CHIP offers safety net for families lacking insurance

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By ANGELA WARD

Tuesday, September 04, 2007


Kevin Green/News-Journal Photo

Parents and their children wait recently at the Gregg County Health Clinic in Longview. School officials hope more kids enroll for the state's CHIP, which provides medical care for children whose families earn too much to qualify for Medicaid.




Among the mountains of paperwork parents have to fill out when their children register for school, there usually is at least one document that requests medical insurance information. In the past, parents who didn't have employer-provided insurance but whose income was too high to qualify for Medicaid had no choice but to leave that line blank.

Since 2000, Texas families have had the option of applying for the Children's Health Insurance Program. Texas' program, known as CHIP, covers children whose families can't afford health insurance, but who make too much money to qualify for Medicaid. About 70 percent of the program is funded by the federal government, with the rest coming from the state. Texas has budgeted $620 million for the program in 2008-09.

In recent years, officials have pushed to ensure that families know about the program and get their children enrolled.

\"Hopefully we'll see an upswing in enrollment program during the next couple of months,\" said Camille D. Miller, president of the Texas Health Institute. \"As parents take their children to be vaccinated so they can attend school, they should be exposed to information about CHIP at clinics or doctors' offices.\"

Under the program, families with two members can have annual incomes of $27,380. Families with eight or more members can make up to $69,140 a year.

\"Most of the families who participate in CHIP have at least one parent in the workforce,\" Miller said. \"However, many of them work for small businesses or are self-employed and don't have insurance available to them through their employment.\"

Miller's group seeks to provide leadership to improve the health of Texans through education, research and policy development. She said one of the problems her group is seeking to address is that many families that are eligible to participate don't know about it or are overwhelmed by the application process.

Federal funding for the program is up for renewal this year, but Congress and the White House have not agreed on how to continue the program. The House and Senate have passed bills to extend and expand the State Children's Health Insurance Program to cover children from families that are in somewhat higher income brackets, in recognition that the cost of living in some states is higher than in others. President Bush has said he would veto those proposals because of a concern that some families who make enough money to afford private insurance could switch to the government-funded program.

Mark Young, the executive director of the Longview Wellness Center, said he believes having insurance, privately, through the state program or an employer-provided plan, encourages parents to seek preventative health care for their children, rather than waiting until health problems escalate to a point where emergency care is needed.

\"We definitely try to promote signing up for CHIPS for our patients who are eligible for it,\" Young said. \"It's a good program that covers a lot of services.\"

Parents are sometimes confused by the changing eligibility rules for the program, he said, such as whether they are required to include the family's assets when applying or whether they need only report their income. The clinic typically sees a drop in the number of patients covered by the state program when the eligibility rules change, but it usually picks back up a few months later.

\"Sometimes families can lose their CHIP eligibility because one of the parents will get a pay raise that boosts their income to a level where they are no longer eligible for state-funded insurance, yet still work for a business that doesn't provide medical insurance as a benefit,\" Young said. \"This can be a problem because most privately purchased insurance is prohibitively expensive. On the other hand, sometimes families leave CHIP because one of the parents has found a job which offers medical insurance to its employees.\"

There are 300,262 children in Texas enrolled in CHIP, according to Elizabeth Smith, health and human services program manger for the Northeast Texas Public Health District. The district encompasses 14 counties, including Gregg, Upshur and Rusk counties.

Changes that became effective Sept. 1 should lead to more families being eligible to enroll in CHIP, Smith said. The changes include increasing the asset limit and allowing childcare expenses to be deducted from the household income.

Wire services contributed to this report.

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