Back in 2009, Lt. Gov. David Dewhurst made an emphatic endorsement for increasing the number of children enrolled in the Children’s Health Insurance Program. “If I had a magic wand, I’d get them all enrolled in the CHIP program,” he said. “Why? I think that at the end of the day, it’s the moral thing to do and, in the long run, the most economical thing to do.”
The moral and economic incentives to enroll as many children as possible are there for both the moderate-income children who qualify for CHIP and lower-income kids eligible for Children’s Medicaid. Both CHIP and Medicaid help children hit important developmental milestones, so they enter school ready to learn. Having insurance also helps kids get check-ups and treatment they need and supports families by staving off bankruptcies that can come from unexpected medical expenses. Improved coverage is important for communities, too, since reducing the number of uninsured brings down costs that otherwise get passed along to everyone. Many Texans pay higher premiums and more for health services due to uncompensated care from fellow Texans, including kids, who are uninsured.
Getting all Texas children covered is more feasible today than ever before. For the first time, nearly all kids are eligible for coverage — whether through CHIP, Medicaid or the new health insurance marketplace.
Since the roll-out of the Affordable Care Act, more families have found out what’s available to them, and more are looking at their options leading up to a Dec. 23 deadline for enrolling in coverage that kicks in at the start of the new year. Many families who earn too much for CHIP or Medicaid have learned they can get financial assistance paying for a plan available in the health insurance marketplace. If this pattern continues and more families get their kids enrolled, our state’s uninsured child rate–the second-highest in the nation—could easily plummet.
That won’t take a magic wand, but it will take allowing the health law to work as intended. Our state should make sure that enrollment experts through the navigator program can do their jobs without excessive restrictions. Texas can maintain common-sense consumer protections without making it harder for people to get the information they need to learn about their options and sign up. Applying for health coverage can be daunting, and the focus should be on helping families with that process.
Also, our state leaders should oppose red tape that stands in the way of children getting health coverage. The Affordable Care Act eliminated some of the hoops that families once had to jump through, for example, to keep their kids enrolled in Medicaid. Texas leaders should support, not fight, the removal of barriers like these.
Our state should have a goal of covering every young person who needs health insurance. For example, foster youth who leave state care, without ever having been adopted, are some of the young adults who are most vulnerable to poor health and life outcomes. Maintaining their health coverage options safeguards these youth through a difficult transition and puts them on a better trajectory. Our state administration, however, is proposing to erode these benefits for some former foster children. That would leave young adults who have no family support to fend for themselves.
Last, Texas can stop standing in the way of whole-family coverage. Roughly 1 in 3 adults who aren’t seniors are uninsured. When hard-working, low-income parents have no affordable coverage options for themselves, they are less likely to know about coverage available to their children. Supporting families’ economic security and their health requires accepting a way to get all members of a family covered.
Instead, our state delayed accepting an expansion of Medicaid, sending hundreds of thousands of working parents into a coverage gap and leaving billions in federal funds on the table. A report just released by the Commonwealth Fund looked at the cost to Texas taxpayers for this delay in coverage expansion and found we Texans will lose more than $9 billion through 2022. The result will be fewer jobs created and fewer resources flowing into our local communities.
Texas is making progress, but more than a million kids in the Lone Star State remain uninsured. Meeting our state’s moral obligation and making the most of an opportunity to improve our state’s economic outlook doesn’t require magic. It requires the resolve to let our federal laws function as intended and continued investments in coverage approaches like CHIP and Medicaid that work.
Travis is a policy fellow at Texans Care for Children.