CHIP) expire on September 30. Texas and other states are keeping the program going right now using existing funds, but those will only last for a few months. Several states have already laid out plans for stopping enrollment and/or shutting the CHIP program down, some as soon as November.
Congress’ inaction is a real threat for children’s access to needed health care, and the degree of harm inflicted increases each week Congress fails to reauthorize CHIP.
While some Congress members have started moving legislation to fund CHIP, a prominent House bill includes controversial proposals to offset the costs of extending CHIP funding, suggesting they may not be truly committed to quick CHIP renewal. The U.S. Senate has not revealed its funding plans. The worst House proposal is the repeal of special rules that have ensured that doctors and other providers delivering prenatal or pediatric care are paid promptly in situations where the patient has both Medicaid and another “third party” (e.g., a private) coverage. This includes cases where there is a medical child support order in effect, and it prevents the medical provider from having to pursue the private insurer for payment. Without this policy in place, more providers of child and prenatal health care may stop accepting Medicaid patients, and those who do accept it may delay care while they chase payments from the private insurer.
The Clock is Ticking: Coverage for over 399,000 Texas Kids Is at Stake
Our Texas CHIP coverage program was created with bipartisan support by the 1999 Texas Legislature, and started covering kids in May 2000. The program serves children in households who earn just slightly too much to qualify for Children’s Medicaid. To qualify, for example, a child in a family of three earning $31,000 before taxes is ineligible for Medicaid, but can get Texas CHIP coverage.
Here are numbers for Texas as of June 2017:*

In Texas, Medicaid and CHIP combined today cover about 45 percent of Texas kids (3.4 million out of 7.3 million children).
Over 3.1 million Texas children are covered in Medicaid, and
Another 399,000 children who are not eligible for Medicaid, but lack access to affordable health coverage, get health care in CHIP.
In addition, about 36,000 Texas women received prenatal care and post-delivery check-ups with CHIP funds in June, and
Around 249,000 children in Texas Medicaid were covered under the more generous federal CHIP match rate, which reimburses the Texas budget for over 92 cents for each dollar of care provided in 2017 (92.33 cents in 2017).
Texas’ 2018-2019 state budget assumes $3.2 billion in federal CHIP funds. If Congress does not act, this will tear a hole in the state budget.

If Congress fails to fund CHIP soon, Texas will be forced to join other states in planning how to shut CHIP down. This means kids going without care, expectant moms going without prenatal care, poorer birth outcomes, and low-income families struggling even harder to meet basic needs. Not to mention the big hole in Texas’ budget.
Read more.
For more information, take a look at:
“What’s next for CHIP?” by the Georgetown Center on Children and Families
Renew CHIP even though kids don’t make campaign donations
Dallas Morning News: Funding Disagreements Put Children’s Health Insurance Program at Risk
CHIP worked. It’s not too late for Congress to bring it back. Ken Janda, for the Houston Chronicle, October 13, 2017.
Fort Worth pediatrician says 1 in 10 U.S.-born babies born in Texas.
* Note: Texas Medicaid-CHIP enrollment is typically reported on a monthly basis. However, some national sources may report the number of “ever-enrolled” children in a year, meaning they would include a child even if only enrolled for one month out of 12. Naturally, these annual numbers are higher than for a monthly enrollment snapshot. You can see Texas’ ever-enrolled annual numbers here.

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Factsheet

Children’s Health Insurance Program (CHIP) Essential Care, Designed for Texas Children

Post author By admin
Post date October 16, 2017

Tags Children’S Medicaid, Chip, Health Care, State & Federal Budget

Executive Summary Report

Consequences of the Texas Public School Funding Hole of 2011-16 – Executive Summary

Post author By admin
Post date October 3, 2017

Tags K-12 Public Education, School Finance

Blog

Gap between Texas and U.S. in Health Coverage Continues to Widen, Census Shows

Post author By admin
Post date September 12, 2017

Today’s U.S. Census data release confirms that the number of Texans without health insurance continued to decline in 2016, with uninsured Texans dropping by 70,000 from the 2015 number, and by over 1.2 million since 2013. But despite the progress, Texas still has both the largest number (4.5 million) and percentage (16.6 percent) of uninsured residents in the country.
Today’s release of the Current Population Survey (CPS) by the U.S. Census, including a sneak preview of health insurance data from the American Community Survey (ACS), provides the third year of Census data showing how much health insurance coverage has grown since the launch of new private and public coverage options under the ACA in 2014. Nationally and in Texas, uninsured rates dropped by smaller margins from 2015 to 2016 than in the first two years of ACA coverage implementation.
“We are really pleased to see that in 2016, the Affordable Care Act continued to boost health insurance coverage in Texas,” said CPPP Associate Director Anne Dunkelberg. “But too many hard-working, low-income Texans are still left uninsured, and the long-lasting effects of Hurricane Harvey have now created new need among Texas families. Today’s release underscores the need for both rapid health care relief for those affected by Harvey, and long-term solutions to provide free or low-cost health coverage to a newly-enlarged population of poor and low-income working families. All Texans will see health benefits and cost savings if Texas follows the lead of the majority of states – including very conservative states –by expanding coverage for these families using federal Medicaid dollars.”
Today’s Texas highlights from the Census Bureau’s Uninsured data:
*Texas saw another year of improvement in our overall (all ages) uninsured number and rate:
**2013 = 5.7 million Texans (22.1 percent)
**2014 = 5.0 million Texans (19.1 percent)
**2015 = 4.6 million Texans (17.1 percent)
**2016 = 4.5 million Texans (16.6 percent)
Note: Percentage declines in 2016 are statistically significant changes from 2013, 2014 and 2015.
*The Census findings for 2016 add to the important gains we saw in for 2014 and 2015. From 1999 to 2013, Texas’ uninsured rate fluctuated between 21 and 25 percent, and we never had a one-year improvement of even a full percentage point. But since 2013, our state’s uninsured rate has dropped a total of 5.5 percentage points, with 1.2 million fewer uninsured Texans since new ACA coverage options started up in 2014.
*Texas again had a notably smaller improvement in health care coverage than did states that have expanded Medicaid to cover below- and near-poverty adults. New Mexico’s uninsured rate was cut in half from 18.6 percent in 2013 to 9.2 percent in 2016 (a drop of 9.4 percentage points); Louisiana dropped from 16.6 percent uninsured to 10.3 percent; and Kentucky improved from 14.3 percent in 2013 to 5.1 percent in 2016, (a huge drop of 9.2 percentage points).
*The main source of coverage gains in the U.S. and Texas since 2013 has been direct purchase of insurance by individuals and families, including through the ACA marketplace or directly from an insurer (direct purchase coverage grew by 4.8 percentage points for the U.S., about 16.2 million Americans). Medicaid coverage was the second largest source of gains nationally (nationally, coverage under Medicaid grew 1.9 percentage points, by about 7.4 million Americans).
*States that did some form of Medicaid expansion showed larger improvements in their uninsured rates for working-age adults (18-64) than Texas did. This is because non-Medicaid expansion states like Texas cover only a fraction of parents, and cover no uninsured adults without dependent children at home (unless over 65 or disabled, and in poverty). About 23 percent of working age Texans (ages 18 to 64) were uninsured in 2016, compared to a U.S. average of 12.1 percent. Census analysts report that in non-Medicaid expansion states, the uninsured rate for adults in poverty is almost twice the rate found in states with a coverage expansion for the working poor.
*Texas remains the state with both the largest percentage and the highest number of uninsured residents. Prior to 2014, California was the state with the largest number of uninsured residents despite a much lower percentage than Texas, because their population is so much larger than Texas. But California has seen robust increases in both private insurance coverage under the ACA Marketplace and public coverage for working poor adults due to the state’s Medicaid expansion, reducing their total number of uninsured residents below Texas’. California’s uninsured rate dropped from 17.2 to 7.3 percent from 2013 to 2016, bringing the number of uninsured down to 2.8 million, or 1.7 million fewer uninsured than in Texas.
*A much larger percentage of Texas kids (90.2 percent) than adults (77 percent) have health insurance thanks in large part to Medicaid-CHIP coverage available to many low-income Texas kids. Still, the Texas children’s uninsured rate (at 9.8 percent or about 752,000 uninsured for those under age 19) leaves us at the bottom of the rankings with Alaska for the worst uninsured rate for children and teens in the country. Texas needs to do more to get more children who qualify for Medicaid and CHIP enrolled and to fix the barriers that prevent kids in families at higher incomes from getting coverage.
Stay tuned as Thursday (Sept. 14) the Census Bureau will release more American Community Survey data, including Texas-specific data about poverty and income. To better understand the difference between the two American Community Survey (ACS) and the Current Population Survey (CPS), view our side-by-side comparison.
Background:
Last year’s Census release of 2015 data confirmed that the ACA was allowing millions of Americans to gain affordable health coverage. Today’s release of 2016 estimates gives us one more year of data on the downward trend in the uninsured. Today’s data from the ACS—with a massive sample size of about 3.5 million people across the U.S.—confirm with a much higher degree of accuracy what earlier, smaller-sized surveys had predicted. For more information or to schedule an interview with a CPPP expert please contact Oliver Bernstein at bernstein@cppp.org.

Tags ACA, Anne Dunkelberg, Census, health and wellness, Health insurance, Health Insurance and Reform, Health insurance marketplace, Health insurance marketplace subsidies, Medicaid, Medicaid Expansion, Texas Medicaid Coverage Gap

Blog

Legislature Pits Education against Health Care

Post author By admin
Post date August 15, 2017

CPPP Senior Policy Analyst, Chandra Villanueva, co-wrote this post.
This post was updated on August 16th, 2017.
The final version of HB 21 is a step in the wrong direction, worsening funding disparities between charter and traditional public schools. HB 21 also maintains an inefficient funding stream known as ASATR (Additional State Aid for Tax Reduction) for some struggling districts instead of fixing the funding formula that led to their financial hardship in the first place. Finally, HB 21 fails to offer any solutions for Texas’ outdated and underfunded school finance system.
To finance HB 21, the Legislature agreed to use a familiar budget gimmick of putting off a hefty Medicaid payment until the NEXT 2-year budget. Think about putting your rent payment on your credit card and dealing with it later, except it’s the state putting a whopping $563 million bill on its credit card and relying on a future Legislature to pay for it. We oppose both the method of finance and the dramatically smaller investment in K-12 education (the final version of HB 21 gives $351 million for K-12 and $212 million for TRS-Care, compared to $1.8 billion in the House’s original version of the bill).
Deferring Medicaid payments is tolerable if there is a clearly stated commitment by both chambers to fully fund Medicaid supplemental needs in the 2019 session (already projected at least $1.2 billion), and a statement that this deliberately-made shortfall will not result in reductions in benefits, eligibility, or provider payment rates. Considering this year’s self-inflicted tight budget, proposals in this special session to limit state spending, and the Legislature’s history of tax cuts, it’s hard to imagine that will be the case. Chairman Jane Nelson offered such assurances earlier in the Senate Finance Committee debate, but with the Legislature now adjourned sine die, there have not been any written statements providing such assurances.
The Legislature’s decisions to reduce state-budget support for public education have increased local property taxes. Similarly, their decisions not to adequately fund Medicaid have resulted in a shift of health care costs to counties, which now fund over half the state share of Texas hospitals’ Medicaid revenues.
It’s important for all Texans to understand this, and to tell their elected officials that financing and overseeing basic public services is far more important than passing tax cuts that leave the state budget short-funded and shift costs to counties and school districts. The inevitable result of starving the state treasury is to pit health care against education, when the state should instead be fully supporting both of these equally important needs.