Focus Report, Volume 76, Number 5, February 1999 Page: 3
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A draft of Texas' plan to implement Phase II, which
* would further expand CHIP eligibility, became available
in January 1999 on the Internet at the HHSC's web site,
www.hhsc.state.tx.us.
During the interim, the House Appropriations
Committee, the House Public Health Committee, and the
Senate Interim Committee on Children's Health
Insurance met jointly to receive testimony and advice
from consumers, insurers, and providers. Rather than
expand Medicaid eligibility, which would not allow
Texas to cap state expenditures at a predetermined dollar
amount, legislators directed HHSC and TDH to come up
with other plans that met federal CHIP requirements and
that also:
" covered as many children as possible;
" analyzed costs for eligibility levels ranging from 133
percent to 200 percent of poverty;
" considered additional benefit options; and
" included cost-sharing and outreach activities.
The agencies estimated costs and participation rates
* for three types of CHIP plans: a Medicaid expansion; a
Medicaid "look-alike" plan in which the benefits and
administrative structure would be similar to Medicaid
but enrollment would be capped when state
appropriations were spent; and a separate state-designed
health-benefit plan that would have used a distinct
administrative structure. In November 1998, the agencies
recommended adopting a Medicaid look-alike plan that
would use existing Medicaid administrative structures.
The agencies predicted that state costs for the state-
designed plan could range from $69 million to $166
million in the initial biennium and from $164 million to
$375 million in fiscal 2002-2003, depending on further
direction by the Legislature regarding program
eligibility, benefits, and outreach activities.
Major issues:
- Should Texas be involved in CHIP? Opponents say
Texas should not yield to the enticement of federal
dollars and set up another public program. They say
that the number of uninsured children has been
exaggerated and that Texas should not expand
government bureaucracy to pay for something that
families should handle on their own. They also say
that federal assistance is guaranteed for only 10
years, making it hard to dismantle a program once
federal funds dried up.Yearly Income and the Federal Poverty
Level (FPL) by Family Size, 1998Percent
of FPL
25%
100%
133%
150%
185%
200%
235%Family Size
=2-
$ 2,712
10,850
14,431
16,275
20,073
21,700
25,498Family Size
= 4
$ 4,113
16,450
21,879
24,675
30,433
32,900
38,658Sources: U.S. Department of Health and Human Services
for 100% of poverty; HRO extrapolation to show income
at levels above and below poverty.
Supporters counter that CHIP would reduce the costs
that state and local governments and school districts
bear for caring for uninsured children. They say
CHIP also would help prevent economic losses and
other costs associated with decreased worker
productivity and poor childhood development.
Supporters say a CHIP plan can be designed to
support parental responsibility by requiring families
to pay what they can and inducing families to obtain
insurance in the private market as their incomes rise.
Fears that the federal government would dismantle
this program are unwarranted, since it had bipartisan
support. Also, Texas has three years to spend each
year's CHIP allotment, so it would have three years
to modify or phase out the program should the federal
government reduce assistance after the tenth year.
" State funding proposals. The interim House and
Senate committees recommended spending $151
million annually on a CHIP program. HB 1, the filed
version of the budget bill for fiscal 2000-01, would
appropriate $179.6 million for the biennium for CHIP
from funds the state is scheduled to receive from the
settlement of its lawsuit against major tobacco
companies. (See page 11.) Not specified in either
proposal was whether the recommended amount
would cover increased enrollment of children in the
Medicaid program, an expected outgrowth of efforts
to enroll CHIP kids. However, the January draft of
Phase II anticipates covering the costs of both CHIP
and the newly enrolled Medicaid children within the
recommended $151 million annual budget for CHIP.
Supporters of the Phase II draft say that state
expenditures could be budgeted with greater certainty,Page 3
House Research Organization
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Texas. Legislature. House of Representatives. Research Organization. Focus Report, Volume 76, Number 5, February 1999, periodical, February 4, 1999; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth641172/m1/3/?rotate=180: accessed July 16, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.