Texas medical officials hopeful about CHIP expansion

A U.S. House-approved measure that would expand the federal Children's Health Insurance Program could extend coverage to tens of thousands of uninsured Texas children.

Passed by the House this week, the bill would make CHIP coverage available to children of legal immigrants without a waiting period and would raise the maximum income threshold for CHIP eligibility.

Children's advocates on Thursday celebrated the possible expansion of the program, but state officials reacted more cautiously, saying it was too early to know what changes are in store for CHIP in Texas.

Nationwide, the legislation - which President George W. Bush vetoed twice - is intended to extend coverage to 4 million children and continue coverage for 7 million children. A similar bill is under consideration in the Senate Finance Committee.

The measure allows states to cover families who earn up to 300 percent of the federal poverty level, or $63,600 for a family of four. Currently, Texas and other states extend CHIP coverage to families who earn up to 200 percent of the federal poverty level, or $42,400 for a family of four.

Federal law previously prevented states from extending CHIP coverage to legal immigrants who are under 21, as well as pregnant women, until they have been in the United States for five years.

A tax increase on tobacco and cigarettes would help fund the CHIP expansion, which carries a $32 billion price tag.

In Texas, children who are legal immigrants already qualify for CHIP coverage, but the state receives no federal funding for it, said Stephanie Goodman, spokeswoman for the Texas Health and Human Services Commission, which oversees CHIP and Medicaid in Texas. The state will pay for coverage of 20,000 children in that category this fiscal year at a cost of $33.3 million, she said.

If the federal bill becomes law, Texas would be able to draw down more federal dollars for CHIP, possibly insuring and reaching more children, she said. The Texas Legislature would have to take up the issue first, however.

Texas' CHIP already covers pregnant women who earn up to 200 percent of the federal poverty level.

Luisa Saenz, director of the Children's Defense Fund of the Rio Grande Valley, said Thursday that the federal legislation was an important step but that the Texas Legislature must agree to pony up funds for other aspects of CHIP as well. Each state must provide matching funds to receive federal CHIP dollars, and Texas legislators have chosen not to appropriate matching funds for some parts of the program.

"I hope that Texas will use the additional funds ... to add more children and make the services more complete," Saenz said.

According to a recent report by the nonprofit Texans Care for Children, about 21 percent of Texas children were uninsured as of 2007.

And too many Texas children are still falling through the cracks, ineligible for CHIP or Medicaid, Saenz said.

"We need to add on as many children as need coverage," she said.

Many uninsured children in Texas - about 170,000, according to the Health and Human Services Commission - qualify for CHIP but still aren't enrolled, Goodman said. The state already has undertaken outreach efforts to enroll these children, but with additional federal funds the agency could do more, she said.

Every step toward insuring more children is welcome, said Dr. Brian Smith, regional director for Texas Department of State Health Services' Region 11, which includes the Rio Grande Valley.

"The more people we can cover, the better off we are - the more children will receive vaccines, the more able we'll be to deal with the early effects of obesity," Smith said.

Melissa McEver covers health and environment issues for Valley Freedom Newspapers. She is based in Harlingen and you can reach her at (956) 430-6252.