Transcript Slide 1

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Covering Texas Kids:
Federal SCHIP Reauthorization is Next Step in Building on
Success of Texas Medicaid and CHIP
Town Hall Meeting on Children’s Health Coverage
Austin, Texas
January 11, 2007
Anne Dunkelberg, Associate Director
900 Lydia Street - Austin, Texas 78702
Phone (512) 320-0222 – fax (512) 320-0227 - www.cppp.org
Center for Public Policy Priorities
www.cppp.org
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Texans and Health Insurance
US Census Bureau Statistics (March 2006 CPS):
• Approximately 5.5 million Texans uninsured in 2005
–24.6% of Texans of all ages were uninsured (versus
15.7% U.S.)
–26.9% of Texans under age of 65 were uninsured
• Another three million Texans covered by Medicaid or CHIP
(i.e., generally not insured through private coverage)
Center for Public Policy Priorities
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CHIP and Medicaid: Helping Texas Kids
As of December 2006:
• 1.76 million Texas children were enrolled in Medicaid
• about 97,000 of these children get Medicaid because of a serious disability
• About 125,000 in TANF cash assistance families (7% of the kids)
• Other 1.5 MILLION predominantly in WORKING poor families
• 326,231 Texas children were enrolled in CHIP.
“CHIP stands on the broad shoulders of Medicaid”
That’s 2.09 million Texas children –
nearly one-third of all our kids.
Center for Public Policy Priorities
www.cppp.org
Texas Kids’ Uninsured Rate Drops,
Thanks to CHIP and Medicaid
Since CHIP and Streamlined Children’s Medicaid:
• 20.4% of Texas children under age 19 (1.37 million) are uninsured
– just over two-thirds (68%) are in families below 200% FPL.
• There are about 6.6 million Texas children (under age 19).
BEFORE CHIP and streamlined Children’s Medicaid
In 1997, When Congress created the CHIP Block Grant, U.S. Census
estimated that:
• 24%-25% of Texas children were uninsured (about 1.4 million
children),
– and over three quarters (76%) of these were in families at or below
200% FPL.
• There were about 5.95 million Texas children (under age 19).
Texas CHIP and streamlined children’s Medicaid have provided
health coverage for about 1 million more Texas children.
Uninsured Texas children below 200% FPL (kids potentially served
by children's Medicaid and CHIP) have dropped from 35% to
29%.
Center for Public Policy Priorities
www.cppp.org
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Income Caps for Texas Medicaid and CHIP, 2006
250%
200%
$21,708
$30,710/yr $30,710/yr
$22,078/yr
150%
100%
$16,600
$33,200
222%
200%
Long
Term
Care
CHIP
$7,476
185% 185%
133%
50%
100%
$2,256
$3,696
13.6% 22.3%
74%
0%
Pregnant Newborns Age 1-6 Age 6-18 TANF Working SSI (aged
Women
parent of Parent of
or
2, no
2
disabled)
income
Mandatory
Optional
Income Limit as Percentage of Federal Poverty Income
Annual Income is for a family of 3,
except Individual Incomes shown for SSI and Long Term Care
Center for Public Policy Priorities
www.cppp.org
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Uninsured Texas Children:
We CAN Cut the Number in Half by Enrolling
Kids Who are Eligible Right Now
•Texas is home to nearly 1.4 million uninsured children.
• 2/3 of these uninsured Texas children are below 200% of the federal
poverty line, despite Medicaid and CHIP.
•More than HALF our uninsured Texas Kids Could be enrolled in
Medicaid or CHIP today! (Adjusting for ~230,000 undocumented kids; another
160,000 legal immigrant (LPR) children can participate in CHIP (Pew Hispanic Center)).
Texas Children who are Uninsured, 2004-05 – U.S. Census
All incomes, under age 19 (0-18*; 2-year
average 2004-05 Census CPS)
20.4%
1.367 million
< 200% FPL; under age 19 (0-18; 2-year
average 2004-05 Census CPS)
28% of <200%;
13.4% of all
kids
919,000
Center for Public Policy Priorities
www.cppp.org
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Texas Child Medicaid and CHIP
Enrollment
2,200,000
(Jan. 2002-December 2007)
9/03: 2,150,543
1/07: 2,086,914
Children Enrolled
2,100,000
2,000,000
1,900,000
1,800,000
1,700,000
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1,600,000
Source: Enrollment from Texas Health and Human Services Commission; Texas
State Demographer's 0-17 Population Estimates
Center for Public Policy Priorities
www.cppp.org
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Texas Child Medicaid Enrollment
(February 2001-December 2006)
Simplified Enrollment
begins
High:
1,838,239
1,900,000
now:
1,760,683
1,600,000
1,300,000
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Source: Texas Health and Human Services Commission
Center for Public Policy Priorities
www.cppp.org
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Texas CHIP Enrollment
(May 2000-December 2006)
Highest, 5/02:
529,271
600,000
9/03:
507,259
12/06:
326,231
400,000
200,000
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Source: All figures from Texas Health and Human Services Commission;
Compares most recent month with September 2003
Center for Public Policy Priorities
www.cppp.org
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Texas Unspent CHIP Funds Lost to Other
States
FFY 1998 Federal SCHIP Funds Lost - $170 million
FFY 1999 Federal SCHIP Funds Lost - $324.5 million
FFY 2000 Federal SCHIP Funds Lost - $123.7 million
FFY 2001 Federal SCHIP Funds Lost - $85.3 million
FFY 2002 Federal SCHIP Funds Lost - $104.6 million
FFY 2003 Federal SCHIP Funds Lost - $23.8 million
FFY 2004 Federal SCHIP Funds Lost - $61.5 million*
Total lapsed to date (2000-2006): $893.4 million
Scheduled to lapse on March 31, 2007: $20 million, for a total of 913.4 million
• This total is more than 3 times the federal SCHIP funds Texas
used to run the program for an entire year in 2005 (total Texas
federal SCHIP spending in FY 2005 was $288 million).
Source: Center on Budget and Policy Priorities, analysis of CMS data. *Lapse of
2004 allocation based on Congressional Research Service reports as of
12/13/2006.
Center for Public Policy Priorities
www.cppp.org
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Texas Needs the Federal SCHIP Block Grant
to Grow - Or Else Texas CHIP Cannot Grow!
• Had CHIP enrollment stayed at 2003 levels (or grown),
Texas would need more federal funds TODAY
• In order for Texas CHIP to grow, and to cover the
hundreds of thousands of eligible, but not enrolled, kids,
we WILL need Congress to increase the block grant.
• The new Texas CHIP perinatal program will also speed
up Texas’ need for more federal SCHIP funds.
• BUT, Texas’ CHIP allocation (share of the pie) will likely
be targeted for cuts by some in Congress based on our
recent lower enrollment.
Center for Public Policy Priorities
www.cppp.org
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Federal SCHIP Reauthorization, 2007:
The National Picture
• The Original SCHIP block grant did not grow with
population or inflation, so more funds are needed JUST
to let states keep serving their current children with the
same income limits
• Federal CHIP officials estimate that without more money
in the block grant CHIP enrollment will have to be cut by
one-third—from 4.4 million to 2.9 million children
nationwide.
• Many other states also want to reach their eligible, but
not enrolled children! More Block Grant funds will be
needed to allow us to provide all eligible kids with costeffective health care.
Center for Public Policy Priorities
www.cppp.org
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Too Close to Turn Back:
Every Child Needs Access to Comprehensive
Health and Mental Health Coverage
• Inspired by the success of Medicaid and SCHIP, three
states have begun implementing programs with a goal of
covering all children with no upper income limit.
• Building on their child Medicaid-CHIP programs
Massachusetts, Illinois, and Pennsylvania provide
subsidized coverage of children up to 300% to 400% of
poverty, and allow buy-in for children at higher incomes.
• A number of other states (CA, CO, MN, NM, NY, OR,
WA, WI) are currently considering similar major
expansions of access to care for children, designed to
ultimately reach coverage for every child.
Center for Public Policy Priorities
www.cppp.org
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What Texas Kids Need
Federal SCHIP Reauthorization, 2007
• SCHIP Block Grant must grow to allow states to:
– Keep their current programs, without cuts to enrollment or
benefits
– Cover all eligible/not enrolled children @ current eligibility
thresholds. Texas needs this to cut the number of uninsured
children in half!
• As recent exciting new state-level initiatives to cover all
children show, Americans are ready today to take steps
to cover more uninsured kids.
• CHIP stands on Medicaid’s broad shoulders: NO cuts to
Medicaid to offset SCHIP.
Center for Public Policy Priorities
www.cppp.org
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