Don’t Accept the Unacceptable Insurance Rates for Texas Kids

This commentary originally appeared in the San Antonio Express-News, the Amarillo Globe-News, and the Longview News-Journal.

When Rocio Castillo’s kids and other San Antonio children are healthy, they are more likely to make it to school each day and focus in the classroom.


When kids are able to go to regular check-ups, they get immunizations to keep them healthy. When they have appointments during the critical period of early childhood brain development, doctors can spot developmental delays that might require occupational therapy or speech therapy. And when kids across Texas are sick, whether from a strep throat or cancer, they need to receive a quick diagnosis and appropriate medical care.

But new numbers out from the U.S. Census Bureau show that many kids in San Antonio and throughout Texas are not able to get the health care they need.

The data show that Texas has the nation’s highest rate of children without health insurance — by far. In Texas, 11.2 percent of kids were uninsured in 2019, twice the national average and much higher than the second-worst rate, Alaska’s 9.4 percent. It’s a problem throughout the state, with metro areas from Amarillo to Brownsville, Longview to Odessa, and Dallas to San Antonio all dealing with these high uninsured rates.

Lately, Texas has been moving in the wrong direction, with the uninsured rate for kids getting worse each of the last two years. Data from our state’s Health and Human Services Commission reveal a big reason that more children are uninsured: The number of Texas kids enrolled in Medicaid or the Children’s Health Insurance Program fell by 228,000 from December 2017 to June, a 7 percent decline.

This brings us back to Rocio Castillo’s kids — and what the Legislature can do to get Texas moving in the right direction.

During the recent legislative session, the San Antonio Express-News reported that Castillo’s children, like thousands of other children in Texas, lost their Medicaid health insurance due to the extra red tape in the state’s system.

The paper reported, “She is constantly sending documentation to the state, she said, even though nothing is changing with her family income.”

At a time when so many employers in Texas pay low wages and offer little to no health coverage, Medicaid and CHIP are critical to provide health care to the children of construction workers, sales clerks, janitors, home health aides and other Texans.

But the state requires many families to keep providing documentation throughout the year, on a tight timeline, to remain enrolled. As a result, many Texas kids cycle on and off insurance, leaving gaps in their health care and creating more paperwork for everyone involved.

State legislators on both sides of the aisle have recognized that the system needs to be improved so eligible children stay enrolled in Medicaid. During this year’s legislative session, San Antonio Rep. Philip Cortez teamed up with House Human Services Committee Chairman James Frank and children’s advocates to pass a measure through the Texas House that would have taken a first step toward reducing unnecessary paperwork.

Unfortunately, the Senate did not take up the legislation. In the end, the Legislature did not pass any bills to reduce the uninsured rate for Texas children.

We’re disappointed the Legislature came up short, but we’re also hopeful that state leaders will build on the conversation that started during the recent session, take a hard look at the numbers and decide to make children’s health coverage a priority.

By making administrative improvements to the state’s system this year and passing children’s health coverage legislation during the 2021 legislative session, state leaders can cut through the red tape that families face and ensure that more eligible kids stay enrolled in their health coverage.