More than 400,000 children and pregnant women in Texas could lose their health insurance if Congress fails to renew federal funding for the Children’s Health Insurance Program (CHIP) by Dec. 9.

The Texas Department of State Health and Human Services in November asked the federal government for an additional $90 million to continue funding through February.

Federal funding for CHIP has received consistent bipartisan support, State Sen. José Menéndez (D-San Antonio) told the Rivard Report, but it is currently “being used as a political football.”

Since the program’s creation, the percentage of uninsured children in the United States dropped from 15 percent in 1997 to 5 percent in 2015.

“No one should be playing politics with children’s health insurance,” Menéndez said. “Children should not be partisan political chips. It’s up to all of us to take care of them.”

Senator José Menéndez (D26) speaks at the unveiling of San Antonio as Military City USA.
State Sen. José Menéndez (D-San Antonio) speaks during a recent event at City Hall. Credit: Hannah Whisenant / San Antonio Report

As of August, 27,070 children in Bexar County were covered under CHIP, according to the Center for Public Policy Priorities, a nonprofit, nonpartisan public policy organization. The same report lists 1,446 women as receiving perinatal CHIP, which provides prenatal and post-delivery services for low-income pregnant women who don’t qualify for Medicaid or have other health coverage.

A dramatic spike in Texas’ maternal mortality rate underscores the perinatal program’s importance. The State’s Maternal Mortality and Morbidity Task Force‘s 2016 joint biennial report found that the rate of pregnancy-related deaths in Texas has nearly doubled since 2010. More than 36,000 low-income women across Texas now run the risk of losing CHIP coverage.

If Congress doesn’t renew funding, 9 million children across the country would become uninsured, according to Anne Dunkelberg, associate director at the Center for Public Policy Priorities.

“[That] leaves [some] parents with a couple of options and other parents with no options,” she said.

Texas House Speaker Joe Straus in November requested that the State’s Health and Human Services Commission “identify … contingency funding options to continue coverage for children currently enrolled in CHIP as Congress completes the reauthorization process.”

The state budget for 2018-19 assumed $3.2 billion in federal CHIP funds; Congress’ failure to renew funding would create an enormous hole in Texas’ budget.

In a letter sent to the Congressional leaders on Dec. 1, Gov. Greg Abbott urged immediate action to renew funds for CHIP, stating it is “necessary because the commercial insurance market is unstable due, in large part, to the Affordable Care Act and other measures,” making plans financially out of reach for many Texas families.

Abbott said that while Texas desperately needs approval for the $90 million requested to continue coverage through the end of February, that “the real solution is for Congress to reauthorize CHIP funding.”

If that doesn’t happen, parents with employer-sponsored coverage may be able to enroll their children in their plan, or they may shop for coverage on the Affordable Care Act (ACA) marketplace, Dunkelberg explained. The deadline for some state residents, including those in Bexar County, to enroll in the ACA has been extended to Dec. 31 due to Hurricane Harvey.

Medicaid and CHIP combined cover about 45 percent of all children in the state. CHIP is specifically designed for children whose parents make too much to qualify them for Medicaid, but are less likely to have an employer-sponsored plan. In Texas, a family of four with monthly income of $4,043 or less, or annual income of $48,513 or less, can qualify for CHIP.

Anne Dunkelberg, CPPP Associate Director
Anne Dunkelberg, CPPP Associate Director

Dunkelberg said that many families rely on CHIP because adding dependents to healthcare plans is expensive and because employers are not required to contribute to the care of covering dependents. This “‘family glitch’ … is the norm in Texas,” she added.

She estimates that adding a child to a parent’s plan can run upward of $500 a month.

While there are options available if CHIP funding is not renewed, Dunkelberg said people will likely experience gaps in their insurance coverage, which may be concerning for parents with sick children. Not having coverage could cause patients to miss out on doctor’s appointments, necessary prescription medications, and medical procedures.

“Normal, healthy kids can probably weather [a gap in coverage],” Dunkleberg said. “But if you have an ongoing, chronic health condition, that could be a problem.”

CHIP benefits are designed specifically to ensure children have access to comprehensive pediatric care without cost barriers, Dunkelberg said, and to support children who face greater needs and, thus, more and higher copayments. Research from the U.S. Government Accountability Office shows that CHIP coverage is more beneficial for Texas children than individual or employer plans.

Menéndez said that if the State doesn’t receive the $90 million from the federal government, lawmakers may have to shut the program down. By law, they would be required to notify families about the change in coverage 30 days in advance; the notifications would reach families just three days before Christmas.

Colorado was the first state to notify residents that they could potentially lose their CHIP coverage if Congress does not approve funding by Dec. 9 and urged beneficiaries to begin looking for alternative coverage. The state has funding to last through the end of January.

“This is a scary time,” Menéndez said. “Real people’s lives are caught in the balance. I can’t understand why renewing this funding isn’t a priority.”

Roseanna Garza

Roseanna Garza

Roseanna Garza reports on health and bioscience for the San Antonio Report.