In 2023, the Texas House passed HB 1599 by Reps. Bucy, Harless, Oliverson, Jetton, and Bonnen, but it did not pass the Senate. In 2025, to empower parents, connect more Texas kids with health coverage, and cut the uninsured rate for kids, the Legislature should pass legislation that mirrors HB 1599.
We’re pleased to see that the Texas children’s uninsured rate has declined in recent years. However, now that pandemic-era policies have ended, the state is likely to see a reversal of that positive trend unless the Legislature takes action. Fortunately, by informing parents of their children’s eligibility for insurance, Texas can make significant strides on kids’ health coverage without expanding eligibility.
There is an urgent need throughout the state to connect more children to health coverage. The following metro areas had children’s uninsured rates in 2022 that were more than twice the national average of 5.1%: Abilene, Beaumont, Brownsville, Dallas-Fort Worth, El Paso, Houston, Laredo, Longview, McAllen, Midland, Sherman, and Waco.
A key reason why the Texas children’s uninsured rate is so high is parents are unaware that their kids are eligible for health coverage. Almost half of the uninsured kids in Texas are eligible for Medicaid/CHIP but not enrolled. Similarly, research with parents of Texas children who are uninsured but eligible for Medicaid/CHIP found that about half were unaware their kids were eligible.
Because so many jobs do not offer health insurance for employees’ children or pay employees enough to purchase private insurance, Medicaid/CHIP is the only viable insurance option for many children. When children do enroll, these programs are successful. For example, 85% of kids enrolled in Medicaid go to their well-child checkups.
To empower parents to support their children’s health, we encourage the Legislature to pass legislation that mirrors HB 1599 from the 2023 session. Under the bill, if a state eligibility worker reviews a family’s SNAP application and determines that their child is eligible for Medicaid or CHIP, then HHSC would contact the parents and offer them an opportunity to enroll the child in health insurance. The bill makes clear that the parents must provide affirmative consent to enroll the child.
In 2023, the bill passed the House with overwhelming bipartisan support, but it arrived at the Senate HHS Committee during the final days of session and did not have a hearing. A wide variety of groups endorsed HB 1599 in 2023, including the Texas Catholic Conference of Bishops, Texas 2036, the Texas Public Policy Foundation, and many medical and faith-based organizations.
Other states, including Alabama, South Carolina, Louisiana, and Georgia, have successfully implemented similar policies.
