March 19, 2007
The LSG evaluates the CHIP bill

Today the committee substitute for HB 109, also known as the CHIP restoration bill gets brought to the House floor. You already know what I think about this, so I'm just going to tell you what the Legislative Study Group thinks. Click on for their evaluation of the bill, both its good and not-so-good points.

In 1999, the 76th Legislature pased SB 445, creating the Children's Health Insurance Program (CHIP), designed for working families who earn too much to qualify for Medicaid yet are unable to afford private insurance for their children. After its implementation in April 2000, the Texas CHIP program became one of the best in the country and by May 2003 had enrolled 513,742 children. Since 78th Legislature's implementation of HB 2292 and its bureaucratic roadblocks in 2003 the state caseload had dropped to a low of 291,530. Current levels are at 325,479 as of February 2007. Texas is home to nearly 1.4 million uninsured children. Two thirds of these children are at or below 200% of the Federal Poverty Level and eligible for either Children's Medicaid or CHIP. The impact of uninsured children is felt by physicians, local emergency rooms, clinics and state taxpayers.

While CSHB 109 has repealed many unneeded provisions, this bill fails to restore CHIP enrollement to pre-2003 levels. The fiscal note for this bill states that 102,224 additional children will be enrolled by fiscal year 2009. This is still 86,039 short of the 513,742 level before HB 2292.

An assets test is not required by federal law and Texas is one of only two states with this stipulation. While CSHB 109 modifies the assets test applied in the state, continuation of its practice does not further the state's goal of ensuring health care access to eligible Texas children. HB 2292 instructed the Health and Human Services Commission to adopt rules to implement an assets test and income verification. However, CSHB 109 permanently places the assets test and income verification in state statute whereas currently they are flexibles rules adopted by the commission. Including this in the bill locks these provisions into statute leaving no flexibility for the commission to change provisions by rule in the future.

CSHB 109 changes the income language from gross income to net income. This will allow the applicant to make certain deductions for child care and child support payments made to other households. This bill also creates a community outreach and education campaign which will provide information relating to the availability of health benefits for eligible children. This is a positive aspect of the bill. The eligibility standards in CSHB 109 increase the allowable family assets from $5,000 to $10,000. This bill also makes exemption for vehicles, the first for up to $18,000 and the second up to $7,500. Currently vehicle exemptions are $15,000 for the first and $4,650 for the second.

This bill restores the twelve months of continuous coverage. The previous six months of coverage was proven to be administratively unfeasible and a barrier to providing health coverage to Texas children. Twelve months of uninterrupted healthcare access ensures a healthier Texas and greater fiscal responsibility by the state. Shortening the period of health coverage for children enrolled in CHIP increases administrative costs to the state and interrupts continuity of care for Texas children. The final provision of CSHB 109 eliminates the 90 day wait period for health coverage which was an added barrier to enrollment.

All emphases in the original.

Posted by Charles Kuffner on March 19, 2007 to Budget ballyhoo