Legislature must build on children's health coverage progress

This commentary originally appeared in the Austin American-Statesman.

When it comes to making our state healthier, a new report shows that we really can make progress when we roll up our sleeves and get to work – and that we still have more work to do here in Texas. Our state has made progress ensuring that fewer children face a major obstacle when they need to go to the doctor when they’re sick or to get the preventive care that keeps them healthy. That means more smiling kids, more students showing up to class, more kids playing with their friends without spreading germs, and less time parents have to take off of work.

A report our Texas Well and Healthy coalition recently released with Georgetown University’s Center for Children and Families found that last year the number of uninsured Texas children fell by an estimated 100,000. The progress reflects the success of the state’s Children’s Health Insurance Program (CHIP) and Medicaid programs, as well as enrollment in health plans through the federal Marketplace.

But that’s only half the story. The data also shows that even with that progress, Texas is in a dead heat for the worst rate of uninsured children in the nation, with 11 percent of Texas kids — a total of about 784,000 children — going without health insurance last year.

The nationwide data in the report also suggests how Texas can build on our success. The numbers reveal that the states that made the most progress connecting kids with health insurance are the ones that accepted Medicaid expansion funding to cover uninsured, low-wage workers.

It turns out that when parents have an affordable health insurance option for themselves, it’s more likely that their kids will enroll in CHIP or Medicaid.

Of course this "welcome mat” effect isn’t the only way that kids benefit when their parents have health insurance. Kids also benefit when parents are healthy — particularly before, during and after a pregnancy — and when families don’t have the financial and emotional stress of stacks of unpayable medical bills.

Currently, around a million uninsured Texas adults could get health insurance if state leaders rolled up their sleeves and developed a plan to accept the federal health funds intended to cover these workers and parents. These one million Texans don’t qualify for the state’s bare-bones Medicaid program, which for now only covers working-age parents if they make less than about $3,700 per year for a family of four, have a disability, or are pregnant. These Texans don’t get insurance from their jobs as child care providers, construction workers and cooks, and their jobs don’t pay enough for them to qualify for subsidized health insurance on the federal Marketplace. These are our family and friends and neighbors stuck in what’s called the coverage gap.

We agree with the chambers of commerce, economists, doctors, religious leaders, and others who are urging the governor and the Texas Legislature to accept the federal government’s offer to negotiate a plan to cover these workers, just as several other "red states” have done. They point out that closing the coverage gap would help small businesses that can’t afford to provide insurance to their employees or have them out sick; create hundreds of thousands of new jobs; and cut down on the higher insurance premiums and local taxes that many of us pay for the safety net system for the uninsured.

Those are all important reasons, but we believe closing the coverage gap is particularly important for Texas children. Given this new research, the experience of other conservative states and the diverse Texas voices calling for a coverage solution, it’s time for lawmakers to build on the progress we’ve made and ensure that more Texas children and families have access to affordable health insurance.

Stephanie Rubin is CEO of Texans Care for Children.