April 16, 2009 -- In all the fuss and fear over the swine flu pandemic, it is wise for everyone to take some commonsense precautions. One of the best is to see a doctor if you or your child has the symptoms of the flu.
Good advice, but for an estimated 1.5 million children in Texas that simply can't be followed. You see, they have no health insurance and their parents simply cannot afford to pay for a visit to the doctor or for any medication that might be prescribed.
Texas has the highest rate of insured children in the country, as well as the lowest rate of employer-sponsored health coverage in America. That isn't something to be proud of.
Too often, uninsured Texans are forced to go to the emergency room for care. That can be expensive -- for the rest of us. According to a study by the Harris County Hospital District in Houston, treating a child's mild asthma attack costs about $100 in a doctor's office. But if that child goes to the emergency room, the cost soars to $7,300.
And who pays that bill The rest of us who use the hospital, or at least the insurance companies that pay the bills. As a result, private health-care premiums are 13 percent higher to help pay for treatment of the uninsured. In addition, local property taxes must be higher to pay for county reimbursements to local hospitals for charity care.
There is a solution available right now: Medicaid and the Children's Health Insurance Program, or CHIP. Medicaid provides coverage for the poorest of the poor, while CHIP provides coverage for the next tier of children whose families make up to 200 percent of the federal government's shockingly low poverty level.
The Texas Legislature is working on the state budget for the next two years and it is critical that adequate funding for CHIP and Medicaid be included. Both the state Senate and state House have included funding for the programs in their budget bills, but they differ considerably and a compromise acceptable to both sides must be worked out in conference committee.
In addition to our moral responsibility to ensure that all children in Texas have access to adequate medical care, there is a financial incentive to consider as well. For every dollar the state puts into the Children's Medicaid program, the federal government puts in $1.47. For CHIP, the dividend is even greater: For every dollar Texas spends on the program, the federal government provides $2.53. But the state has to invest its money first before the federal government pays its share.
There are several aspects of both the House and Senate versions that must be preserved in the final compromise bill. The Senate measure increases payments to health-care providers who see Medicaid and CHIP patients. Keeping that provision would ensure that more doctors would accept those patients.
The Senate bill also includes a critical program to assist families who earn barely more than 200 percent of the federal poverty level to buy into the CHIP program. Keeping this provision could lead to adding 80,000 more Texas children to the roll.
The House version addresses some non-medical issues that hinder the ability of the working poor to enroll. Current regulations require families eligible for Medicaid to re-enroll in the program every six months, while the House bill would extend that to once a year. That is important because it can take up to three months for a Medicaid application to be processed in Texas (it only takes eight days in Louisiana). The House bill would provide adequate staffing for the Health and Human Services Commission to cut down the waiting period to a more reasonable time.
All children in Texas should have access to needed medical care. We are all better off if all children are healthy. Illnesses such as the swine flu will have a harder time spreading if children can see a doctor when they need to.
We all need to let our state lawmakers know that we support CHIP and Children's Medicaid -- and we expect them to do so, too.
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