Texas Dumping Children Out of Low Income Medical Insurance Program

Tony Abdo gojack10 at hotmail.com
Wed Nov 12 10:55:28 MST 2003

54,000 children off insurance rolls
Advocates blame rule changes
Copyright 2003 Houston Chronicle Austin Bureau

AUSTIN -- More than 54,000 low-income children dropped off the rolls of a
popular state health insurance program this year as new, stricter rules
passed by the Legislature took effect.
>From June 1 to Nov. 1, enrollment in the Children's Health Insurance Program
fell from 512,986 to 458,166, the Center for Public Policy Priorities
reported Tuesday.     Even before the 11 percent enrollment decline in CHIP,
Texas led the nation in the rate of uninsured, with one in four residents
lacking health insurance.

The center said that 49,000 of the children who would have been enrolled in
CHIP are not enrolled because of policy changes that took effect in
September.    Among the changes are a three-month waiting period for
enrollment, the inability to deduct child care and child support payments in
calculating income and a requirement to recertify twice a year instead of
once.     Other changes are still to come, including a stricter assets test
to qualify for the program.    Anne Dunkelberg, health policy analyst at the
center, said the figures suggest that estimates of a 169,000 enrollment cut
over the next two years is no exaggeration.

"That amounts to a one-third cut. If people were hoping those estimates were
too extreme then they're going to be disappointed," Dunkelberg said.

But Kristie Zamrazil, spokeswoman at the Health and Human Services
Commission, suggested that most of the cutback came from weeding out
children in families whose incomes have risen.     "Overall, the '04-'05
budget projects a decrease in caseloads largely based on the eligibility
check every six months, which ensures that families who are enrolled in CHIP
meet the eligibility requirements," she said.

The center's report suggests that the enrollment decline resulted from a
combination of changes, some that actually terminate coverage and others
that discourage continued coverage.     For instance, families must now
claim gross income and can no longer deduct expenses such as child support
and child care first.     "The impact of this number is already evident in
the November 2003 CHIP enrollment figures," the center's report said. "About
16,800 children lost CHIP coverage due to this change."

Another factor contributing to the decline so far is a new three-month
waiting period for new enrollees to the program as of Sept. 1. It means that
those who applied in September won't begin getting health coverage until
December.     "This effect accounts for a significant amount of the
reduction in enrollment already seen in October and November," according to
the report.

While Zamrazil said requiring eligibility checks twice instead of once a
year will ensure that only children in eligible families receive CHIP,
Dunkelberg said it also reduces rolls because a certain percentage of
parents will fail to recertify eligible children.    Dunkelberg said she
expects to see another sharp drop in CHIP around March of next year,
reflecting a new assets test.     The assets test won't begin until January.
It will apply to families above 150 percent of the federal poverty line --
$27,600 for a family of three -- and will limit a family's assets to $5,000.
Assets will include any money in checking or savings accounts, plus certain
values placed on vehicles.

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