Background on Children’s Health Insurance Program (CHIP)
In 2006, Rep. Sylvester Turner’s legislative office received a phone call from Tamika Scott, the mother of Devante Johnson, a young child who suffered from advanced cancer. Ms. Scott reported her obstacles in enrolling her son in health coverage. As a result, Devante was without health coverage for several months, leaving him without essential treatment for his illness. Rep. Turner through the assistance of the Texas Health and Human Services Commission along with Ms. Scott was able to finally have Deveante enrolled in health coverage. Unfortunately, Devante lost his life less than a year later.
The challenges Devante’s mother faced in enrolling him in coverage highlighted numerous problems with CHIP. These problems included a new eligibility contractor, changes in eligibility requirements, staff turnover, lack of eligibility staff training and outreach cutbacks. Devante’s case was also part of a disturbing and growing trend at the time in which more than 181,000 children had lost CHIP health coverage since budget cuts took effect in September, 2003 resulting in a 36% enrollment loss. The cuts also caused a loss to the state of $900 million in federal matching funds that were returned to the U.S. Treasury and spent by other states. In addition, Texas had the highest rate of uninsured children in the nation with one in five children or 1.4 million lacking coverage. Half of the 1.4 million children were eligible but not enrolled in CHIP or Medicaid.
CHIP was originally passed into law in 1999 with the support of both Republicans and Democrats in the Texas Legislature. The intent of CHIP was to provide health coverage for uninsured children who did not qualify for Children’s Medicaid and whose parents did not earn enough to afford private health coverage. It was developed with extensive input from communities and pediatric health care professionals from around the state.
The building blocks of the program were simple – a non-bureaucratic application process, well-funded community based outreach, comprehensive health care services designed for children, and continuous eligibility for 12 months.
An integral component to the creation of CHIP was its vital role in keeping children as healthy as possible by making it easy for families to get the regular check-ups and preventive care children need. It also ensured that parents could access high quality medical care for their children when they do get sick or injured. Sadly in 2006 7 years after the programs creation, the number of children served by the program had peaked in 2003 and in 2006 had dropped to less than 300,000.
In an effort to boost enrollment within his district in Northwest Houston and throughout Harris County Rep. Turner hosted a CHIP Enrollment Drive and CHIP Town Hall Meeting, May 6, 2006 at the George R. Brown Convention Center. At the event, more than a thousand children throughout Harris County applied for CHIP and Medicaid and several hundred were ernolled. HHSC staff including spanish speakign staff were on hand to assist families fill out the applications.
Passage of HB 109 which Restored CHIP to its Original Design
Just one week after the CHIP Enrollment Drive, Rep. Turner held a press conference May 11, 2006 to announce the filing of House Bill 174 in a Special Session of the Texas Legislature. The intent of House Bill 174 was to return CHIP to its original design of a simple application process, twelve months of continuous coverage, strong outreach to enroll eligible children and a fair and equitable income asset test. The net effect of HB 174 was to cut red tape and removing the barriers to enrollment. During the press conference Rep. Turner stated, “Families applying or renewing their applications for CHIP are experiencing an obstacle course that ends with children receiving no service. Families are frustrated, children are getting sick with no care and county hospitals are facing the daunting future costs of treating children whose visits to the emergency room could have been prevented by CHIP“.
House Bill 174 did not pass in the special session, however, Rep. Turner continued to seek passage of this legislation by filing it again in the regular session of the 80th Texas Legislature.
On November 13, 2006 the first day of pre-filing for the 80th Legislative Session, Representative Turner re-filed House Bill 174 in the form of House Bill 109 which again sought to reinstate CHIP and restore it to its original design. The bill eliminated the barriers that families had encountered when applying or renewing their applications for coverage, allowed for parents to enroll their children for up to 12 months of continuous coverage and eliminated a 90-day waiting period. It was estimated that the bill would add 130,000 more chidlren to the CHIP rolls by the end of the biennium.
In a Republican majority led House and Senate, Rep. Turner was able to successfully pass HB 109 and the bill was signed into law by the Governor. In September 2007, several months after the bills passage, the Health and Human Services Commission reported CHIP enrollment had increased by 27,117 children and as of March, 2010, 500,194 are currently enrolled in CHIP. Following the passage of HB 109, Rep. Turner received numerous awards for his persistent and tireless efforts to ensure eligible children received the health care they needed.
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