Expanding Health Coverage for Texas Children

Texas Times
With little fanfare, in late 2007, Congress extended the current State Children’s Health Insurance Program (SCHIP) for 15 months. The development was good for Texas, and it’s worth reviewing how it happened.

 

Children’s health is an important issue to many Texans. There are too many people in our state without adequate access to health insurance. We need to reduce that number, and remove barriers that have increased the ranks of the uninsured—particularly children.

 

SCHIP was conceived 11 years ago as a limited program to cover children in working poor families. Medicaid already covers families at or below the poverty line. SCHIP was designed for families with income up to twice the poverty level, currently $42,000 for a family of four. Most funding comes from the federal government, but state government participation is required.

 

A bill passed twice by Congress last year—and vetoed both times by President Bush—would have expanded the program and established 300 percent of the poverty level as the standard. In fact, some states, particularly in the north and east, have tried to expand SCHIP up to 400 percent of poverty.

 

In my opinion, that plan was not good for Texas. The federal government already pays approximately half of all medical costs in the U.S. This expansion would have increased that percentage. Some believe the federal government should pay for all medical procedures, and this bill would have moved us in that direction.

 

It’s irresponsible for Congress to expand existing programs when it cannot pay for those we’ve already authorized. The bill also relied on funding gimmicks. It would have created more than $50 billion in future expenditures that are not covered by revenue.

 

There were other problems with the bill such as a major tax increase on tobacco products that would have fallen heavily on lower-income citizens. Taking from lower-income taxpayers in order to fund middle-class programs is not standard tax policy.

 

The SCHIP extension means we can concentrate on locating and signing up the estimated 800,000 Texas children eligible for SCHIP and Medicaid who are not enrolled. The Texas Department of Health and Human Services, under the leadership of Albert Hawkins, recently announced it had signed up approximately 53,000 new SCHIP children since September, when revamped regulations approved by the 2007 state legislature became effective.

 

Bringing up enrollment levels will take time. But Texas currently has close to $1 billion in unspent federal funds to do that—without having to impose a major tax increase. There will be more than sufficient federal funds to cover all eligible children. The two bills vetoed by the President would not have insured one more Texas child.

 

I want to preserve the positive parts of the private U.S. health care system. I want as many people as possible to have private health insurance, be able to choose their own doctor and be in charge of their medical decisions.

 

We can move in that direction by eliminating rules that drive up cost, reduce access and prevent people from being able to afford insurance. We can allow risk pooling, increased portability of insurance coverage, more transparency in health information and records, increased preventative care, medical liability reform and equity on health care in our tax system.

 

These reforms may not seem as easy as turning over health care to a single-pay, government-run system. But what we have learned from other countries is that socialized medicine leads to rationing and reduced quality. “Free” care turns out to be expensive, indeed.

 

In the meantime, we have stopped a plan—at least for 15 months—that would have taken millions in Texas taxpayer money and shipped it to other states with SCHIP programs that have lost their focus on providing health coverage for low-income kids. That’s why the little-noticed extension deserves more attention.

 

Sen. Cornyn serves on the Armed Services, Judiciary and Budget Committees. In addition, he is Vice Chairman of the Senate Select Committee on Ethics. He serves as the top Republican on the Judiciary Committee’s Immigration, Border Security and Refugees subcommittee and the Armed Services Committee’s Airland subcommittee. Cornyn served previously as Texas Attorney General, Texas Supreme Court Justice and Bexar County District Judge.