PUBLIC BENEFITS


The center focuses on health care access, immigrants' access to services, food and nutrition, the state's eligibility and enrollment system, and TANF.

Recent Public Benefits Publications

Your County and the ACA (09/27/2012)

CPPP has compiled data for all 254 Texas counties to illustrate the expected impact of Affordable Care Act (ACA) implementation on uninsured numbers and rates by county. The sources are drawn from respected and reliable experts including the US Bureau of the Census, Texas demographers Michael Cline, Ph.D. and Steve Murdock, Ph.D., and the Texas Health and Human Services Commission.

Testimony on Texas HHSC LAR (09/26/2012)

The center's Anne Dunkelberg testified at the Legislative Budget Board-Governor’s Office on Budget and Policy public hearing on the Texas Health and Human Services Commission’s Legislative Appropriations for the 2014-2015 budget period. The center’s testimony stressed the importance of the $3.7 billion GR in additional appropriations for 2012-2013 that will be needed to continue Medicaid and CHIP operations after March 2013.

Choices and Challenges: How Texas County Uninsured Rates Will Drop Under Health Care Reform (09/19/2012)

Texas is projected to see the largest percentage gain in insurance coverage of any state under health care reform. With nearly one in four of the 25 million Texans lacking coverage today, any significant gain in coverage will reduce local charity care and uncompensated care costs and tax burdens. A recent model developed by Michael E. Cline, Ph.D., and Steve H. Murdock, Ph.D. of Rice University provides county-level projections to help local officials and residents plan for how increased coverage under the Affordable Care Act could affect their communities.

Testimony: Buying Health Insurance From Other States Will Not Make Coverage Affordable for the Uninsured (09/12/2012)

The center testified at an interim hearing of the Senate State Affairs Committee that allowing Texans to purchase health insurance from companies in other states will not make coverage affordable for the uninsured. Instead, cross-state health insurance sales would create a “race to the bottom,” letting insurance companies choose their regulator and skirt state consumer protection laws.

Comments on Proposed Rules Regarding the Texas Women’s Health Program (09/5/2012)

The Medicaid Women’s Health Program (WHP) provides essential well-woman services to low-income women, saving the state over $40 million annually in the cost of unplanned births and, subsequently, abortions. For every dollar the state spends in the program, the federal government provides nine more. Federal funding in WHP was forfeited when Texas adopted existing program rules designed solely to exclude Planned Parenthood, which provided about 45 percent of services in WHP. These rules conflict with federal Medicaid law by denying women freedom of choice to select their own health care providers, and are currently being challenged in court.

Comments: Proposed Rule Reduces Transparency in Health Insurance Balance Billing (09/3/2012)

When consumers are treated by doctors who are not part of their health insurance’s network, they may be billed by the doctor for everything insurance did not cover " a practice called balance billing. Even diligent consumers who carefully check whether providers take their insurance can end up unexpectedly being treated by an out-of-network provider and balance billed.

What We Know About the Medicaid Expansion (08/1/2012)

The U.S. Supreme Court’s June 28 decision to uphold the Affordable Care Act (ACA) could benefit Texas more than any other state, offering an opportunity to dramatically improve uninsured rates, increase family economic security, and reduce uncompensated care burdens. Legal experts say that the only change to the ACA was the removal of a full loss of federal Medicaid funds as a potential penalty for states denying coverage to U.S. citizen adults in 2014"all other Medicaid provisions remain in effect. Still, the Court’s decision raises the possibility that Texas could refuse to expand Medicaid to adults below and just above the federal poverty line, leaving billions of federal dollars on the table and millions of our poor uninsured.

Essential Health Benefits in Texas (07/23/2012)

Starting in 2014, the Affordable Care Act (ACA) requires that health insurance plans for individuals and small businesses contain “essential health benefits” " a new floor for benefits that will help ensure people have comprehensive coverage. Essential Health Benefits (EHB) must also be included in the benefit package offered through the Medicaid expansion to adults up to 133 percent of the federal poverty level starting in 2014. The ACA outlines ten broad categories of essential health benefits (EHB) that include hospitalization, ambulatory care, maternity, mental health care, prescription drugs, and pediatric services.

Presentation: Texas Has a Health Care Spending Problem, Not a Medicaid Problem (07/13/2012)

Anne Dunkelberg, associate director and senior policy analyst, delivered this presentation to medical students and health care professionals on Tuesday, July 10, 2012, at the University of Texas Medical Branch’s 2012 Health Policy Lunch and Learn Lectures in Galveston, Texas. Her lecture covered the facts and remaining questions about the Medicaid expansion option and what it means for Texas. Materials will soon be revised to reflect new cost estimates released by the Texas Health and Human Services Commission this week.

Texans Need Real Solutions to Our Health Care Needs (07/9/2012)

Associate Director Anne Dunkelberg on the Governor’s announcement about Medicaid expansion and establishment of an insurance exchange as part of the Affordable Care Act.

“Expanding Medicaid is a great deal for Texas and refusing to do so is not something the Governor should decide by himself before Texans have had a full and thoughtful conversation about what's at stake for our state, and then the Legislature needs to decide on a course of action. Our state has an opportunity to help millions of Texans get the quality, affordable health care they need, and we should not pass it up."

Statement: Supreme Court’s Decision Means Affordable Coverage for Texas Families (06/28/2012)

(AUSTIN, Texas)"The Center for Public Policy Priorities released the following statement today regarding the Supreme Court’s decision to uphold the Patient Protection and Affordable Care Act:

“Today’s Supreme Court decision to uphold the Patient Protection and Affordable Care Act is great news for Texas families. With more than 6 million Texans uninsured and billions of dollars in federal funding on the table for our state, Texas has the most to gain from today’s pivotal decision."

What’s at Stake: Texas Has the Most to Lose if the Supreme Court Overturns Health Reform (06/26/2012)

Texas is arguably the biggest beneficiary of the Affordable Care Act (ACA), the national health reform law. That means Texans have the most to gain or lose as the U.S. Supreme Court determines the constitutionality of the ACA. This policy page describes what is at stake for Texans as the Supreme Court reviews the ACA.

Testimony: Federally Facilitated Health Insurance Exchange (06/18/2012)

The U.S. Department of Health and Human Services recently posted guidance for states on Federally Facilitated Exchanges and Partnership Exchanges. Health insurance exchanges are new, competitive health insurance markets that will open in all states by 2014. The Affordable Care Act allows states to set up their own exchanges, but provides the fall-back of a federal exchange in states that choose not to act. Because Texas has chosen to delay planning for an exchange, it is likely that Texas will have a Federally Facilitated Exchange in at least 2014, and possibly longer. The creation of an effective and user-friendly exchange in Texas will be fundamental to expanding coverage in the state, where one of four people is uninsured. The center submitted the following comments on how the federal guidance can be strengthened so that FFEs better serve consumers’ needs.

Statement: New Report Shows Texas Falls Short in Summer Meal Programs (06/8/2012)

The Food Research and Action Center (FRAC) released a national analysis today that shows Texas’ participation in the Summer Food Programs remains low. Only 9.4 percent of low-income kids received summer meals on an average day in July 2011, according to the Hunger Doesn’t Take a Vacation report. Texas’ poor performance, which is lower than the national average of 1 in 7, means missed meals for children and missed dollars for the state. Texas families can find nearby summer meal sites and more information by calling 2-1-1 or through the Texas Department of Agriculture’s website.

The Center Joins Anti-Hunger Partners to Launch Texas Hunger Research Project Website (06/7/2012)

The center is excited to join with our partners to launch a new website, the Texas Hunger Research Project.

The website is maintained through a collaborative effort between three Texas anti-hunger organizations: Texas Hunger Initiative at Baylor University, the Texas Food Bank Network, and CPPP. The site will serve as a clearinghouse for hunger and nutrition-related data, research, and publications. County and state-level statistics on participation in federal nutrition assistance programs along with other relevant indicators will be available and updated as new data is released.

Encouraging Healthy Food Purchases: Alternatives to Restricting Choices in SNAP (05/30/2012)

While the Supplemental Nutrition Assistance Program provides low-income Americans with resources they need to avoid going hungry, it can also be an important contributor to the fight against obesity. Recent research has found that the more SNAP benefits a household received, the more their vegetable, dairy, and meat consumption improved. Low-income Americans who are not participating in the SNAP program or receive relatively low levels of SNAP benefits have been found to be at a significantly higher risk of being overweight or obese than those on the program.

HHSC Enhances Online Eligibility Portal (05/23/2012)

In April, the Texas Health and Human Services Commission (HHSC) launched the newest version of its web-based, “self-service benefit portal.” The new self-service portal is designed to streamline the way that eligibility for benefits is determined. At YourTexasBenefits.com, clients can access information about their application status or benefits from any computer, anytime.

HHSC Enhances Online Eligibility Portal (05/23/2012)

In April, the Texas Health and Human Services Commission (HHSC) launched the newest version of its web-based, “self-service benefit portal.” The new self-service portal is designed to streamline the way that eligibility for benefits is determined. At YourTexasBenefits.com, clients can access information about their application status or benefits from any computer, anytime.

America Has a Health Care Spending Problem, Not a Medicaid Problem (05/15/2012)

Associate Director Anne Dunkelberg testified before the Texas Senate Committee on Health and Human Services May 8. The committee was hearing public testimony related to current and future spending cuts to the Texas Medicaid program. Her testimony stressed that Medicaid per capita costs have grown more slowly than either Medicare or private insurance, and that Texas Medicaid costs per enrollee have dropped over the last decade.

Comments: Improve Care and Satisfaction for Texans Enrolled in Medicaid and Medicare (05/15/2012)

The center submitted comments to the Texas Health and Human Services Commission on the agency’s draft proposal to federal Medicaid and Medicare authorities for a “Texas Dual Eligible Integrated Care Demonstration Project” which would pilot having low-income seniors who qualify for Medicaid and Medicare get coordinated health care and long term services and supports from a single HMO.

Comments to HHS: New Rules Shouldn't Create New Barriers for Families (05/14/2012)

The center submitted comments to U.S. Health and Human Services (HHS) Secretary Kathleen Sebelius on two sets of rules relating to the eligibility determinations and enrollment of individuals into health coverage under the Affordable Care Act (ACA). These rules are critically important to ensure the successful implementation of the ACA and that consumers have a family-friendly and seamless experience in the years ahead. The center’s comments focus on how coordination requirements for Medicaid, CHIP, and new Health Insurance Exchanges can be strengthened to reduce the barriers faced by families.

School Budget Cuts Threaten to Increase Summer Childhood Hunger (05/10/2012)

Texas households experience food insecurity at a rate of nearly 19 percent (one of the highest in the nation). Kids without access to meals are less likely to perform well in school and more likely to be at risk of poor health. While most children have access to meals during the year through the national school lunch program, participation in summer nutrition programs is drastically low, causing food insecurity rates to jump during summer months.

Cuts to SNAP Will Hurt Texas Families Struggling to Afford Food (04/19/2012)

The center on yesterday’s vote by the U.S. House of Representative’s Agriculture Committee to cut the Supplemental Nutrition Assistance Program (SNAP, formerly known as Food Stamps).

“Yesterday’s vote by the U.S. House of Representative’s Agriculture Committee to cut SNAP by $33 billion will hurt the families struggling to afford food in this time of high unemployment and economic distress. A cut of this magnitude would affect over 300,000 Texas families who will struggle to put food on the table without the support SNAP provides. SNAP was designed to expand when unemployment is high and contract as economic conditions improve. In this way the program assures that Texans stay healthy during period of job loss and stimulates our struggling economy. Cuts to this program will only weaken our nation’s ability to weather these rough economic times and return to prosperity."

The Health Reform Law Two Years Later (03/23/2012)

Millions of Texans already benefiting as the Supreme Court considers the law

March is a big month for the Affordable Care Act or the health reform law. March 23rd marks the health reform law’s second anniversary. The health reform law will not be fully implemented until 2014, but many provisions are already in effect and benefiting millions of Texans. From March 26-28, the U.S. Supreme Court will hear legal arguments challenging the constitutionality of the health reform law. Their ruling is expected in late June. We can’t know the final outcome of the case yet, but several lower courts and leading conservative judges have upheld the law.

Examining the Alternatives for the Women’s Health Program (03/9/2012)

Governor’s proposal for a state-only program that excludes Planned Parenthood is a poor choice

The Women’s Health Program provides essential well-woman services. The program is part of Medicaid, a federal-state partnership. For every dollar the state spends in the program, the federal government provides nine more. These federal dollars are at risk, however, because of a new state rule that excludes Planned Parenthood from participating in the program. This new state rule violates federal law, which guarantees women freedom of choice to select their own providers. Now the Governor has proposed keeping the state’s new rule but paying for the program with state funds only. This policy paper examines the state’s alternatives and explains why paying for the program with state funds only is a poor choice.

Testimony: Health Reform under the Affordable Care Act and Texas (03/7/2012)

CPPP provided testimony on the Affordable Care Act (ACA or health reform) to an interim joint hearing of the House Public Health and House Insurance Committees on February 27. Testimony from Anne Dunkelberg provided context on health care spending and highlighted ACA provisions that are in effect now and already benefiting millions of Texans. Testimony from Stacey Pogue focused on the steps Texas needs to take this year to define its “essential health benefits” package, a floor for the coverage millions of Texans will have staring in 2014.

We Must Maintain Our Investment in SNAP: An Efficient, Effective Way to Prevent Hunger and Reduce Food Insecurity (03/7/2012)

The center on the Congressional House Government Oversight Committee hearing on fraud in the Supplemental Nutrition Assistance Program (SNAP, formerly Food Stamps).

“The Center for Public Policy Priorities shares the federal government’s commitment to safeguard taxpayer dollars and applauds USDA’s success, in partnership with the states, at reducing SNAP fraud to historic lows. Given its efficiency and effectiveness at preventing hunger and reducing food insecurity, we call on Congress to maintain its investment in SNAP and reject any efforts to cut benefits or otherwise undermine the program’s ability to fight hunger.

“SNAP, which helps low-income individuals and families supplement their food resources, is critical in Texas where one in six families struggle to afford food. Over three-quarters of the 3.6 million Texans who receive SNAP benefits are children, seniors, or persons with disabilities. To qualify, a family’s net earnings must be below the federal poverty level, $22,350 for a family of four. The majority of SNAP households include someone who works, and program rules require all able-bodied adults to work to receive benefits."

We Must Preserve Our Women’s Health Program (02/28/2012)

The center on Texas’ plans to exclude Planned Parenthood from participating in the Women’s Health Program.

“Every one of us wants to live and work in healthy communities where we all have the opportunity to reach our potential. But our state’s elected leaders are pursuing a tragic course that undermines these goals. Effective March 14, the state plans to implement a new rule designed to exclude Planned Parenthood from participating in our state’s Women’s Health Program, but which in reality will destroy the program.

"The Women’s Health Program provides essential well-woman services, including pap smears, birth control, and breast exams to low-income women without health insurance ages 18 to 44. By implementing this new rule, the state provokes an almost certain cut-off of 90 percent of the program’s funds, which come from the federal government."

Texans Among Americans Least Likely to be Insured Through Work (02/23/2012)

A national report shows employer-provided health coverage has been on the decline over the last decade, and Texans are among the Americans least likely to be covered by their job, or by their spouse or parent’s job. The report from the Economic Policy Institute in Washington, D.C., compares employer-provided health coverage rates for persons under 65 across the states between 2000"01 and 2009"10. While on the decline, however, the report confirms that employer-provided health coverage is still the primary way Americans are covered.

Feeding Minds: Texas Takes on Hunger and Obesity (02/22/2012)

"Feeding Minds: Texas Takes on Hunger and Obesity" is a documentary film that explores the overlapping challenges of childhood hunger and obesity, and what seven cities in Texas are doing to solve this problem.

What Happened and What Work Remains? Texas Health Care and the 2011 Legislature (02/16/2012)

Providing affordable, quality health care for all is a tough challenge for our state and nation. Health care costs have grown far faster than inflation, and despite spending more than all other industrialized nations, nearly 50 million Americans"one in four Texans"lacks health coverage. Slowing health care cost growth depends on reforms to private insurance, Medicare, and Medicaid. This year, Texas’ health challenges were worsened by a deep revenue shortfall from the global recession and an outdated state tax system. Still, we are in a time of great possibility, with market reforms underway and expanded coverage in 2014 under the Affordable Care Act (ACA) health reform law.

Comments: Essential Health Benefits Are Critical Component of Health Reform (02/1/2012)

The center along with nine other Texas consumer groups submitted comments to U.S. Health and Human Services (HHS) Secretary Kathleen Sebelius to offer ways in which HHS’ approach to essential health benefits can be strengthened and improved to support access to quality, affordable health care for all Texans.

New Report on School Breakfast Shows Texas Outperforms Most States; Houston ISD Ranks 3rd Among America’s Big Cities (01/30/2012)

Two new national reports on the National School Breakfast Program demonstrate Texas’ strong commitment to improving the nutrition, health, and academic achievement of its students by providing them a nutritious start to the school day.

Congress Should Continue Emergency UI, Forget Phony Reforms (01/29/2012)

Unemployment insurance (UI) is a critical piece of ensuring financial stability for families and economic recovery for communities during times of high joblessness. Over the next several days, Congress will debate whether to continue emergency unemployment insurance benefits through 2012 as well as various changes to the program. Even as the unemployment rate continues to improve, it will take several years of strong job growth to return to pre-recession employment levels. There are too few jobs available for the number of job seekers, with more than four workers per job opening. Since the federal UI extensions began in Texas in 2008, Texans have made more than two million federal unemployment claims, totaling well over $9 billion. These dollars have protected families and generated demand for goods and services, helping maintain jobs. Cutting off UI abruptly will devastate families and undermine communities. Emergency UI will automatically phase out as the economy improves and the unemployment rate drops. In the meantime, Congress should continue UI through 2012 and reject phony reforms proposed in the House that would allow states to lower benefit amounts, use UI revenues for other programs, and deny UI to workers.

Consumer Groups Applaud Federal Rejection of Texas Effort to Delay Health Reform Consumer Protection (01/27/2012)

Federal officials today rejected the Texas Department of Insurance’s (TDI’s) request to delay full implementation of a new rule that requires insurers to increase the value of health insurance or provide rebates to policyholders.

Essential Health Benefits in Texas (01/25/2012)

On December 16, 2011, the U.S. Department of Health and Human Services (HHS) released a bulletin describing its proposed approach to defining the “essential health benefits” under the Affordable Care Act (ACA, commonly referred to as national health reform). Starting in 2014, the essential health benefits (EHB) will serve as a floor for the package of health care services that must be covered in many health insurance policies. The ACA establishes some parameters for EHB, but HHS’ recent bulletin leaves it up to the states to define EHB within the federal framework. HHS is accepting public comment on its EHB approach through January 31, 2012, via EssentialHealthBenefits@cms.hhs.gov. This Policy Page explains EHB, reviews Texas’ options, and discusses what we still do not know about minimum standards for coverage in 2014.

Statement on Approval of Waiver That Allows Texas to Expand Medicaid Managed Care (12/12/2011)

Associate Director Anne Dunkelberg on the approval of the “Texas Healthcare Transformation and Quality Improvement” Medicaid 1115 Waiver. (Note: This waiver is different from the waiver to block grant Medicaid, which the Health and Human Services Commission has not yet submitted and about which the Center has grave concerns.)

Texas Medical Loss Ratio Adjustment Request A Bad Deal for Consumers (12/7/2011)

The health of our entire state is improved when every one of us has access to quality, affordable health care. A key new consumer protection from the national health reform law will make it easier for Texans to purchase health care plans that provide better value for our money. Insurers are now required to meet minimum standards for how much of each premium dollar is used for health care, and to make rebates to consumers if they miss those standards. A recent request from the Texas Department of Insurance (TDI) seeks to delay full implementation of this new consumer protection, which will redirect to insurance companies hundreds of millions of dollars in rebates due by law to Texas consumers.

Press Release: Texas Consumers Stand to Lose $260 Million in Health Insurance Rebates Under State Proposal (11/29/2011)

(AUSTIN, Texas) - On Monday, Federal officials finalized an application from the Texas Department of Insurance (TDI) to delay full implementation of a new rule that requires insurers to increase the value of health insurance or provide rebates to policyholders. If approved, Texans who buy insurance on their own outside of the protection of an employer could lose $350 in forthcoming rebates on average.

Better Texas Film (11/19/2011)

The Better Texas film. Together we can make our state a better place for all of us. A place of opportunity and prosperity. Because we all do better when we all do better.


National Call-In Day to Urge Congress to Protect SNAP, Child Nutrition Programs in Deficit Reduction Plan (11/17/2011)

The U.S. Senate and House Agriculture Committees have recommended a $4 billion cut to the Supplemental Nutrition Assistance Program (SNAP, formerly Food Stamps) over the next 10 years as part of the deficit reduction plan being developed in Congress. A cut of this magnitude would harm thousands of low-income Texas families who struggle to put food on the table. It would also harm the food industry, Texas agriculture, food retailers and cost jobs. Our state and local economies receive an enormous boost from SNAP spending, particularly during a recession. Last year, 3.6 million Texans received SNAP assistance, pouring over $5 billion into the economy and generating a total of $9.1 billion in overall economic activity. Low-income Texans should not be asked to bear the burden of budget cuts. Congress has smarter and fairer ways at its disposal to balance the budget and resolve our long-term deficit problem, through a balanced package of selected tax increases and careful spending cuts.

Comments on Affordable Care Act (National Health Reform) Implementation (11/1/2011)

CPPP submitted comments on several proposed federal rules that implement pieces of the Affordable Care Act related to Medicaid, Exchanges, premium tax credit eligibility and enrollment, and uniform summaries of insurance benefits. Taken together, these rules outline a sweeping vision for consumer-friendly tools and processes to help people understand and enroll in affordable coverage through Medicaid, CHIP, and the Exchange.

Statement on Reducing the Federal Deficit (10/7/2011)

Executive Director F. Scott McCown regarding what should be done by the Joint Select Committee on Deficit Reduction (the “supercommittee”). The Budget Control Act requires the committee to propose by October 14 a way to reduce the federal deficit by $1.2 to $1.5 trillion over the next 10 years.

“For the good of the country, the committee needs to succeed. But success requires a balanced package that combines selected revenue increases with careful spending cuts. A cuts-only approach would devastate low- and moderate-income Americans because it would mean severe cuts in critical areas like Medicare, Medicaid, and Social Security.

“Our state would be among those hit hardest by a cuts-only approach because we have so many low-income families. Doing nothing would also be hard on Texas because it would trigger automatic cuts, including to defense. Texas benefits from significant federal spending, including from military bases and defense contracting. Most important, though, is that doing nothing would leave the country with an unsustainable imbalance between revenue and spending."

Congress Threatens to Cut TANF Funding While Need Rises (09/23/2011)

Temporary Assistance for Needy Families (TANF) is an important federal program designed to help needy families achieve self-sufficiency.

Nearly 4.4 million Texans live in poverty. At 17.9 percent, Texas’ poverty rate is the 8th highest among the 50 states. Children in Texas are hit particularly hard: 25.7 percent, or more than one out of four children, are living below the poverty line.

While TANF caseloads are projected to increase 7.6 percent from state fiscal year 2011 to 2013, federal funding for TANF remains stagnant and threatens to decrease.

How Texas Measures Up in the 2010 American Community Survey (09/22/2011)

American Community Survey

New data from the Census Bureau’s 2010 American Community Survey (ACS)1 illustrates that poverty and uninsured rates vary dramatically by age, race and ethnicity, and across Texas’ metropolitan areas. Our analyses of the ACS data, released September 22, focus on 10 of the most striking findings.

New Census Data Show Texas' Uninsured Rate Tops Nation (09/13/2011)

The September 13 data released by the U.S. Census Bureau’s Current Population Survey shows that in 2010, Texas remained the state with the highest uninsured rate in the nation at 24.6 percent. The total number of uninsured Texans is 6.2 million people, roughly 250,000 fewer than in 2009.

Children continued to lose coverage through their parents’ job-based insurance. A significant positive note for Texas was the decline for a second consecutive year in the number and percent of uninsured children. This improvement is largely due to more children signing up for Medicaid and CHIP’s public insurance (which more than made up for the loss in job-based coverage), showing the essential role of these programs in protecting children during economic hard times.

Get the full story in the links below.

Federal Report Illustrates Low-income Texans Struggle to Afford Good Nutrition (09/7/2011)

The U.S. Department of Agriculture (USDA) released its annual report that illustrates the struggle low-income Texans face in affording a consistent and nutritious diet. The USDA report, Household Food Security in the United States in 2010, reveals that almost one in five Texas households (18.8 percent, or 1.7 million households) were food insecure between 2008 and 2010, compared to 14.6 percent of households nationwide. Over one-third of these households (6.9 percent) are classified as having very low food security"the more severe condition associated with food insecurity"compared to 5.6 percent of U.S. households. Texas ranks second in the nation for the highest percentage of food insecure households, and is tied for third in the share of households experiencing very low food security.

Major Medicaid-CHIP 2012-13 State Budget Decisions (07/25/2011)

The 82nd Legislature’s state budget for 2012-13 includes Medicaid-CHIP provisions with a mix of specific direct cuts and spending reductions totaling $2.03 billion general revenue (GR: state dollars) including $805 million GR in cuts to fees paid to Medicaid service providers; other benefit and spending cuts totaling about $843 million GR; managed care expansion savings of nearly $386 million GR; and roughly $4.8 billion GR in under-funding"an IOU that will come due early in 2013. This Policy Page summarizes high-level Medicaid-CHIP decisions adopted for health and human services agencies; key funding developments for non-Medicaid health programs will be featured in an upcoming August analysis.

Comments Submitted to U.S. Health and Human Services on Rate Review (07/14/2011)

CPPP submitted comments to the U.S. Department of Health and Human Services (HHS) urging HHS to protect health insurance consumers by broadly applying rate review and disclosure provisions from the Affordable Care Act. Rate review is an important tool for expanding health insurance coverage by controlling costs. HHS requested comments on whether health insurance sold through “association health plans” should be treated like other insurance sold to individuals and small businesses, and subject to new rate review protections.

Premiums Lowered in Federal High-Risk Pool (07/13/2011)

Federal and state high-risk pools provide key coverage options for Texans


The health of our whole state is ensured when all of us have access to quality, affordable health care-when we can count on the preventative care we need to stay healthy and see a doctor when we are sick. For many of us with pre-existing medical conditions, we can only get coverage through a high-risk pool. The Pre-existing Condition Insurance Plan (PCIP) is a federally administered high-risk pool created by the Affordable Care Act. Recently, the federal government announced changes that will help increase access to this coverage"premiums in Texas were reduced by 24 percent and applicants can now prove they have a pre-existing condition by providing a letter from a health care professional, instead of waiting to receive a rejection letter from an insurance company. PCIP is one of two high-risk pools that provide coverage options for Texans.

Threats to Health Care: Attacks on Medicaid, Medicare, CHIP, and Health Reform in Austin and Washington (06/30/2011)

Over 4 million Texans"3 million children and 1 million seniors, adults with disabilities, expectant mothers, and very poor parents"rely on Medicaid or CHIP for the critical health care and community supports they need.

Now, Medicaid and CHIP are targeted for extreme cuts in Austin and Washington.

Memorandum on Medical Loss Ratio Adjustments (06/24/2011)

Under the Patient Protection and Affordable Care Act (ACA), health insurers must spend a reasonable share of premium dollars on medical care and quality improvement efforts, as opposed to administration, marketing, and profits. These standards, known as medical loss ratio (MLR) requirements, hold insurers accountable for how they use consumers’ premium dollars.

Statement on HHSC Earning $6.2 Million in Incentives for Accuracy in SNAP Payments (06/16/2011)

Today, U.S. Department of Agriculture Secretary Tom Vilsack awarded performance bonuses to the states with the best payment accuracy rates in the Supplemental Nutrition Assistance Program (SNAP, formerly Food Stamps) in fiscal 2010. The Texas Health and Human Services Commission (HHSC) earned $6.2 million in payment incentives for its performance in two categories: best payment accuracy and most improved payment accuracy. Center for Public Policy Priorities (CPPP) Senior Policy Analyst Celia Cole released the following statement.

“CPPP applauds HHSC Executive Commissioner Tom Suehs for his leadership, and HHSC’s frontline staff for their hard work in achieving this recognition. At 97.87 percent, Texas’ payment accuracy rate was above the national average of 96.19 percent. (Payment accuracy is measured by the amount of benefits issued accurately as a share of total benefits issued.) And at 4.77 percent, Texas’ tops the nation in most improved accuracy rate."

Statement on Governor’s Addition of Immigration Legislation to the Call for the Special Session (06/8/2011)

On June 7 the Governor added to the call for the special session: “Legislation relating to the use of the federal Secure Communities Program by law enforcement agencies, the issuance of driver's licenses and personal identification certificates, and the abolishment of sanctuary cities in Texas.”

Last year, we released Common-Sense Principles for Immigration Reform, which is a useful starting point to considering these issues. In that paper, we concluded: “To maintain national security, we must be able to control our borders. To grow our economy, we must welcome immigrants who want to work and who have the skills we need. And, we must enforce our laws in a way that honors American traditions and constitutional principles. We can do all this through a common-sense, fact-based approach to immigration reform.”

As the Legislature considers any legislation in response to the Governor’s call, we urge a common-sense, fact-based approach that recognizes the important role immigrants play to our economic vitality and is consistent with who we are as Americans.

HB 5 Texas Medicare-Medicaid Block Grant Compact (06/6/2011)

CPPP testified in opposition to House Bill (HB) 5 of the first called Session. HB 5 would allow Texas to ask Congress’ permission to convert all federal health spending for Texas into a block grant based on 2010 levels. Medicare, Medicaid, CHIP, and all public and mental health block grants would be included; only military, veterans, and Indian Health funding would be excluded. As proposed, Texas could choose to eliminate any current federal standards for these programs (including who cover). The House Committee on State Sovereignty approved the bill for a vote by the full House.

April and May 2011 tracking polls from the Kaiser Foundation find most Americans oppose the idea of converting Medicaid to block grant financing to reduce the federal deficit, and the public remains opposed to major Medicare spending cuts as a way to reduce the federal deficit.

Testimony: Senate Bill 7 by Nelson (06/2/2011)

CPPP testified in favor of Senate Bill (SB) 7 of the first called Session. SB 7 includes elements from the 82nd Regular Session’s SB 23, SB 7, House Bill (HB) 32, HB 3537, and SB 8, plus some additional provisions. CPPP registered concerns about selected provisions of the bill, as well.

Alert: Special Session Health Care Bills Have Public Hearings Thursday, June 2 (06/1/2011)

Major health care bills have been quickly re-filed in the 82nd Texas Legislature’s First Called (“special”) Session. Bills set for a hearing on Thursday, June 2"the third day of the new session"include a stand-alone proposal for Texas to ask Congress to turn Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and all mental health and public health funding into a Block Grant to be run by Texas state government, and to end all federal minimum standards for who gets health care and how federal funds are used [Senate Bill (SB) 5 and House Bill (HB) 5]. Also set for hearing are nearly-identical large “omnibus” bills (SB 7 and HB 7) which set the stage for generally-positive health care payment and delivery reforms, with some troublesome provisions included.

Proposed Federal Cuts Would Sap SNAP of Proven Ability to Help Poor, Hungry Texans (05/25/2011)

With one or more U. S. House-passed, budget-cutting proposals expected on the Senate floor for debate this week, the Center for Public Policy Priorities (CPPP) and the Texas Food Bank Network (TFBN) say that the cuts proposed to the Supplemental Nutrition Assistance Program (SNAP, formerly known as Food Stamps) would weaken the program’s proven ability to help poor and hungry Texas kids and families.

Wrong-Headed Decimation of Family Planning (05/24/2011)

Access to birth control for low-income Texas women will be critically wounded under the conference committee proposed budget, collateral damage in battles over abortion. Contraceptive services"not abortion"will be gutted in the state budget on two fronts. Like all states, Texas funds family planning through federal block grants and through Medicaid coverage. It should be noted that these programs provide not only birth control, but also preventive care and basic check-ups to low-income and largely uninsured women (one-third of Texas working age adults are uninsured). Sadly, the Texas legislature now proposes to profoundly undermine both areas of birth control access (again, not abortion services, which are not covered under either funding source, or funded in any way through our state budget). As proposed, these budget actions will cause over 400,000 Texas women to lose family planning and basic health services.

State Budget Conference Committee Medicaid Decisions: Cuts, IOUs, and Gray Areas (05/24/2011)

The conference committee on the state budget for 2012-13 adopted recommendations for nearly all health and human services issues on May 16. Medicaid provisions adopted include a mix of specific direct cuts and spending reductions totaling $1.65 billion general revenue (GR: state dollars) including $805 million GR in cuts to fees paid to Medicaid service providers; and a $4.8 billion GR under-funding or IOU that will come due early in 2013.

Proposals Would Weaken SNAP’s Proven Ability to Help Poor, Hungry (05/17/2011)

CPPP supports efforts to reduce obesity and encourage Texans to pursue a healthy diet. However, we are opposed to proposals currently being debated in the Texas Legislature [House Bill (HB) 1151 and HB 3451] and the United States Congress that would restrict the use of Supplemental Nutrition Assistance Program (SNAP, formerly food stamps) benefits. These proposals have the potential to erode the value of SNAP benefits─already too little─and would weaken the programs proven ability to help the poorest and hungriest among us.

Bills Harmful to Texans Health (05/13/2011)

CPPP has teamed up with nine other consumer, patient, and faith-based organizations to voice our opposition to a group of bills in 2011 Legislature which fundamentally undermine or radically restructure Texas Medicaid and health reform.

Budget Bills Short on Health Care for Texans (05/12/2011)

The Texas House and Senate have adopted two different budget bills, and a conference committee has begun to work out a compromise budget.

Both chambers provide less money for Texas health and human services than was budgeted in 2010-2011. But the Senate’s version of the budget provides substantially more money for health care and social services than the House version.

Testimony for SB 7: Reforming Texas Medicaid Payment and Delivery Incentives (05/11/2011)

Associate Director Anne Dunkelberg testified for Senate Bill (SB) 7 by Senator Jane Nelson.

Smart Move to Keep our Options Open (05/11/2011)

As the 2011 Legislature winds down, time is running out for Texas to pursue its surest route to a state-based health insurance exchange. A health insurance exchange is a competitive marketplace where individuals and families can purchase private health insurance starting in 2014. Exchanges are established by the Affordable Care Act (ACA or federal health reform), which lets each state choose whether to design and run its own exchange, or turn the task over to the federal government. The ACA’s timeline gives states a limited window in which to pursue a state-based exchange before the federal government assumes the responsibility. Inaction this legislative session does not guarantee that Texas will ultimately have a federal health insurance exchange, but it certainly makes that outcome much more likely.

Medicaid Co-Pays: Proposals Moving Ahead (05/10/2011)

The 2011 Texas Legislature is considering a range of bills that would make major changes to Medicaid, from block granting the program along with Medicare and all other federal health funding, to using Medicaid as the laboratory for testing new models of care delivery and payments. Several bills, including the House and Senate budget bills, assume provisions to start charging some level of co-payments in Texas Medicaid. Given the current extreme revenue shortfall, the pressure to introduce co-payments is greater than ever before; for example, adoption of co-payments for visits to the emergency room that involve non-emergency medical care is considered likely. This Policy Page describes the Health and Human Services Commission’s (HHSC) proposals for Medicaid and the Children’s Health Insurance Program (CHIP) co-payments, the changes proposed in current bills, and the federal law and rules that Texas must comply with when imposing Medicaid and CHIP co-payments.

Testimony on House Bill 5: Will Texas Block Grant Medicare, Medicaid, and all Public Health and Mental Health Services? (05/10/2011)

Associate Director Anne Dunkelberg testified against House Bill (HB) 5 by Rep. Lois Kolkhorst.

Testimony for House Bill 2723: Improving Consumer Notices of Health Insurance Rate Increases (05/9/2011)

House Bill (HB) 2723 by Representative Walle ensures that people who buy health insurance in the individual market (directly from an insurer, not through an employer) will be sent notices of premium increase at least 60 days in advance. This mirrors the notice timeline for job-based health insurance, giving families sufficient time to either shop around for more affordable coverage, or adjust their budgets to be able to absorb the increase.

Testimony on Senate Bill 1430: Authorizing a New Health Insurance Option (05/9/2011)

Senate Bill 1430 authorizes a new type of fully insured health benefit plan, an exclusive provider organization (EPO), that combines features from preferred provider organization (PPO) plans and health maintenance organizations (HMOs). EPOs have the potential to lower premiums, which can increase access to coverage for small employers and families. However, lower EPO premiums come with tradeoffs for consumers"less access to out-of-network care than a PPO and higher and less predictable out-of-pocket costs (deductibles and coinsurance) than an HMO.

Medicaid Selected Article II Analysis (05/3/2011)

The House’s adopted budget and the Senate Finance Committee’s approved budget (the full Senate has not yet voted on this bill) take significantly different approaches to allocating and cutting funding for Texas Medicaid and CHIP. Still, one important approach used by both chambers is a substantial under-funding of the program overall that is not associated with particular policy changes or program cuts. Since Medicaid is an entitlement, an underlying assumption is that the state will keep paying Medicaid and CHIP health providers for services every month as long as there is money available, and can cover the “unassigned” budget cuts with a supplemental appropriations bill in the 2013 session as long as funds do not “run out” before January 2013.

The Texas Health Care Primer (Revised 2011) (05/2/2011)

The Center for Public Policy Priorities and Methodist Healthcare Ministries are pleased to release this updated primer, designed to give readers an introductory overview of factors shaping Texans' access to health care. Readers will be better able to contribute to federal, state, and local debates about how to improve health care access.

Legislation Would Increase Access to Healthy, Affordable Food (05/2/2011)

Senate Bill (SB) 1454, by Senator Eddie Lucio, Jr., and House Bill (HB) 2414, by Representative Boris Miles, seek to improve the nutritional health of Texans by exploring ways to increase access to healthy and affordable food.

Designing a Health Insurance Exchange: The Right Choices for Texas (04/19/2011)

The Affordable Care Act (federal health reform) creates new health insurance “exchanges” or marketplaces that will open in 2014. Each state will have an exchange, and will decide whether to design and run its own exchange, or turn that job over to the federal government.

If Texas chooses to set up and run its exchange, the state will have broad flexibility to design a health insurance marketplace that meets the needs of Texans. If Texas leaders do not act soon, the federal government will have the responsibility of designing Texas’ exchange. Whether decisions are ultimately made by the Texas Legislature or the Obama administration, Texas’ exchange should be designed to give Texas families and small businesses more control, high-quality choices, and better protections when buying health insurance.

Testimony: SB 1004 Encourages Nutrition, Creates Revenue (04/19/2011)

The Center for Public Policy Priorities supports Senate Bill (SB) 1004, because it addresses two major challenges facing Texas: the need to fund a balanced approach to the 2012-13 budget, and the need to improve nutrition and curb obesity, which cost the state $9.5 billion in 2009. Imposing a tax on soft drinks could raise up to $4 billion over the biennium. Increasing the cost of soft drinks has been proven to discourage their consumption, which is associated with poor diet, high rates of obesity and risk for diabetes. Texas needs this additional revenue, along with dollars from the Rainy Day Fund, to minimize damaging cuts to public education, higher education, and health and human services.

Testimony: House Bill 13 Strips Medicaid Protections from Most Vulnerable Texans (04/14/2011)

House Bill 13 by House Public Health Committee Chairman Lois Kolkhorst would direct The Texas Health and Human Services Commissioner to seek a “waiver” of federal law to dramatically restructure the Texas Medicaid program. In laying out the Committee Substitute for her bill, Chairman Kolkhorst identified a recent Rhode Island “1115 waiver” as a model for what Texas might seek. CPPP testified in opposition to the bill. Our testimony details our objection to overly broad terms of the bill that do not give any guarantee of protections for current beneficiaries, covered populations and services. We detail a list of specific provisions which would prevent the concept from being workable in Texas without substantial additional changes to Texas law and protections for Medicaid’s vulnerable population of children, seniors, Texans with disabilities, and expectant mothers.

Statement on the Devastating Effects of the Ryan Budget (04/12/2011)

The Center for Public Policy Priorities (CPPP) released the following statement regarding U.S. House Budget Committee Chairman Paul Ryan’s budget resolution.

Current Budgets Would Place Texas Medicaid and CHIP in Critical Condition (04/8/2011)

Texas Medicaid and the Children's Health Insurance Program (CHIP) provide vital health care and life-saving supports for some of our poorest and most vulnerable.

HB 643 Will Help Kids Eat Right During the Summer (04/7/2011)

House Bill (HB) 643 would ensure more children in low-income neighborhoods have access to nutritious meals during the summer. This legislation by State Representative Eddie Rodriguez would increase the number of school districts subject to a state law requiring districts in low-income communities to operate the program. The Summer Food Program provides over $52 million in federal funds each year to low-income communities in Texas to help serve nutritious meals to children in safe, enriching environments. The Summer Food Program is critical in a state like Texas, where too many children are in poor nutritional health.

Updated Medicaid Spending Losses by County Under CSHB 1 (04/7/2011)

Medicaid funding in the House’s budget falls $5.8 billion in general revenue (GR) below what is needed to maintain the program benefits and populations (state dollars; $13.7 billion all funds). This is after the House added $1.8 billion in GR ($4.3 billion all funds).This is still six times the size of the painful cuts to Medicaid and the Children's Health Insurance Program (CHIP) made by the Legislature in 2003.

Testimony: Support for HB 3397 (03/31/2011)

CPPP supports HB 3397, which would make felony drug ex-offenders eligible to receive federally funded food assistance and employment services through the Supplemental Nutrition Assistance Program (SNAP, formerly Food Stamps). Enabling this population to receive SNAP services would help ex-offenders to rebuild their lives and reintegrate into our communities, thereby reducing recidivism and the state cost of reincarceration. This legislation comes at a critical time for Texas, as lawmakers are considering eliminating $21.2 million for Project Rio, one of the few sources of funding for reentry services.

HB 3397 Would Help Ex-Offenders Rebuild Lives and Reintegrate into Communities (03/25/2011)

The House Human Services Committee will hear HB 3397 on Tuesday, March 29. HB 3397, by Representative Alma Allen would make felony drug ex-offenders eligible to receive federally funded food assistance and employment services through the Supplemental Nutrition Assistance Program (SNAP, formerly Food Stamps). Enabling this population to receive SNAP services would help ex-offenders to rebuild their lives and reintegrate into our communities, thereby reducing recidivism and the state cost of reincarceration. This legislation comes at a critical time for Texas, as lawmakers are considering eliminating $21.2 million for Project Rio, one of the few sources of funding for reentry services.

Testimony on Eliminating Finger Imaging for Food Stamps (03/23/2011)

When finger imaging was first implemented, the eligibility determination process for food stamps was paper-based. At that time, there was no way for the Health and Human Services Commission (HHSC) to electronically verify an applicant’s identify to prevent that person from applying for benefits more than once. HHSC has since deployed the TIERS system and introduced electronic third-party verification using sources such as Data Broker and other electronic interfaces. This technology provides HHSC with more cost-effective tools to verify applicant information and confirm identify.

Celia Cole provided testimony to the House Committee on Human Services on HB 710, explaining that the finger imaging requirement for food stamps both undermines HHSC’s efforts to develop more efficient eligibility and enrollment processes, and costs the state of Texas millions in crucial taxpayer dollars.

Why Texas Should Not Jump Into an Interstate Health Care Compact (03/21/2011)

Opponents to national health care reform are proposing to use federal dollars to fund alternative interstate health care compacts that effectively Block Grant federal health care funding.

Testimony on TDI and OPIC Sunset Bills (03/21/2011)

Texas Department of Insurance (TDI) and Office of Public Insurance Council (OPIC) are under “Sunset review” this session and must be reauthorized by the Legislature to continue. Both agencies are needed to protect Texas insurance consumers.

Medicaid and the State Budget: Mortal Injury? (03/9/2011)

House Bill (HB) 1 and Senate Bill (SB) 1 under consideration today fall short of continuing all state services by at least $27 billion in state General Revenue (GR). The Legislative Budget Board (LBB) estimates Medicaid alone is short $7.6 billion GR"$18 billion including the loss of federal-matching funds. This under-funding would be more than seven times the depth of the disastrous 2003 Medicaid and Children’s Health Insurance Program (CHIP) cuts.

HB 636, Health Insurance Connector: Testimony to the House Insurance Committee (03/3/2011)

The health insurance connector (or exchange) will play a critical role in expanding coverage to low- and moderate-income working Texas families. Under health reform, connectors must both create a consumer-friendly, competitive marketplace for purchasing health insurance and determine eligibility for and facilitate enrollment in exchange premium subsidies, Medicaid, and CHIP. House Bill 636 will establish a Texas health insurance connector. Decisions made by the Texas Legislature in designing a state-based connector will determine whether it can serve the best interest of Texas small businesses and families and enhance constructive competition.

What is a Health Insurance Exchange? (03/2/2011)

The Affordable Care Act (commonly called federal health reform) creates new health insurance “exchanges” that will open in 2014. An exchange is a competitive marketplace for health insurance"think of Travelocity for airplane tickets and Amazon for books"that will give consumers more control, quality choices, and better protections when buying health insurance.

Medicaid and Health Care Access Issues for the 82nd Texas Legislature (02/24/2011)

Medicaid funding proposed in HB l is estimated by the Legislative Budget Board (LBB) as falling $18 billion (All Funds) below the amount need to maintain current benefits, provider fees, and eligibility standards. This underfunding would be more than 7 times the depth of the disastrous 2003 Medicaid and CHIP cuts. While delivery reforms and best practices can and should be aggressively implemented, the best program improvements combined cannot achieve savings anywhere near the $7.6 billion GR shortfall. The Legislature should begin immediately looking for ways to mitigate the damage to our state’s most vulnerable through a balanced approach to balancing the budget that looks to savings and new revenues, not a cuts-only approach.

Standards for State Review of Proposed Insurance Rate Hikes Should be Strengthened (02/23/2011)

CPPP, La Fe Policy Research and Education Center, Texas Legal Services Center, and Texas Public Interest Research Group submitted comments to U.S. Health and Human Services (HHS) Secretary Kathleen Sebelius in response to the notice of proposed rulemaking for Rate Increase and Disclosure Review. While the proposed rule gives consumers and regulators more information on proposed rates hikes, we urge HHS to strengthen the standards for effective state review to better protect consumers and help constrain the growth in health insurance rates.

SB 1 Must Protect Progress in Rebuilding Eligibility System (02/23/2011)

The Texas eligibility system delivers over $25.7 billion in benefits annually, and more than 6.4 million needy Texans rely in these services. When our eligibility system fails, Texas loses out on billions of federal dollars that fuel our state and local economies"particularly during a recession when unemployment has risen and consumer spending has dropped.

We need to provide adequate funding to support the Texas Health and Human Services Commission's eligibility system and DSHS WIC/Farmer's Market Nutrition services.

Proposed Medicaid Cuts More Than Seven Times Deeper Than 2003 (02/16/2011)

Medicaid funding proposed in HB l is estimated by the Legislative Budget Board (LBB) as falling $18 billion (All Funds) below the amount need to maintain current benefits, provider fees, and eligibility standards. This underfunding would be more than 7 times the depth of the disastrous 2003 Medicaid and CHIP cuts. While delivery reforms and best practices can and should be aggressively implemented, the best program improvements combined cannot achieve savings anywhere near the $7.6 billion GR shortfall. The Legislature should begin immediately looking for ways to mitigate the damage to our state’s most vulnerable through a balanced approach to balancing the budget that looks to savings and new revenues, not a cuts-only approach.

SB 1 Must Protect Progress in Rebuilding Eligibility System (02/8/2011)

The Texas eligibility system delivers over $25.7 billion in benefits annually, and more than 6.4 million needy Texans rely in these services. When our eligibility system fails, Texas loses out on billions of federal dollars that fuel our state and local economies"particularly during a recession when unemployment has risen and consumer spending has dropped.

We need to provide adequate funding to support the Texas Health and Human Services Commission's eligibility system and DSHS WIC/Farmer’s Market Nutrition services.

Scott McCown's Remarks on Federalism and the Affordable Care Act (01/18/2011)

On January 13, CPPP Executive Director Scott McCown was invited by the Texas Public Policy Foundation to debate Ted Cruz, former Solicitor General of Texas, on federalism and the constitutionality of the Affordable Care Act. Scott explained why conservatives should support the Act and the advantages for Texas.

Texas Top Five: Key Steps to Make the Most of Health Reform (01/7/2011)

What do we want Texas to be? A state that won’t squander an opportunity to properly implement the new health reform law.

The new law changes the health care landscape in Texas. It is an important tool Texas can use to achieve our own health policy goals, such as increasing coverage, improving transparency and quality, and controlling costs.

News Release — Early Christmas: New Law Increases Investment in Child Nutrition Programs (12/21/2010)

(AUSTIN, Texas)"Low-income children in Texas received an early Christmas present last week. On December 13, President Obama signed the Healthy, Hunger-Free Kids Act into law, which increases investment in the Child Nutrition Programs: School Breakfast and Lunch, Women Infants and Children (WIC), which provides food benefits and nutrition counseling to new mothers and children with a nutritional risk, and the Child and Adult Care Food Program (CACFP), which reimburses day care providers and afterschool programs for the meals and snacks they serve to low-income children and seniors in their care.

Congress Should Extend Unemployment Insurance (11/17/2010)

Congress should extend Unemployment Insurance through 2011: 1) to protect hardworking Texas families whose breadwinners are struggling to find work after the global economic recession, 2) to protect Texas jobs in an economy only beginning to recover, and 3) to avoid shifting costs to the federal-state public assistance programs, particularly when states faces massive revenue shortfalls. With the so many workers chasing so few jobs, it is far too soon for Congress to cut off Unemployment Insurance. This emergency spending is essential to our economic recovery, and Congress should not require offsetting spending cuts. Public opinion strongly favors Congress acting now to protect families and our economy.

Testimony: Interim Charge 4 - Healthy Texas (10/28/2010)

We appreciate this opportunity to comment on the Committee on Insurance’s Interim Charge 4 related to implementation of the Healthy Texas program. As health insurance premium increases outpace small employers’ ability to afford coverage, many Texans are left without access to job-based coverage. Recognizing that new tools and strategies are needed to address health insurance issues for small employers, the 2009 Texas Legislature passed Senate Bill 78, creating the Healthy Texas program, based on a successful public reinsurance program in New York. The center supports the creation of this innovative program and has been an active participant in its implementation.

Special Report: Texas Health Reform Checklist: Key Steps to Make the Most of Reform (09/28/2010)

The new national health reform law will change the health care landscape in Texas. Though Texans’ opinions of the new health care reform law cover the full spectrum from approval to those who would have preferred a different approach, the new law is an important tool that states can use to achieve their own health policy goals, such as increasing coverage, improving transparency and quality, and controlling costs.

Testimony: Sustaining Progress Made in Eligibility System Will Require Additional Resources for Caseload Growth, Implementation of Health Care Reform (09/22/2010)

We commend Executive Commissioner Suehs and the Health and Human Services Commission for the significant progress HHSC has made in improving the performance of the eligibility and enrollment system over the last year. This progress is the result of the infusion of 850 additional workers and a set of policy and procedural changes designed to improve worker productivity. However, sustaining these improvements will be impossible unless the Legislature gives HHSC the staffing and other resources its needs to handle growing caseloads and the implementation of national health care reform in 2014. HHSC’s LAR exceptional items related to staff retention and hiring (#6 and #7) outline these essential needs. Without these resources, the performance of the eligibility system will deteriorate, and Texas will lose out on billions of federal funds that are critical to the health and well-being of our state’s residents and economy.

Uninsured, Poverty on the Rise in Texas in 2009 (09/16/2010)

The year 2009 definitively shows Texas has the most to gain from the health reform law, as Texas remained the state with the highest uninsured rate in the nation at 26.1 percent, or 6.4 million uninsured people, new Census Bureau data show.

The Bureau also released preliminary state-level data showing that poverty rose substantially in Texas, with 428,000 new Texans joining the ranks of the poor from 2008 to 2009; the state's poverty rate rose to 17.3 percent from 15.9 percent.

Plaintiffs Dismiss Federal Food Stamp Lawsuit Sustaining Progress Up to the Legislature (09/1/2010)

On July 31, 2009, Stacy Howard and Linda Thornberg on behalf of themselves and all others similarly situated filed a class action in federal district court against the Executive Commissioner of the Health and Human Services Commission for failure to comply with federal timeliness standards in processing applications for the Supplemental Nutrition Assistance Program (SNAP), formerly called Food Stamps.

Something Old, Something New: Texas' Two High-Risk Pools (07/19/2010)

Thanks to national health reform, Texas now has two separate high-risk pools that offer health insurance to Texans who cannot get coverage in the private market due to pre-existing health conditions: the state-administered Texas Health Insurance Pool, established in 1998, and the federally administered Pre-existing Condition Insurance Plan created by the new federal health reform law.

Starting July 1 Texans With Pre-existing Conditions Have New Access to Quality, More Affordable Health Coverage (07/1/2010)

An important reform of the 2010 Patient Protection and Affordable Care Act launched July 1 when Texans who have been without health coverage for at least six months and who have been denied coverage because of pre-existing health gained access to more affordable, quality coverage. They will receive it through a new Pre-existing Condition Insurance Plan created by the U.S. Department of Health and Human Services (HHS).

What Every Texan Should Know About Health Reform Implementation (06/10/2010)

There is much work to be done to educate fellow Texans about health care reform, protect it against attacks, and ensure strong implementation of new state roles.

CPPP Testimony on Texas' Health Reform Implementation Responsibilities (05/27/2010)

The new federal health reform law will significantly change the health insurance market in the next few years. Changes must occur at the Texas Department of Insurance and the Office of Public Insurance Council as well, as the state takes on new roles and functions necessary to successfully implement the health reform law. The sunset review process provides an opportunity for legislators and the public to rethink the roles of these vital agencies and give them the tools needed to protect consumers and foster competition in a changing health insurance market.

CPPP Testimony on Health Reform Law's New Accountability Measures (05/18/2010)

The federal health reform law establishes new accountability measures for unreasonable health insurance premium increases and "medical loss ratios""a measure of how insurers spend premium dollars. CPPP recently submitted public comments to a request for information from federal agencies developing health reform regulations on these topics. The center has done research on rate review and medical loss ratios in Texas, and submitted comments to the federal agencies encouraging strong standards that benefit consumers.

Modernizing Texas' Unemployment Insurance System (05/18/2010)

CPPP Senior Policy Analyst Don Baylor presented this testimony on modernizing Texas' unemployment insurance system to the House joint hearing on unemployment insurance and the trust fund.

Health Reform Law & Texas (04/23/2010)

CPPP joined the Legislative Study Group House Caucus last Thursday for a briefing on health care reform and its impact on Texas. The Event was cosponsored by the Texas Legislative Black Caucus and the Mexican American Legislative Caucus.

CPPP Goes on the Road to Talk About Health Care Reform (04/14/2010)

CPPP’s Texas Voice for Health Reform team hopes to focus much of our energy over the next several months traveling across the state to help Texans learn about the new health reform law. We know from polling that many Americans still know little about the law, and that support for the new law is high when people learn about what reform will do.

State Auditor's Report on Supplemental Nutrition Provides Blueprint for Fixing Eligibility System (03/30/2010)

The State Auditor’s office released a report today on the Supplemental Nutrition Assistance Program (SNAP) at the Health and Human Services Commission (HHSC). The report provides a blueprint for restoring access to SNAP (formerly called Food Stamps) and fixing the state’s eligibility and enrollment system for SNAP, Medicaid, and Temporary Assistance for Needy Families (TANF) cash assistance. HHSC’s Executive Commissioner Tom Suehs requested the audit to inform his efforts to end severe delays in SNAP application processing. The delays cause food hardship to tens of thousands of needy Texans struggling to feed their families in the worst economic downturn since the Great Depression.

Texans are Among the Biggest Winners in Last Night's Vote for Historic Health Care Reform (03/22/2010)

With more than one in four Texans currently lacking health care insurance and runaway premiums adding daily to that 6.1 million count, relief cannot not come too soon for our overburdened health care system. In addition to providing new economic security to millions of Texas families, the national health reform bill will also bring billions of dollars back to Texas each year through health insurance tax credits for middle class and low-income Texans, and Medicaid coverage for our poorest citizens.

Our state leadership should move promptly and in good faith to facilitate the implementation of health insurance reforms. Texans can look to the establishment of the Children’s Health Insurance Program (CHIP) and our response to Hurricane Ike as recent examples of the excellent performance of which our state government is capable when it has the backing of leadership.

CPPP Sends Letter to Congress Urging Passage of Health Care Reform (03/19/2010)

CPPP sent a letter today to the Texas Congressional Delegation urging passage of the health care reform bill. The letter included the real-life health care-related struggles of Sarah, Mario, Andrea, Bruce and Cher, showing how the bill Congress is currently considering will improve their lives and the lives of other Texans just like them.

How Health Reform Will Help Our Economy (02/25/2010)

Passing health reform isn’t just the right thing to do because it will cover many of the uninsured; it will also create tremendous economic benefits for Texas families and small businesses. Health reform makes health insurance coverage more secure, 1) reducing bankruptcies caused by medical bills, 2) allowing entrepreneurs to start new ventures without fear that leaving a current job will mean losing health coverage, and 3) letting small firms operate without providing health benefits while ensuring that their employees still have access to high-quality affordable coverage. Health reform also slows the growth in health care costs, 1) reducing the federal deficit, 2) shoring up Medicare, and 3) allowing employers to increase wages, hire new employees or make other investments in their business with money that would otherwise be eaten up by skyrocketing health insurance premiums. This Policy Page examines the many economic benefits of health reform. For an overview of provisions in the Senate health reform bill, see at the recent CPPP publication What’s in the Health Reform Bills?

Webinar: Update on Health Reform & Texas (02/24/2010)

Want to prep for the 2/25 health reform summit with a good update on What's in the Health Reform Bills"what they will mean for Texas, and what is happening with them in Washington? Have questions you’d like to get answered?

On February 24 from 10:30 a.m. - 12:00 p.m. CST, the CPPP hosted a webinar to answer all your questions about what's in the health reform bills.

We covered:

  • The latest on the debate and process in Washington
  • The main building blocks for expanding coverage and insurance reform
  • Issues where compromise is still being worked out
  • Immediate reforms and Medicare improvements What YOU can do to affect the debate

Click here to view a video recording of the webinar, or click here to download the powerpoint presentation.

Texas & National Health Reform Who Will Gain Coverage; Issues for Texans and State Government (02/22/2010)

CPPP Associate Director Anne Dunkelberg made this presentation, "Texas & National Health Reform: Who Will Gain Coverage? Issues for Texans and State Government," at the Texas Hospital Association's 2010 Leadership Conference on February 17, 2010. The panel, "The Trickle-down Effect: How Health Care Reform will Impact the Texas Budget," included State Sen. Steve Ogden (R-Bryan), and Tom Suehs, executive commissioner, Texas Health and Human Services Commission, Austin.

Texas Revenues, Medicaid & National Health Reform (02/16/2010)

CPPP Associate Director Anne Dunkelberg made this presentation to a meeting of the Texas Medical Association’s Select Committee on Medicaid, CHIP and the uninsured. The committee includes primary care and subspecialty physicians from across the state and is charged with developing TMA’s regulatory and legislative policy relating to indigent health care, Medicaid, and CHIP.

What's in the Health Reform Bills? (02/15/2010)

The Kaiser Family Foundation released mid-January poll results that found Americans squarely divided on national health reform proposals"at least at first glance. The poll went on to show that large proportions of Americans are unaware of the major provisions of heath reform bills, and their support increases dramatically when told about provisions like tax credits to help small businesses cover their employees, health insurance exchanges where coverage options can be compared; closing the Medicare drug benefit “doughnut hole,” and eliminating denials and rate hikes because of pre-existing conditions.

The sometimes raucous debate over hot-button issues (and outright untruths) of the last 6 months has worked against Americans getting a clear picture of the framework of health reform. This Policy Page provides a high-level outline of the key insurance coverage elements of the Senate bill, noting areas in which compromises with the House are likely.

A side-by-side analysis of key differences for Texas between Senate and House national health care reform bills (01/22/2010)

Texas particularly needs national health care reform: 6.1 million Texans have no health insurance, including 1 in 3 working-age adults and 1 in 5 children. Narrowing the scope of pending legislation to address only health insurance reform won’t help Texas because so many Texans cannot afford health insurance. If Congress abandons two of the key provisions of reform"help with premiums and out-of-pocket costs for low-to-moderate income Texans and Medicaid expansion for working poor adults"Texas will see very little reduction in uninsured citizens.

Fighting Hunger, Improving Nutrition: Progress and Opportunities in the Texas Legislature (01/22/2010)

CPPP senior food and nutrition policy analyst Celia Hagert delivered this presentation on "fighting hunger, improving nutrition" to the Texas Food Policy Roundtable, a new initiative founded by the Christian Life Commission of the General Baptist Convention of Texas.

CPPP Urges Administration and Congress to Move Forward on National Health Care Reform (01/22/2010)

CPPP today issued a statement on national health care reform, urging Congress and the Administration to move forward with the reform effort.

Texas & National Health Reform: Who Will Gain Coverage; Issues for Texans and State Government (01/15/2010)

As the Senate and House leadership worked to negotiate a compromise national health reform bill, the CPPP’s Anne Dunkelberg made this presentation comparing key coverage features of the bills and illustrating the scope of increased Medicaid enrollment and costs under the 2 bills to the Texas Public Policy Foundation’s Annual Policy Orientation. Medicaid expansion and increased take-up by already-eligible kids will require significant new state Medicaid dollars, but those will be offset with Texas receiving from 10 to 13 new federal matching dollars for each state dollar Texas must contribute.

State Auditor to Review SNAP Administration (01/12/2010)

Last month, Texas Health and Human Services Commissioner Tom Suehs asked the Texas State Auditor to review the agency’s Supplemental Nutrition Assistance Program (formerly known as the Food Stamp Program) operations and recommend changes to address the persistent and severe backlogs and delays in application processing, among other performance problems. The audit presents a critical opportunity to investigate the root causes of the problems facing our eligibility system and identify solutions.

This Policy Page outlines the problems, summarizes recent efforts to resolve them, identifies areas for further investigation, and offers potential solutions.

The Texas Health Care Primer (Revised 2009) (01/7/2010)

The Center for Public Policy Priorities and Methodist Healthcare Ministries are pleased to release this updated primer, designed to give readers an introductory overview of factors shaping Texans' access to health care. Readers will be better able to contribute to federal, state, and local debates about how to improve health care access. There are two versions of the primer: The Booklet Version was designed for two-sided printing. The Side-by-Side Version was designed for on-screen viewing.

Small Steps Forward and Missed Opportunities in the 81st Texas Legislative Session Show Need for National Health Reform (01/7/2010)

Every legislative session, Texas legislators struggle to allocate sufficient state dollars to ensure public health. Because of our hit-or-miss approach to health care and our lack of an adequate state revenue system, a higher percentage are shut out of health insurance in Texas than in any other state in the nation.

The following report summarizes how health care fared in the 2009 legislative session. It shows how often Herculean efforts resulted in mostly slight improvements in our state’s public health care structures. For example, while the state took a few small steps forward in funding health care and access to coverage, the session was defined by the high-profile missed opportunities related to the CHIP program buy-in and the Texas Department of Insurance Sunset. Small steps forward are inadequate in light of the health care crisis in our state.

Comments to TDI on Healthy Texas Rules (01/5/2010)

With more than 6 million Texans lacking health insurance coverage and the cost of coverage growing much faster than incomes, Texas needs to take bolds steps to confront barriers to health coverage. Healthy Texas, a new public "reinsurance" program has the potential to put private health insurance coverage within reach of many uninsured Texans. To help the program live up to its goals, a few provisions in the proposed rules related to continuation rights, medical underwriting, and payroll supporting documentation should be modified. CPPP submitted the comments below on the proposed Healthy Texas rules to the Texas Department of Insurance.

Why CPPP Supports Congress' Health Reform Bills and What You Can Do to Make the Final Bill Better (12/23/2009)

Austin, Texas--The Center for Public Policy Priorities today released a statement regarding the center’s position on the U.S. Senate’s national health reform bill. During the holiday recess and the weeks to come, please visit and call on your member of Congress to do everything in their power to improve the final bill by including the House’s stronger affordability and market reform provisions in the final bill.

Expanding the Reach of the Summer Food Program (12/21/2009)

Texas has one of the largest School Lunch Programs in the nation, serving meals to more than 2.5 million low-income children every day. The Summer Food Program is intended to serve the same population, yet it reaches only a fraction of the low-income children who eat lunch during the school year. This paper compares participation in the Summer Food Program to participation in the School Lunch Program for each county in Texas. It documents Texas’ progress in the Summer Food Program, explores the barriers to participation, and makes recommendations for expanding the reach of the program in Texas.

Open Letter to Texas Congressional Delegation on National Health Reform Conference (12/16/2009)

CPPP Executive Director F. Scott McCown and CPPP Associate Director Anne Dunkelberg sent a letter to Texas' congressional delegation urging them to:

  • Adopt the House bill’s stronger affordability measures for families below 250 percent of the federal poverty income guidelines; and
  • Require the House’s much stronger standards for a Health Insurance Exchanges--whether through a single national exchange or state-level exchanges--to empower exchanges to negotiate with insurers and deliver better value to individuals and small businesses.

Laid-Off Workers Will Lose Health Coverage Today as Federal Cobra Subsidies Expire (12/1/2009)

Millions of Unemployed Workers and Dependents Received Federal COBRA Subsidies, but for Many Those Subsidies Expire on November 30

To Buy COBRA Coverage without Subsidies, Texas Families Must Pay an Average of $1,081 per Month " More Than 78 Percent of Average Unemployment Insurance Checks

Washington, D.C. " On December 1, many of the millions of laid-off workers and dependents who received federal subsidies to help pay for health care coverage will lose those subsidies and may join the ranks of the uninsured, according to a report issued today.

Rising Health Insurance Premiums in Texas Reinforce Need for National Health Reform (11/30/2009)

Texans with health insurance today through their jobs stand to benefit greatly from national health reform that makes coverage more affordable, stable, and secure for employers, employees, and employees’ families. This Policy Page examines trends related to employer-sponsored health insurance and ways national health reform can shore up employer-sponsored health insurance to establish stable and secure coverage Texans can count on.

CPPP Thanks Texas Members of Congress for "Yes" Votes for HR 3962, the Affordable Health Care for America Act (11/17/2009)

On November 17, CPPP sent a thank-you letter to the members of the Texas congressional delegation who voted to approve HR 3962, the Affordable Health Care for America Act. Their votes were a historic step toward making real health reform a reality for our country.

New Federal Report Shows One-in-Six Texas Households Struggled with Hunger as Recession Hit (11/16/2009)

Policy Institute Urges State to Fix Eligibility System to Get Help to Hungry Texans

Austin, Texas"The Center for Public Policy Priorities (CPPP) today pointed to a new report from the U.S. Department of Agriculture (USDA) to show the urgent need for Texas to fix its system for enrolling needy families in the Food Stamp program. USDA reports 16.3 percent of Texas households struggled to afford food during 2006-2008. Nationally, 12.2 percent or more than 17 million households were food insecure in 2008 " up from 13 million in 2007 and 12.6 million in 2000. The 2008 figures represent the highest level of household food insecurity observed since the survey was initiated in 1995.

Twenty-One Texas Groups to Congressional Delegation: Pass Meaningful Health Reform This Year (11/3/2009)

Joint letter urges meaningful action on health care affordability, highlights utility of public option

Austin, Texas"Twenty-one Texas organizations today submitted the following letter to the Texas congressional delegation strongly urging passage of meaningful health care reform in 2009. These groups organized their effort through Texas Voice for Health Reform, a project that aims to educate Texans and give them a voice in the national health reform debate. The letter urges legislators to take meaningful steps to make health care affordable and conveys the groups’ consensus that a public option is an important tool for achieving affordability.

Below is the full text of the letter.

Cost-Benefit Analysis of Medicaid Changes in National Health Care Reform: Huge Positive Gains for Texas (10/9/2009)

In explaining why they oppose national health care reform, specifically the Senate Finance Committee’s version, Governor Rick Perry and Senator John Cornyn both point to the increase in the cost of Medicaid for the state budget based on a preliminary estimate by the Texas Health and Human Services Commission (HHSC). HHSC says costs would increase by “$20.4 billion over 10 years.” In this paper, we analyze HHSC’s cost estimate and compare it to the benefit to Texas’ economy from Medicaid expansion. We explain that HHSC’s estimate includes paying for already eligible but unenrolled children and a shift of certain costs from local to state. We also explain that the estimate cannot be compared to other national estimates because it covers a longer time. We conclude that the agency estimate is unrealistically high, but that by any measure, including the estimate itself, the economic benefit to Texas dramatically outweighs the cost to the state budget.

Texas' Eligibility System Continues to Fail Needy Texans (10/1/2009)

Texas’ short-staffed eligibility system for safety net programs continues to struggle to provide accurate and timely service to needy Texans seeking assistance in feeding and caring for their families. The 81st Legislature took some baby steps to address this crisis, including mandating a staffing analysis, but failed to provide adequate staff or resources to improve the system’s performance. Serious and widespread delays in processing Food Stamp applications resulted in the filing of a federal lawsuit in July against the Texas Health and Human Services Commission (HHSC) for failure to meet the application processing timeframes required by federal law. The lack of adequate numbers of trained staff also has caused Food Stamp/SNAP error rates to soar, which could cost Texas millions in federal sanctions. This Policy Page discusses these developments and the actions needed to fix the crisis in our eligibility system.

Federal Government Demands State Take Immediate Action to Help Struggling Texans While State Dithers, Denying HHSC Request for Critical Eligibility Staff (09/28/2009)

Austin, Texas"The Center for Public Policy Priorities today condemned the Legislative Budget Board’s (LBB) denial of a request from the Texas Health and Human Services Commission (HHSC) to fund hundreds of new eligibility staff for our state’s overwhelmed public benefits system. The new staff would be an essential step toward fixing our system, which cannot process applications timely or accurately. LBB’s denial comes as the state faces an increased need for public safety net services during the worst economic climate in a generation, a demand by the U.S. Department of Agriculture on September 24 for immediate corrective action, and a private class-action lawsuit against the state for failure to meet federal Food Stamp timeliness standards.

Texas' Eligibility System Continues to Fail Needy Texans (09/28/2009)

Texas’ short-staffed eligibility system for safety net programs continues to struggle to provide accurate and timely service to needy Texans seeking assistance in feeding and caring for their families. The 81st Legislature took some baby steps to address this crisis, including mandating a staffing analysis, but failed to provide adequate staff or resources to improve the system’s performance. Serious and widespread delays in processing Food Stamp applications resulted in the filing of a federal lawsuit in July against the Texas Health and Human Services Commission (HHSC) for failure to meet the application processing timeframes required by federal law. The lack of adequate numbers of trained staff also has caused Food Stamp/SNAP error rates to soar, which could cost Texas millions in federal sanctions. This Policy Page discusses these developments and the actions needed to fix the crisis in our eligibility system.

Metro- and Congressional-Area Census Data Show Need for National Health Reform (09/22/2009)

Austin, Texas " The 2008 American Community Survey (ACS) data released by the U.S. Census Bureau on September 21 show that Texans stand to gain the most from national health reform. Nearly all of Texas’ metro and rural area uninsured rates exceed the U.S. average. Texas again had the nation’s highest statewide uninsured rate, and some localities far exceeded the statewide rate of 24.1 percent. Texas entered the recession later than the rest of the nation and experienced low rates of unemployment through most of 2008, so these new data reflect only the very beginning of the recession’s impact on Texas.

New Census Data Show Texas Stands to Gain Most from Health Reform (09/10/2009)

New data released today by the U.S. Census Bureau show that in 2008, Texas remained the state with the highest uninsured rate in the nation with an uninsured population that now tops 6 million people. With so many Texans lacking health security, Texas has more to gain than other states from national health reform legislation, which the Congressional Budget Office projects will cover 94 percent of Americans under age 65. Due to the steep rise in the state unemployment rate in 2009, Texas’ uninsured population is most likely even larger today than these latest 2008 estimates indicate.

Recommendations to USDA for Ending Hunger by 2015 and Reducing Child Obesity (09/10/2009)

CPPP Senior Policy Analyst Celia Hagert offered recommendations to USDA on reducing childhood obesity and ending hunger.

New Report Shows Texas Is Missing Out on Millions in Unclaimed SNAP Benefits (09/9/2009)

Austin, Texas"The Center for Public Policy Priorities (CPPP), Houston Food Bank, and San Antonio Food Bank today highlighted the findings of a new report revealing millions in unclaimed federal benefits available for hungry Texans, as well as newly-calculated data showing the significant effect of anti-hunger stimulus spending on the Texas economy.

Hunger in America's Classrooms: Share Our Strength's Teacher Project (09/4/2009)

This summer, Share Our Strength, a national organization that works to prevent child hunger in America, is talking with teachers across the country about child hunger in their classrooms. The Hunger in America's Classrooms: Share Our Strength's Teacher Project is intended to raise awareness about child hunger in America and build a movement of Americans dedicated to ending it. You can help by spreading the word to teachers across Texas.

Congress Must Not Leave Any Wounded American Worker on the Economic Battlefield (09/3/2009)

If the First Infantry suffered 9 percent wounded, while the Second Infantry suffered “only” 7.9 percent, sending medicine to the First Infantry, but not the Second, would make no sense. Every wounded soldier deserves help. And, if the Second Infantry is bigger than the First, sending help to the Second would be even more important to the strength of the army. Yet, HR 3404 (McDermott) and S 1647 (Reed) propose to trigger an additional 13 weeks of critically important Emergency Unemployment Compensation for unemployed American workers based upon state unemployment rates. Unemployed workers in 28 states, including Texas, would not get help because of state rates below the trigger. This approach is unfair to American workers and counterproductive for the national economy. Congress should help workers in all states equally.

Health Reform Amendments Contradict Misinformation, Highlight Compromises (09/2/2009)

National health reform will bring more security and stability to Texans who have health insurance coverage today and extend coverage to millions of uninsured Texans. To stop reform, some opponents have spread misinformation and downright lies about the bills. Understandably, this misinformation alarmed many recipients. This Policy Page highlights House Energy and Commerce Committee amendments passed just before the August recess that explicitly prohibit practices falsely alleged to be in health reform bills, including “rationing care,” “covering undocumented immigrants,” and other misinformation. This document also summarizes the significant amendments resulting from compromises with both the “Blue Dog” and progressive Democrats.

On the November Ballot--Proposition 4: Creating More Tier-One Universities in Texas (08/19/2009)

The most important natural resource Texas has is Texans. Unfortunately, our state suffers from a “brain drain” as many of our best and brightest students leave to further their education. A contributing cause is a lack of “tier one” universities in Texas. Proposition 4 (a constitutional amendment to create a National Research University Fund to help fund certain state universities to become nationally recognized research institutions) would provide funding to Texas universities seeking to attain tier-one status. With more university research, the state hopes for new jobs, increased wages, and more state and local tax revenue. This Policy Page describes criteria commonly used to determine tier-one status, the benefits of having more tier-one universities in Texas, progress of selected Texas schools toward tier-one status, and the specifics of Proposition 4.

CPPP Urges Governor to Disavow Attacks on Medicare and Medicaid, Start Digging Texas Out of Health Care Hole (08/18/2009)

Austin, Texas"The Center for Public Policy Priorities (CPPP) today released the following statement from CPPP Associate Director Anne Dunkelberg decrying attacks made against Medicare and Medicaid during the governor’s press conference on health reform.

Texas Health and Human Services Commission Sued for Failure to Meet Federal Food Stamp Timeliness Guidelines (08/3/2009)

Austin, Texas"On Friday, July 31, 2009, the Texas Legal Services Center (TSLC) and the National Center for Law and Economic Justice (NCLEJ) filed a class action complaint in U.S. District Court against the Texas Health and Human Services Commission (HHSC) for failure to process Food Stamp applications within the timeframes required by federal law.

Top Ten Reasons to Love the House Health Reform Bill (07/23/2009)

Health reform bills moving through Congress right now will extend affordable, quality health coverage to 97 percent of Americans and protect families against high health care costs. If you lack health insurance, your best chance to get it is health reform. If you do have health insurance, you may soon lose it without health reform. The U.S. House is considering a very strong bill, expected to be far stronger than the Senate Finance Committee’s forthcoming package. In this Policy Page, CPPP provides a very high-level view of the major strengths of the House bill, and a few key observations on the potential Texas impact.

CPPP Expresses Disappointment with House Failure to Vote on CHIP; Thanks All Who Supported CHIP (06/1/2009)

Austin, Texas--The Center for Public Policy Priorities today expressed disappointment with the Texas House of Representatives’ failure to vote on the Conference Committee Report for SB 2080, legislation that would have made more uninsured children eligible for the Children’s Health Insurance Program (CHIP). The Senate adopted the CCR for SB 2080 on Sunday night, but the House adjourned on Sunday without considering the legislation and refused to consider it today before adjournment.

Broad Coalition Praises Senate CHIP Vote, Urges House to Act Quickly to Get CHIP Buy-In to Governor’s Desk (05/28/2009)

Austin, Texas"A broad coalition of Texas organizations today released the following joint statement applauding Senate passage of Senator Averitt's CHIP buy-in proposal, which was included as an amendment to HB 1795. The legislation would allow more families without meaningful access to private health insurance coverage to insure their children by paying monthly family-income-based CHIP premiums. Last night's Senate passage of this legislation will allow for a House vote on the final bill before it is sent to the Governor's desk.

Broad Coalition Presses Leaders in House and Senate to 'Act Swiftly and Forcefully to Pass CHIP Bill' (05/26/2009)

Austin, Texas"Several statewide organizations (listed below) today released the following joint statement on the legislative process regarding SB 841 and HB 2962--strong, similar Children’s Health Insurance Program (CHIP) bills which passed their originating chambers of the state legislature with bipartisan sponsorship and support. Each of these bills, currently delayed in the legislative process, would allow more families without meaningful access to private health insurance coverage to insure their children by paying monthly family-income-based CHIP premiums.

SB 6: Healthy Texas (05/22/2009)

Nearly 6 million Texans are uninsured, and premiums in Texas are growing ten times faster than our incomes. With only one-in-three small employers offering coverage, bolstering access to employer-sponsored coverage through small businesses is an essential step in covering the uninsured. Because previous efforts to increase access for small employers have had limited success, we need bold, innovative steps like SB 6. Healthy Texas can put private health insurance coverage within reach of many uninsured Texans working for small employers by addressing the primary barrier to coverage"the high cost of premiums"using an innovative public-private partnership. SB 6 passed out of the House Insurance committee and is waiting to be set on the House calendar.

CPPP Comments to U.S. Senate Finance Committee on "Expanding Health Care Coverage: Proposals to Provide Affordable Coverage to All Americans" (05/21/2009)

The Center for Public Policy Priorities (CPPP) in Austin, Texas is a nonpartisan, nonprofit 501(c)(3) research organization founded in 1985 and committed to improving public policies and private practices to better the economic and social conditions of low- and moderate-income Texans. CPPP appreciates the opportunity to comment on the Senate Finance Committee’s May 14, 2009 report, “Expanding Health Care Coverage: Proposals to Provide Affordable Coverage to All Americans.”

SB 1569 on House Calendar Wednesday! (05/19/2009)

Unemployment is high and continues to rise. As of May 5, more than 353,000 Texans were receiving unemployment benefits, more than triple the number of Texans receiving UI benefits a year ago. SB 1569 by Senator Eltife is on the House’s Major State Daily Calendar for Wednesday, May 20, 2009. SB 1569 strengthens our UI system to protect unemployed Texans and qualifies Texas for $555 million in federal funding to reduce UI taxes for employers. The bill also provides a vehicle to extend unemployment compensation for about 70,000 Texans who will otherwise exhaust their federal Emergency Unemployment Compensation (EUC) beginning in July. The federal government would pick up the entire cost to extend UI for these Texans, delivering more than $250 million in federal funding for the Texas economy.

How to Improve the Health Insurance Market Using Medical Loss Ratios (05/14/2009)

One in four Texans lacks health insurance. All of us pay for care for the uninsured through taxes and higher health insurance premiums. We need to strengthen our private health insurance market to ensure more of us are covered and all of us are getting the most for our health care dollar. This policy page outlines one way to strengthen our private market"the required disclosure of medical loss ratios. A medical loss ratio is a number calculated by dividing the cost of health insurance claims paid by the amount of health insurance premiums collected to show the percentage of premiums that go to paying for health care rather than insurance company administration and profits. Requiring disclosure of medical loss ratios increases the efficiency of the market by empowering consumers to shop for policies with a better understanding of what they get for their premium dollars. This policy page also discusses how regulators can use medical loss ratios to strengthen the market.

CSHB 2962 by Coleman: CHIP Buy-In and Eligibility System Performance (05/13/2009)

The Texas House’s CHIP Buy-In bill, CSHB 2962 by Coleman, will be voted on by the full House on Thursday, May 14. CSHB 2962 would create a new kind of CHIP coverage for uninsured children with working parents earning between 200-300 percent of the federal poverty level. These families would be able to buy discounted CHIP coverage for their children, paying a “sliding” monthly premium that increases with income. While provisions for a monthly-premium CHIP program for children from 200-300 percent FPL are virtually identical to the Senate’s bill, the House bill includes a limited Full-Cost Buy-In program from 300-400 percent FPL for children who would otherwise lose Medicaid or CHIP due to family income. This compromise addresses technical state agency concerns and may be acceptable in the Senate. This Policy Alert describes differences between SB 841 and CSHB 2962, and provides additional background information on the need for this kind of coverage for uninsured Texas children.

Keep Rider to Use Federal Recovery Funds for 12-Month Children's Medicaid in 2010-2011 Budget, At No Cost to the Bill (05/8/2009)

Conferees deciding the final form of the Texas state budget for 2010-2011 must decide whether or not to keep alive House Rider 52 in Article II, Special Provisions Relating to all HHS agencies, which funds 12-month children’s Medicaid only in 2010-2011, while additional Medicaid funding is available from the American Recovery and Reinvestment Act.

SB 6: Healthy Texas: Testimony to the House Insurance Committee (05/5/2009)

The Center for Public Policy Priorities (CPPP) appreciates this opportunity to testify on SB 6, which will create the Healthy Texas program. With nearly 6 million Texans lacking health insurance coverage and the cost of coverage growing ten times faster than incomes, Texas needs to take bolds steps to confront issues with access to health coverage. Healthy Texas has the potential to put private health insurance coverage within reach of many uninsured Texans working for small employers by addressing the primary barrier to coverage"the high cost of premiums"using a public-private partnership.

SB 1771 Helps More Laid-Off Texans Maintain Coverage: Testimony to the House Insurance Committee (05/5/2009)

The federal economic recovery act includes federal subsidies to help people being laid off buy private health insurance coverage for nine months while seeking new jobs. Under current law, employees laid off from larger companies are already eligible for the subsidy if they lost their job after September 1, 2008. But companies with fewer than 20 employees fall into a different category. For those employees to take full advantage of the health care subsidy, the Legislature must make modest changes to state insurance law that require no General Revenue. SB 1771 makes needed changes and will help keep more Texans covered through the private market instead of joining the growing ranks of the uninsured.

Food Stamp Bills Waiting to be Scheduled for a Floor Vote in House (04/30/2009)

Three bills by Rep. Naishtat relating to the Food Stamp Program passed the House Human Services Committee and have been sent to the House Calendars Committee to be scheduled for a vote by the full House: HB 1627, HB 612, and HB 886. These bills are designed to maximize federal food assistance to low-income Texans and/or reduce the workload of the eligibility staff who process Food Stamp applications. We urge you to call the members of the House Calendars Committee today and ask them to schedule these bills for a vote as soon as possible.

SB 76: Child-Only Group Health Plans: Testimony to the House Insurance Committee (04/28/2009)

CPPP is committed to working for an affordable coverage option for every child in Texas. SB 76 would create new coverage options for some children, but it will also allow the potential substitution of existing adult coverage with coverage for children in some cases. It may also encourage some small employers to drop the plans they offer today for employees and dependents and replace them with plans that cover children only.

SB 206 and 207 Increase Consumer Protections Around Health Insurance Policy Rescissions: Testimony to the Senate State Affairs Committee (04/27/2009)

Consumers expect that when they obtain health insurance, their insurance company has completed all medical underwriting and cleared up any questions about information they provided on the application. Once the policy is in force, consumers expect to be covered according to the terms of their insurance contracts. These expectations are not met when health insurance policies are rescinded"a retroactive cancellation of a policy in force. SB 206 and 207 enhance the Texas Department of Insurance’s ability to monitor rescissions to better protect consumers and decrease insurance industry incentives that could drive up rescission rates.

CPPP Congratulates Texas Senate for Unemployment Insurance Vote, Urges Final Passage (04/17/2009)

Austin, Texas---The Center for Public Policy Priorities today released the following statement applauding the Texas Senate for taking steps toward repairing and modernizing the state’s unemployment insurance (UI) system. CPPP also released an analysis of the benefits of UI modernization for each Texas Senate district. Last night, the Senate approved CSSB 1569 on second reading, paving the way for its final passage in the Senate.

Comparing Medicaid and CHIP Provisions in Texas House Appropriations Committee and Senate Budget Proposals (04/16/2009)

The Texas Senate approved its version of a 2010-2011 state budget bill, and the full House is expected to debate the House Appropriations Committee’s version of the bill this Friday, April 17 (supplemental appropriations will be debated the day before). Complications caused by the recession and the federal recovery funding from the American Recovery and Reinvestment Act of 2009 (ARRA) compound the usual challenge of understanding the chambers’ competing funding proposals for Medicaid, CHIP and other health care-related programs. This Policy Page highlights key differences between the chambers’ Medicaid and CHIP proposals, plus selected other health care issues and items missing in both bills.

SB 1257 Increases Protections and Access to Information for Health Insurance Consumers (04/16/2009)

Texas’ commercial health insurance market is considered “healthy” because it has a relatively large number of carriers writing coverage, is subject to a low level of regulation compared to other states, and generates $22 billion in premiums annually. The effect of this market on Texas consumers, however, is anything but healthy. For Texas health insurance consumers, this market produces some of the fastest growing premiums in the nation, one of the lowest rates of coverage through job-based insurance, and small employer premiums as high as $29,000 a year per employee. SB 1257 makes changes in the health insurance market which will allow consumers to maintain coverage during certain disputes with insurers, provide consumers with more information on health insurance, and establish a mechanism to review large rate increases for small employers to ensure they are justified.

CSHB 2453 Helps More Laid-Off Texans Access Federal COBRA Assistance to Maintain Coverage: Testimony to Texas House Insurance Committee (04/14/2009)

The federal economic recovery act includes federal subsidies to help people being laid off buy private health insurance coverage for nine months while seeking new jobs. Under current law, employees laid off from larger companies are already eligible for the subsidy if they lost their job after September 1, 2008. But companies with fewer than 20 employees fall into a different category. For those employees to take full advantage of the health care subsidy, the Legislature must make modest changes to state insurance law that require no General Revenue. HB 2453 makes needed changes and will help keep more Texans covered through the private market instead of joining the growing ranks of the uninsured.

HB 2203--TDI Sunset Bill: Testimony to the Texas House Insurance Committee (04/14/2009)

As the overseer of the insurance market in Texas, the Department of Insurance plays a critical role for the state and its citizens. With one in four Texans lacking health insurance coverage and the cost of coverage increasing ten times faster than incomes, the high cost of health insurance or lack of coverage is something that affects each of us and our communities. The Texas Department of Insurance (TDI) sunset process provides a much needed opportunity for the Legislature to examine TDI’s role and equip it with the tools needed to not only foster a competitive marketplace, but also to make affordable health insurance available to more Texans.

Comments Due April 20 on HHSC Application Redesign (04/9/2009)

The Health and Human Services Commission is redesigning the application for Medicaid, Food Stamps and TANF to make it easier to read, understand and fill out. HHSC has invited stakeholders to provide feedback on the new application and is conducting focus groups around the state to get feedback from clients. A web phone conference to answer questions and share focus group findings is scheduled for April 13 at 2 p.m. Comments are due April 20.

HB 3859 Would Establish Prerequisites for TIERS Expansion and Require Staffing Analysis (04/8/2009)

The House Human Services Committee will hear HB 3859 on Thursday, April 9. HB 3859 would ensure adequate staffing of the health and human services eligibility system and prevent premature expansion of TIERS, the computer system that the Health and Human Services Commission (HHSC) has been piloting since 2003.

HB 613 Would Increase Participation in the Food Stamp Program and Reduce the Workload of Eligibility Staff (04/8/2009)

The House Human Services Committee will hear HB 613 on Thursday, April 9. The bill would increase participation in the Food Stamp Program and improve the performance of the eligibility system by simplifying the Food Stamp enrollment process. HB 613 directs the Health and Human Services Commission to exercise the option in federal law to lengthen certification periods for Food Stamp recipients and reduce unnecessary interview requirements. This Policy Page explains the options available to states to simplify Food Stamp enrollment and summarizes the arguments for adopting these changes to Food Stamp policy in Texas.

SB 841 by Averitt: CHIP "Buy-In" Program
for Uninsured Children Above 200% of Poverty
(04/2/2009)

More than half a million uninsured Texas children have incomes above the current limits for CHIP. In addition, children often fall off of the "CHIP cliff," losing their CHIP coverage when their parents' incomes increase by a small amount, even though those earnings are still too low to purchase private coverage. Texas families turn down raises and cut back work hours just to keep their children covered. Through a CHIP buy-in option, SB 841 by Sen. Averitt keeps families from having to choose between slightly more income or their children's health care. SB 841 has a first hearing April 2 in the Senate Finance Committee. This Policy Page describes the bill, including important details of the expected Committee Substitute.

CSSB 1771 Helps More Laid-Off Texans Access Federal COBRA Assistance (04/1/2009)

The federal economic recovery act includes federal subsidies to help people being laid off buy private health insurance coverage for nine months while seeking new jobs. Under current law, employees laid off from larger companies are already eligible for the subsidy if they lost their job after September 1, 2008. But companies with fewer than 20 employees fall into a different category. For those employees to take full advantage of the health care subsidy, the Legislature must make modest changes to state insurance law that require no General Revenue. CSSB 1771 makes needed changes and will help keep more Texans covered through the private market instead of joining the growing ranks of the uninsured.

SB 66, Relating to Health Care Coverage for Children in Title IV-D Cases: Testimony to the Senate State Affairs Committee (03/30/2009)

CPPP offered testimony today on SB 66, a bill which would attempt to provide health insurance coverage through private insurers for children in Title IV-D child support cases. CPPP Executive Director Scott McCown told committee members that the bill might help or hurt low-income families, depending on its implementation.

Action Needed to Help Unemployed Texans Access Health Insurance Assistance in the Recovery Act (03/30/2009)

Only half of Texans get health insurance coverage through an employer"one of the lowest rates in the nation. Access to employer-sponsored health insurance will decline as the recession deepens and companies cut jobs. The American Recovery and Reinvestment Act of 2009 (federal economic recovery act) includes a temporary COBRA and state continuation premium reduction to help recently unemployed workers and their families maintain private health insurance coverage while they seek new jobs. However, the Texas Legislature must make modest change to our state insurance laws to help Texans losing job-based coverage maximize federal premium assistance. These changes, which require no state general revenue dollars, will help more Texans keep private health insurance and prevent some Texans from joining the growing ranks of the uninsured.

HB 2636 Would Increase Child Support Collections and Strengthen Low-Income Families (03/27/2009)

Historically, federal and state welfare policies focused on moving low-income, custodial parents off of public assistance and into the workforce, and very little attention was paid to the circumstances of low-income non-custodial parents. Texas’ Non-Custodial Parent (NCP) Choices program, a pilot program administered by the Texas Workforce Commission (TWC) and the Office of the Attorney General’s Child Support Division, expanded the reach of state welfare programs to include non-custodial parents. NCP Choices, which focuses on increasing the earnings of non-custodial parents who owe child support, shows that placing a greater emphasis on low-income, non-custodial fathers is a highly effective strategy to lift families out of poverty and improve child well-being. HB 2636 would expand this pilot program to make NCP Choices services available in every child support office in the state. This Policy Page explains how NCP Choices works and why this cost-effective, successful, and innovative program should be expanded.

The Texas Recovery Plan (03/25/2009)

Public structures such as Medicaid, Food Stamps, and Unemployment Insurance were created to help families in tough economic times and to help the economy recover from a down cycle. These are indeed tough times"we face the worst economic crisis since the Great Depression. Tragically, many Texans are becoming aware for the first time of the crumbling nature of many of our public structures, weakened by years of neglect when times were good. Now that times are tough, we find our systems unprepared. Fortunately, though, the new federal economic recovery law makes resources available to help repair and improve these systems, which will in turn energize economic activity and get Texas on the road to recovery.

But, Texas will only get the federal funds"and the needed improvements to our public structures"if state policymakers make the right choices, soon.

Food Stamp Bills Would Maximize Federally Funded Food Assistance to Needy Texans (03/24/2009)

The House Human Services Committee will hear two Food Stamp bills on Thursday, March 26, that would maximize federal funding to provide food assistance for needy Texans. HB 1627 would use the Low-Income Energy Assistance Program (LiHEAP) program to maximize Food Stamp benefits for currently eligible families. HB 612 would eliminate the current ban on Food Stamps for drug felons. This Policy Page explains these bills and summarizes the arguments for adopting these changes to Food Stamp policy in Texas.

HB 531: Minimum Medical Loss Ratios: Testimony to the House Insurance Committee (03/24/2009)

Consumers and employers deserve to know that their hard-earned money going to health insurance premiums is used by insurance companies primarily for health care costs rather than insurance company administration, marketing, and profits. HB 531 sets standards for how insurance companies use premiums dollars that will introduce a much needed level of accountability and transparency to the health insurance market.

TDI Sunset Bill (SB 1007): Testimony to the Senate Government Organization Committee (03/23/2009)

As the overseer of the insurance market in Texas, the Department of Insurance plays a critical role for the state and its citizens. With one in four Texans lacking health insurance coverage and the cost of coverage increasing ten times faster than incomes, the high cost of health insurance or lack of coverage is something that affects each of us and our communities. The Texas Department of Insurance (TDI) sunset process provides a much needed opportunity for the Legislature to examine TDI’s role and equip it with the tools needed to not only foster a competitive marketplace, but also to make affordable health insurance available to more Texans.

Child-Only Group Health Plans (SB 76): Testimony to Senate State Affairs (03/19/2009)

CPPP is committed to working for an affordable coverage option for every child in Texas. SB 76 would create new coverage options for some children, but it will also allow the potential substitution of existing adult coverage with coverage for children in some cases. It may also encourage some small employers to drop the plans they offer today for employees and dependents and replace them with plans that cover children only.

Modernizing the Vehicle Asset Test (HB 1625): CPPP Testimony to the House Committee on Human Services (03/19/2009)

Reliable means of transportation are essential for families trying to get to and from work, and they are especially important for out-of-work Texans trying to find employment. Current asset tests for determining eligibility for public benefits unfairly penalize Texan families for owning reliable means of transportation. CPPP staff recently offered testimony in support of updating Texas' asset tests to ensure that needy individuals and families get the help they need and still have transportation.

Twelve-Month Children's Medicaid: The Right Step for Texas' Neediest Children (03/18/2009)

Long-Term Costs Due to Leaving Kids Uninsured Outweigh Short-Term Savings

The House Human Services Committee will hear seven bills Thursday, March 19, that would extend the coverage period for Texas Children’s Medicaid from the current 6 months to 12 months. This change would benefit Texans from every practical angle:

  • reducing the number of uninsured Texas children by 25 percent; reducing avoidable hospitalizations to cut costs-per-child by about the same amount;
  • improving access to well-child care to improve health and comply with federal court requirements;
  • reducing real taxpayer costs by bringing back federal tax dollars to Texas; and
  • dramatically reducing workloads for Texas’ crisis-ridden eligibility system.

Legislators concerned about the cost of 12-month coverage must look past the state budget bill to consider the huge price paid by Texas taxpayers for costs passed on to local jurisdictions when the state leaves needs unmet and federal dollars on the table. This Policy Page reviews the history of and arguments for 12-month enrollment for children.

High Risk Pool Discount Program (SB 879/ HB 2064): Testimony to the House Insurance and Senate State Affairs Committees (03/18/2009)

The Texas Health Insurance Risk Pool (risk pool) was created by the Legislature to provide health insurance to eligible Texas residents who, due to medical conditions, are unable to obtain health insurance. Because Texas state law allows health insurers to deny coverage to people with preexisting conditions in the individual market, many Texans with medical conditions can only get coverage through the risk pool. Risk pool coverage provides a lifeline to some, but the high cost of risk pool coverage places it out of reach for most Texans. SB 879 and HB 2064 create a sliding scale discount program in the risk pool that will help more low- and moderate-income Texans afford coverage.

FMAP and Health Insurance: Testimony to the House Select Committee on Federal Economic Stabilization Funding (03/12/2009)

Texas is expected to get $5.45 billion in federal funds to help pay for Medicaid through 2011. Congress intended these funds to make sure that in a time of economic hardship when the need is greatest:

  1. states do not cut Medicaid, and
  2. states have extra funds to meet the increased number of uninsured as unemployment rises and incomes decline.

Action Needed to Help Laid-Off Texans Take Full Advantage of COBRA Provisions in ARRA: Testimony to the House Select Committee on Federal Economic Stabilization Funding (03/12/2009)

The American Recovery and Reinvestment Act (ARRA) includes federal funds to help people being laid off maintain private health insurance coverage through COBRA and state continuation while seeking new jobs. The Texas Legislature must modify state insurance laws to maximize the coverage options and premium assistance available to Texans losing job-based coverage. These changes, which require no General Revenue, will help keep more Texans covered through the private market instead of joining the growing ranks of the uninsured.

ARRA TANF Funds (03/11/2009)

Testimony to Select House Committee on Federal Economic Stabilization regarding Texas' use of federal TANF funds and opportunities to provide more assistance to low-income families.

Modernizing Texas' Unemployment Insurance System: Invited Testimony to House Select Committee on Federal Economic Stabilization Funding (03/10/2009)

Unemployment Insurance (UI) helps keep Texas families and the state economy afloat in tough times. This public structure is weaker than it should be. The legislature can make modest improvements in the system to help more Texans remain active participants in the economy when they lose their jobs. Texans need this public structure more than ever, with state unemployment up 49 percent since the beginning of the recession. This presentation details the challenges facing our unemployment insurance system and the opportunity presented by the federal recovery law to strengthen and improve our UI system.

Fixing the Crisis in Our Eligibility System (03/9/2009)

Texas’ broken eligibility and enrollment system cannot handle current demand, much less growing needs with rising unemployment. The Legislature can solve this crisis. First, it must fund the Health and Human Services Commission’s request for $134 million in additional general revenue for the staff needed to improve eligibility system performance. Second, it should adopt 12-months continuous coverage for children on Medicaid, which would greatly reduce the current backlogs in application processing and allow the system to operate competently with fewer staff. The federal economic recovery package provides funds to pay for these additional staff and for 12-months continuous eligibility for children’s Medicaid. This paper makes the case for fixing the crisis in our eligibility system and suggests steps you can take to ensure these priorities are funded in the 2010-11 budget.

CPPP Calls On Texas State Officials to Target Federal Recovery Act Funds to Those Hurt Most by Recession (03/6/2009)

With more than $16 billion in federal recovery spending coming to Texas through state agencies, the Center for Public Policy Priorities urged state policymakers to invest in programs that will give struggling low-income families and unemployed workers new opportunities to succeed economically. CPPP also called on the state to ensure that recovery money helps stabilize the economy and benefits those hurt most by the recession. Spending should be done openly, efficiently and with accountability.

Article II - HHSC: Testimony to the House Appropriations Subcommittee on Health and Human Services (02/26/2009)

The Legislature must fully fund HHSC Exceptional Items 2 and 3 to provide additional staff for the eligibility system. The demand for services is already on the rise and will only increase as the full effects of the recession hit Texas. Without adequate staff, HHSC cannot provide timely and accurate benefits to eligible families. The delay or inappropriate denial or termination of benefits not only causes great hardship to needy Texans; it also causes the state to lose out on critical federal funds for Food Stamps and Medicaid that boost our state and local economies. The Legislature should also use a portion of the biennial balance in TANF block grant funds to increase cash assistance to extremely poor families and help them weather the economic recession. The American Recovery and Reinvestment Act (ARRA) includes an Emergency Contingency Fund that would reimburse Texas for 80% of this increased TANF spending.

CPPP: Texas Lawmakers Should Seize Opportunity to Fix Unemployment Insurance (02/25/2009)

The Center for Public Policy Priorities today urged state policymakers to draw down available funds for unemployment insurance (UI) benefits in the federal recovery law. The center highlighted an exchange yesterday between Federal Reserve Chairman Ben Bernanke and U.S. Senator Jack Reed (D-RI) regarding the counterproductive effects of states forgoing money for UI:

BERNANKE: If unemployment benefits are not distributed to the unemployed, then they won't spend them and it won't have that particular element of stimulus.

SEN. JACK REED (D-RI): So if this was done on a wide basis, it would be counterproductive, not productive?

BERNANKE: It would reduce the stimulus effect of the package, yes.

CPPP Written Testimony on Expansion of School Breakfast Program (02/18/2009)

Last session, HB 4062 directed TDA to study the National School Breakfast Program and make recommendations to the 81st Legislature for increasing participation in the program. Numerous studies before TDA’s have explored the importance of eating breakfast at school. This research has shown that school breakfast improves academic performance, decreases behavioral problems, and improves children’s nutritional health. Despite its documented value, only a little over half of all low-income students in Texas public schools eat school breakfast, when compared to those who eat lunch. Based on its study, TDA has recommended ways to increase school breakfast participation. The Legislature should help TDA implement these recommendations by funding school breakfast expansion initiatives.

Unemployment Compensation Trust Fund: Opportunities to Modernize Eligibility & Fix Solvency: Testimony to the Senate Finance Committee (02/16/2009)

The American Recovery & Reinvestment Act (ARRA) includes more than $555 Million for Texas to modernize its Unemployment Insurance (UI) eligibility rules. To qualify for these funds, the Texas Legislature must make three commonsense policy changes that would save jobs, increase economic activity, and limit demand on other social services programs. This testimony not only explains what Texas must do to get funding under the Unemployment Insurance Modernization Act (UIMA), but also lays out specific reforms to address chronic insolvency of the Unemployment Compensation Trust Fund.

SB 1: Testimony to the Senate Finance Committee (02/16/2009)

Article II -- HHSC: Testimony to the Senate Finance Committee (02/16/2009)

The Legislature must fully fund HHSC Exceptional Items #2 and 3# to provide additional staff for the eligibility system. The demand for services is already on the rise and will only increase as the full effects of the recession hit Texas. Without adequate staff, HHSC cannot provide timely and accurate benefits to eligible families. The delay or inappropriate denial or termination of benefits not only causes great hardship to needy Texans. It also causes the state to lose out on critical federal funds for Food Stamps and Medicaid that boost our state and local economies.

Federal Economic Recovery Legislation and Texas (02/13/2009)

Today, Congress released the details of the American Recovery and Reinvestment Act (ARRA), which provides $789 billion to stimulate the economy. Many of these measures will also help protect vulnerable Texans during this economic downturn. To take full advantage of the benefits in the recovery package and set our economy on the road to recovery, Texas must plan immediately. We applaud Speaker Joe Straus for appointing the Select Committee on Federal Economic Stabilization Funding, charged with monitoring federal action and suggesting to standing committees needed steps to qualify for federal economic recovery funds. This paper summarizes the portions of the bill that affect the state budget.

Gimme a Q. Gimme an A. Gimme an F. What's That Spell? Health Care! (01/30/2009)

As the national recession deepens, Texas must look for ways to generate needed revenue for vital programs like Medicaid that low- and moderate-income Texas families rely on when they need it most. Implementing a hospital quality assurance fee (QAFs) in Texas could generate nearly a billion dollars in state and federal funding that could be used to increase payment to Medicaid providers and expand coverage to the uninsured.

Economic Recovery Package and SCHIP Reauthorization in Congress: What’s at Stake for Texas Health Care Coverage (01/27/2009)

As reported in our alert dated January 13, 2009, Congress is moving quickly on federal legislation to address the deepening economic downturn, and in separate legislation to reauthorize the funding for the state children’s health insurance program, known in Texas as CHIP. Taken together, these bills include provisions that will make large amounts of additional federal funding available for Texas Medicaid and CHIP. Some of this funding will come to our state without any new action by the Texas Legislature, but substantial proposed health care funds will only be gained if our state passes new laws. This alert describes the major funding proposals, estimated funding benefits to Texas where available, new options requiring state action, and the expected legislative schedules for consideration of the legislation.

Lack of Participation in School Breakfast Means Missed Meals for Children and Missed Federal Dollars for Texas (01/14/2009)

The Center for Public Policy Priorities today highlighted a national report on school breakfast programs that showed Texas ranks higher than most states in providing school breakfast to low-income students, but still fails to reach many students. This caused Texas to lose out on more than $30 million in related federal funds. According to the Food Research and Action Center’s (FRAC) School Breakfast Scorecard, Texas ranks 5th among the states in missed federal dollars tied to the school breakfast program.

Moving Fast in D.C.: CHIP Reauthorization and More Federal Dollars for Texas Medicaid (01/13/2009)

Congress is expected to pass a reauthorization of the State Child Health Insurance Program (SCHIP) block grant this week to make it available for the new president’s signature as one of his first acts (this block grant provides the federal share of the Texas Children’s Health Insurance Program, or CHIP). Meanwhile, Congress and the incoming administration are also developing and negotiating a sweeping economic recovery package, now expected to be debated in February. The stimulus package is now expected to include $80 to $100 billion in enhanced Medicaid funding for states over two years. As a result, Texas may receive several billion dollars in additional Medicaid funds for the 2010-2011 state budget. Our Legislature will then decide whether"or not"a portion of those funds is devoted to improving our struggling Medicaid program at a time when families need help more than ever.

Recommendations for Healthy Texas (12/9/2008)

With nearly 6 million Texans lacking health insurance coverage and the cost of coverage growing ten times faster than incomes, Texas needs to take bold steps to confront issues with access to health coverage. Healthy Texas has the potential to put private health insurance coverage within reach of many uninsured Texans by addressing the primary barrier to coverage"the high cost of premiums"using public-private partnerships. The overall goals of Healthy Texas are commendable, but the ultimate value of the program will depend upon key policy decisions, many that have yet to be made.

State’s New Managed Health Care Model for Foster Children (11/17/2008)

Senate Bill 6 in 2005 directed HHSC to create a new health care delivery model to provide foster children with comprehensive services, a “medical home,” and coordinated access to care. HHSC worked with the DFPS to develop STAR Health, a new Medicaid managed-care model for foster children, which was implemented on April 1, 2008. This report explores the initial implementation of the program and STAR Health’s potential to improve health outcomes for foster children.

A Child Alone and Without Papers (11/13/2008)

Report cover image

A Child Alone and Without Papers, released today by the Center for Public Policy Priorities (CPPP), reveals what happens to more than 43,000 undocumented, unaccompanied children removed annually from the United States and repatriated to their home countries. Policy analysis and interviews with adults and children in the system revealed the U.S. often compromises children’s rights, safety, and well-being, contrary to international law and U.S. child welfare standards.

For more information, including a two-page summary, backgrounders and appendices, visit www.cppp.org/repatriation.

Texas Health Care 2008: What Has Happened and What Work Remains (10/23/2008)

CPPP's new report provides an update on major actions on health care access in the 2007 legislative session and the important issues and challenges that remain as we approach the 2009 session.

CPPP Honors Methodist Healthcare Ministries' Kevin Moriarty with 2008 Hobby Visionary Award (09/17/2008)

Methodist Healthcare Ministries (MHM) Chief Executive Officer Kevin C. Moriarty is this year’s recipient of the Hobby Visionary Award. CPPP selected Moriarty for the award because of his strong record of charitable service and advocacy for good public policy, particularly for access to health care. Former Lieutenant Governor Bill Hobby, for whom the award is named, presented the award on September 19 at the 2008 William P. Hobby Policy Conference in Austin.

Emergency Food Stamps for Hurricane Ike Victims (09/16/2008)

The Texas Health and Human Services Commission (HHSC) received approval today from the federal government to provide Emergency Food Stamps to victims of Hurricane Ike. Families must have limited income to qualify, but will only need to provide proof of identity and residence in one of the 29 counties declared a federal disaster area.

Recommendations for the 2009 Child Nutrition Programs Reauthorization (07/15/2008)

Senior Policy Analyst Celia Hagert delivered testimony in a public hearing held by the USDA in Austin on July 15, 2008. Her recommendations for reauthorization of child nutrition programs include improving access, meal quality and nutrition in school breakfast and lunch, summer nutrition, afterschool and child and adult care food programs.

Eligibility System Progress Report (07/14/2008)

Access to health care, good nutrition, and cash assistance is vital to low-income Texas families who don’t earn enough to make ends meet, particularly during economic downturns. Yet, enrolling in programs like Food Stamps and Medicaid has gotten harder over the last year due to problems with TIERS"the new computer system"and a shortage in state workers that resulted from the Legislature’s failed attempt to privatize the system in 2006. Rebuilding and sustaining a viable eligibility system promises to be one of the most important challenges facing Texas in the years to come. Today, the Legislative Oversight Committee overseeing efforts to rebuild the eligibility system will hold a public hearing. The Health and Human Services Commission (HHSC) will provide a progress report and present the benchmarks that will be used in determining whether to continue implementing TIERS. In this report, CPPP outlines recommendations for HHSC to consider.

Legislative Oversight Committee on TIERS/Eligibility System to Hold Hearing on Monday, July 14 (07/11/2008)

Access to health care and good nutrition is vital to low-income Texas families who don’t earn enough to make ends meet. Yet, enrolling in programs like Food Stamps and Medicaid has gotten harder over the last year due to problems with TIERS"the new computer system"and a staff shortage that resulted from a legislatively-mandated attempt by the state to privatize the system in 2006, which failed. Rebuilding a viable eligibility system promises to be one of the most important challenges facing Texas in the years to come. On Monday, July 14, the Legislative Oversight Committee overseeing efforts to rebuild the eligibility system will hold a public hearing. The Texas Health and Human Service Commission (HHSC) will provide a progress report and present the benchmarks that will be used in determining whether to continue implementing TIERS.

Texas Needs Tools to Increase Private Health Coverage: How Improving Public Oversight Can Bring Health Care to More Texans (06/23/2008)

By insurance industry standards, Texas’ commercial health insurance market is considered one of the healthiest in the United States because it has a relatively large number of insurance companies offering plans, is subject to less rate regulation than in most states, and brings in $22 billion a year in premiums. The effect of this market on Texas consumers, however, is anything but healthy. The private health insurance market in Texas leaves one in four uninsured, generates the third highest premium increases in the nation, and produces one of the lowest rates of coverage through employer-sponsored insurance in the nation. Many small-business owners in Texas want to provide coverage to their workers but cannot afford to with premium quotes as high as $23,000 a year per employee. Texans must think twice before switching jobs or starting businesses for fear that a preexisting condition will prevent them from getting health insurance. The notion that a hands-off approach to regulation promotes the best outcomes has not worked any better in the Texas health insurance market than it has in the mortgage industry. Texans deserve a truly healthy insurance market in which insurance companies vigorously compete for business and make reasonable profits while consumers are able to purchase the insurance they need at prices they can afford. This policy page focuses on sensible market reform options"many already enacted by other states"that can help make private health insurance more affordable and accessible in Texas.

CPPP Comments on the TDI Sunset Staff Report (06/6/2008)

Policy Analyst Stacey Pogue submitted comments on the Texas Department of Insurance and Office of Public Insurance Council Sunset Staff Report. With one in four Texans lacking health insurance coverage and the cost of coverage increasing ten times faster than income, the staff report correctly identifies the need for the state to examine its current approach to insurance regulation.

Newly Passed Farm Bill will Help 890,000 More Texans (05/30/2008)

With rising gas and food prices, families need help putting food on the table now more than ever. Nationally, the cost of groceries is up dramatically, especially staples like eggs (up 25% in the last year), milk (up 17%), cheese (up 15%), bread (up 12%), and rice (up 13%). Earlier this month, Congress passed the Farm Bill, expanding the Food Stamps, Emergency Food Assistance, School Meals, and Fresh Fruit and Vegetable programs. This bill will help low-income Americans during these harder times. Thanks to the Farm Bill, Texas will receive $674 million in new money for nutrition assistance over the next nine years, according to the national Center on Budget and Policy Priorities. Not only that, but nearly 900,000 more Texans will receive additional Food Stamp benefits in 2012.

A Central Pillar of Texas Health Care is at Risk: Federal Medicaid Rules Would Cost Texas $3.4 Billion (04/16/2008)

Federal Medicaid officials are trying to impose a number of rules that, if implemented, would make program cuts that would threaten our most vulnerable citizens, limit our ability to serve more low-income children in CHIP, and shortchange taxpayers at the same time. Texas Medicaid officials estimate that these rules would cost Texas Medicaid $3.4 billion in lost federal support over five years. The cuts would force Texas to cut services for children with disabilities and frail seniors as well as support for safety net hospitals, or else raise taxes to make up the lost federal funds. Governor Rick Perry, the National Governors Association, and the National Association of State Medicaid directors all have urged Congress to stop the rules from taking effect, and Congress is now debating bills that would delay the rules for at least a year. In every case, these rules attempt to impose harsher policies than underlying federal law, and in many cases policies that have been specifically rejected by Congress. Read more about the rules and how you can help prevent these cuts (including a letter from Governor Perry urging Congress to stop the rules from taking effect).

A Guide Through the Matrix of HHSC Contracting: Revised (04/14/2008)

The Texas Health and Human Services Commission has released two draft Request for Proposals related to the development and operation of an integrated eligibility system for Food Stamps, Medicaid, TANF, and CHIP. Similar to the now defunct “TAA” contract with Accenture, the RFPs ask vendors to submit their proposals for operating a system of call centers to provide “eligibility support services” for Food Stamps, Medicaid, and TANF; determine eligibility for CHIP-only cases; and provide document processing services through a centralized mail center. CPPP has prepared a contracting matrix that describes these and other major contracting opportunities with HHSC related to the delivery of health and human services, including information on the new Twogether in Texas contract award.

HHSC's Proposed Medicaid Waiver: "Affordable" Coverage Should Not Come from Shrinking Benefits (03/18/2008)

As one step to decrease the number of uninsured, in 2007, the Texas Legislature directed the Texas Health and Human Services Commission to request a “waiver” of federal Medicaid laws to allow Texas to use federal Medicaid dollars to fund a health care coverage program that would be allowed to operate in ways not normally allowed under federal law. In developing a waiver, HHSC must balance keeping the cost per person low against the need to provide a decent and affordable standard of care. Top concerns for the low-income uninsured Texas adults who might be served are (1) a package with “bare-bones” benefits; (2) co-payments that are too high for the poorest parents; and (3) no clear policy on whether parents whose benefits run out will be in debt for the additional care they need. Achieving “affordable” care by cutting benefits dramatically (instead of finding a way to provide an acceptable standard of care) raises serious concerns. An overarching concern for all Texans is whether the financing of the proposed program will hurt our safety net hospitals, which are the backbone of the trauma system for every Texan"rich or poor. Finally, the amount of funding available for the new program is uncertain, and so the number of adults who will be able to enroll is also unknown. This policy page makes recommendations for improving the state’s waiver proposal and explains how you can voice your concern to state officials.

Testimony on HHSC's 1115 Waiver Concept (02/20/2008)

Associate Director Anne Dunkelberg testified on the Medicaid 1115 waiver concept before the Texas Legislature’s Medicaid Reform Oversight Committee.

Child Friendly? How Texas' Policy Choices Affect Whether Children Get Enrolled and Stay Enrolled in Medicaid and CHIP (02/13/2008)

This updated report illustrates the history and consequences of Texas' policies related to children's Medicaid and CHIP, using official state program data. It also summarizes national and state research on the effects of eligibility and enrollment policies, and explains how Texas policies compare to those of other states. The report was funded by the generous support of the Texas Association of Community Health Centers.

Call to Action to Improve Economic Stimulus Package (01/30/2008)

The Senate is soon to take up the economic stimulus bill. We have urged our Texas Senators to vote against the House bill to give the Senate an opportunity to produce a better bill. If the House bill is defeated, we have urged our Texas Senators to vote for the proposal from the Senate Finance Committee. If an amendment to the proposal is offered for a temporary boost in food stamp benefits, we have strongly urged our Senators to support the amendment. A temporary boost in food stamp benefits is a particularly good economic stimulus for Texas. Our letter to our Texas Senators is posted here as a Full Article. We urge you to contact each Senator with a strong message to support the Senate Finance Committee proposal and a food stamp amendment. You can contact Senator Hutchison at http://www.senate.gov/~hutchison/contact.html. You can contact Senator Cornyn at http://cornyn.senate.gov/public/index.cfm?FuseAction=Contact.Home.

Today: Do Your Part to Turn Around the Economy by Signing on to National Letters (01/24/2008)

An effective federal economic stimulus package must target aid to those who will be hardest hit by a recession and who will most quickly boost the economy by spending to support their families. Today, national groups are asking organizations in Texas and other states to sign on to two letters calling for timely, targeted, and temporary assistance to those most in need. The first letter calls on Congress to include (1) an increase in the Medicaid federal medical assistance percentage (FMAP), with a requirement that states must maintain eligibility to qualify for the funds; and, (2) a grant based on population. The second letter urges Congress to boost Food Stamp payments and extend unemployment benefits as part of the stimulus package. The Congressional Budget Office reports that Food Stamps and unemployment insurance would stimulate spending even more quickly than rebates. Congress is reported to have dropped these elements from the stimulus package and would instead boost business tax incentives, which are among the least effective ways to increase economic activity.

Comments on the Health and Human Services Commission’s Draft Request for Proposal #529-08-0135 for Eligibility Support Services (12/31/2007)

Associate Director Anne Dunkelberg and Senior Policy Analyst Celia Hagert submitted comments on the Health and Human Services Commission’s draft Request for Proposal #529-08-0135 for Eligibility Support Services. The draft RFP requests proposals from vendors to operate a call center system to support eligibility determination for CHIP, Medicaid, Food Stamps, and TANF. The RFP describes a system substantively similar to the one developed and operated by Accenture under the TAA contract, which was terminated in March 2007. Comments on the draft RFP were due 12/31/07. HHSC has not yet set a date for the release of the final RFP.

CPPP Comments on Texas HHSC Draft Medicaid 1115 Waiver Concept Paper: Submitted to CMS 12/5/07 (12/27/2007)

HHSC has submitted a draft Medicaid waiver concept paper to federal Medicaid authorities as part of its implementation of SB 10. This is a major proposal which could potentially create programs to provide health coverage for uninsured Texas adults under 200% of poverty. However, public input is critical to make sure the resulting programs provide good benefits at affordable price, and the program has enough funding to really serve large numbers of low-income uninsured workers. The draft concept paper as submitted on December 5, 2007 leaves so many critical elements undefined and key questions unanswered that it is impossible for CPPP to make a clear statement of support for the document or the HHSC effort at this point in development. HHSC solicited public comments by December 28, 2007 on the concept paper. CPPP submitted comments. Readers interested in requesting copies of comments from other Texas consumer and provider organizations may contact dunkelberg@cppp.org.

CPPP Comments on the TANF State Plan (12/18/2007)

Senior Policy Analyst Celia Hagert submitted the following comments on the TANF State Plan.

CPPP Comments on HHSC's Initiative to Revise Application Forms for Public Benefits (12/13/2007)

Associate Director Anne Dunkelberg and Senior Policy Analyst Celia Hagert submitted comments on the Health and Human Services Commission’s efforts to revise and redesign the benefit application forms. These comments relate exclusively to Forms H1010 A/B and H1010-E.

Comments Due Soon on Five Key HHSC Documents (12/12/2007)

The Texas Health and Human Services Commission has posted five important documents on its web site for public comment: revision of the applications for public benefits; the TANF state plan; a Medicaid Waiver concept paper; and two draft Requests for Proposals relating to modernization of the eligibility and enrollment system for public benefits. We know this is a busy time of the year for everyone, but we urge you to take the time to submit comments to HHSC on these important issues.

Texas Schools Lead Nation in Providing Meals to Children (12/11/2007)

Ninety-nine percent of Texas schools participate in the national School Breakfast Program, ranking Texas 7th best in the country, according to a report released today by the national Food Research and Action Center (FRAC). The report, School Breakfast Scorecard 2007, also finds that more than a million low-income Texas children are eating breakfast at school. Despite its relative success compared to other states, there is room for expansion. For every 100 low-income children that participated in the School Lunch Program in Texas, only 53 also ate breakfast.

URGENT ACTION NEEDED: Farm Bill “Cloture” Vote In Senate Tomorrow (12/6/2007)

Your calls to Senators Hutchison and Cornyn are urgently needed now in support of a new motion to force the Senate to finish its work on the 2007 Farm Bill and pass a Farm Bill with a strong nutrition title as soon as possible in December. The bill has been stalled over disagreements on the number and types of amendments that will be in order. A key vote to break the stalemate is set for tomorrow, December 7th. Starting today and until the cloture vote on Friday, December 7th, call your Senators and urge a “yes” vote on the cloture motion on the 2007 Farm Bill. Hungry people can’t wait.

WIC Funding Crisis: Urgent Action Needed (12/4/2007)

If Congress does not provide sufficient funding for the WIC program before they go home for the December holidays, more than 56,000 low-income mothers and young children may be cut from the WIC program in Texas. Congress is developing an omnibus appropriations bill that would represent a compromise between the lower amount of spending requested by the President and the higher level approved by Congress for various programs. WIC is one of the programs that would be cut under this compromise. Please call your Senators and Representatives in their Washington, D.C. offices immediately.

CPPP Comments on HHSC Key Decisions for Texas Medicaid Waiver Concept Paper (11/6/2007)

CPPP issued comments in response to the Texas Health and Human Service Commission's request for public input on key decision areas that will be discussed in an upcoming Texas Medicaid Waiver Concept Paper.

The Texas Health Care Primer (Revised 2007) (11/1/2007)

The Center for Public Policy Priorities and Methodist Healthcare Ministries are pleased to release this updated primer, designed to give readers an introductory overview of factors shaping Texans' access to health care. Readers will be better able to contribute to federal, state, and local debates about how to improve health care access. There are two versions of the primer: The Booklet Version was designed for two-sided printing. The Side-by-Side Version was designed for on-screen viewing.

Call Right Now: Revised CHIP Bill Up for Vote Today (10/25/2007)

There will be a vote WITHIN AN HOUR OR TWO on a revised Children’s Health Insurance Program Reauthorization Act. This bill is particularly important for Texas, which has the highest rate of children without health insurance in the country. House members worked in a bipartisan way to meet objections to the previous bill. Several Texas House members, including Representatives McCaul, Granger, and Neugebauer earlier signed a letter urging the very changes which have been made to the legislation. Please urge your congressional representative to vote yes on the revised legislation, which will provide health care to 10 million children.

Audit Recommends Improvements to Employment & Training Program for Welfare Recipients (10/25/2007)

Earlier this month, the State Auditor’s Office released an audit of the Texas Workforce Commission’s administration of the “Choices” program, the employment and training arm of the Temporary Assistance for Needy Families (TANF) welfare program. TANF’s goal is to help very poor parents become self-sufficient through job preparation and employment. Since 2003, the number of Choices participants has fallen by two-thirds, increasing by 85% the amount of employment and training funds available to spend on each welfare recipient. Despite this increase in funds, outcomes for families leaving welfare have not improved. Though the audit concluded that TWC adequately administers the Choices program, it identified the need to improve case management, increase oversight of Choices program expenditures, and improve employment outcomes for welfare recipients. This Policy Page analyzes the auditor’s report. It also summarizes recent research on the most promising strategies for using education and training to improve outcomes for families leaving welfare.

CPPP Statement on SCHIP Vote (10/18/2007)

We are disappointed that Congress did not vote today to override the President’s veto of the Children’s Health Insurance Program Reauthorization Act of 2007. Texas benefits when all Texas children have regular health care. Healthy children grow into healthy adults better able to contribute to our economy and participate in our democracy. By 2012, this bipartisan legislation would have provided health insurance to almost 4 million children who would otherwise have had none, including many Texas children. CHIP has been particularly important to Texas because we have 1.5 million uninsured kids (1 out of every 5 Texas children), the highest percentage of uninsured children in the country. Too many Texas children live in families that earn too little to afford private health insurance.

How the Bipartisan CHIP Reauthorization Act of 2007 Helps Texas and How the McConnell-Lott-Cornyn Alternative Hurts Texas (10/10/2007)

On October 18, Congress will vote on whether to override the President’s veto of the bipartisan Children’s Health Insurance Program Reauthorization Act of 2007. Anticipating the vote, America is engaged in a major public debate about children’s health insurance. The Texas Congressional Delegation is split. Senator Hutchison and 12 Texas representatives voted for the bipartisan bill. Senator Cornyn and 18 Texas representatives voted against the bipartisan bill. Senator Cornyn is a co-sponsor of an alternative called McConnell-Lott. This paper analyzes how the bipartisan bill would help our state and how the alternative would hurt. Based upon this analysis, CPPP urges our Texas congressional delegation to vote to override the President’s veto.

President Vetoes CHIP But It's Not Too Late to Override (10/3/2007)

For the past 10 years, the Children’s Health Insurance Program has provided low-cost health insurance to millions of children in Texas and across the nation, helping keep kids healthy while strengthening the economy. For every $1 Texas invests in CHIP, Texas receives $2.64 in matching funds from the federal government. Yet, earlier this morning the President vetoed legislation that would have reauthorized the program and expanded health coverage to nearly 4 million uninsured children through the State Children’s Health Insurance Program (SCHIP). “The President’s veto means that the advances Texas plans for our state CHIP program are at risk,” said Anne Dunkelberg, Associate Director of the Center for Public Policy Priorities. “Fortunately, it’s not too late. Even though the President vetoed the bill, Congress can still pass legislation that will make our children and our country better off."

CPPP Statement Regarding Senator Cornyn’s SCHIP Claims (10/3/2007)

CPPP has released a statement regarding Senator Cornyn’s SCHIP claims. We have also posted a letter we sent to Senator Cornyn in August and the Congressional Budget Office (CBO) Table that he is misreading that we discuss in the letter.

The Food Stamp Program is Turning 30: Let's Make This Birthday a Happy One! (10/1/2007)

For 30 years, the Food Stamp Program has ensured that low-income Americans have the means to afford a healthy diet--strengthening families, communities, and the nation. Today, more than 2.3 million low-income Texans--most of them children, seniors, or someone with a disability--use Food Stamps to supplement their food budgets. However, cuts to the program 10 years ago have reduced the purchasing power of Food Stamps, making it harder for families to afford an adequate diet. The average family now receives only $3 per person per day for food. We can help prevent hunger by strengthening the Food Stamp Program. Act now by asking our senators to support a modest increase in the Food Stamp benefit in the 2007 Farm Bill.

Big Tobacco Chooses Smoking Over Children; Targets Senator Hutchison (09/24/2007)

Congress is expected to vote as early as tomorrow on reauthorizing the Children’s Health Insurance Program. The agreement between the House and the Senate would increase the number of low-income children CHIP will cover. The increase would be completely paid for by an increase in tobacco taxes. Big Tobacco has targeted one bipartisan leader, Senator Kay Bailey Hutchison, a supporter of the Senate’s CHIP bill on which the compromise bill is based. Philip Morris paid to send the flyer (see attached) to smokers across Texas urging them to put smoking over health care for children.

From CPPP on CHIP: Update on New Bill and Call to Action! (09/24/2007)

Congress is expected to vote as early as tomorrow on a new bipartisan bill reauthorizing the Children’s Health Insurance Program. The House and the Senate have agreed to increase the number of low-income children CHIP covers and pay for it by increasing tobacco taxes. The President is threatening to veto the bill. A strong bipartisan vote for the bipartisan compromise might stop a veto or strengthen Congress’ hand in the negotiations with the Administration after a veto.

Testimony on Transition Plan Mandated by H.B. 3575 (09/21/2007)

Anne Dunkelberg presented testimony before the Health and Human Services Commission, Subcommittee on Eligibility System on the Transition Plan.

Eligibility System Subcommittee to Consider Transition Plan (09/14/2007)

The 80th Legislature passed HB 3575 to address the problems in the eligibility system for Food Stamps, Medicaid, TANF and CHIP. Among other things, HB 3575 requires HHSC to develop a Transition Plan that outlines its efforts to rebuild the system. HHSC's advisory council has appointed an Eligibility System Subcommittee to oversee the transition. The subcommittee will hold a meeting on Friday, September 21, at 10:00 in the Criss Cole Auditorium at 4800 North Lamar Austin, TX, to review and seek public comment on the Transition Plan. We strongly encourage all parties interested in the future of the eligibility system to attend this meeting. Click here for the agenda for this meeting and a copy of the draft Transition Plan.

Understanding the CHIP Battle in Congress: What Makes a Good CHIP Bill? (08/15/2007)

Funding for the Children’s Health Insurance Program (CHIP) is in jeopardy in Congress. You may have followed the battle over CHIP in the Texas legislature and thought that CHIP had been fully funded. CHIP, however, is a federal and state program. Unless Congress passes a new bill to fund CHIP, and the President signs it into law, authorization for CHIP expires in September 2007. Congress is in recess now, but will return September 4. Just before the recess, the House and Senate each passed bipartisan bills. Now, the House and Senate will have to compromise on a final bill. The President is threatening a veto. While they are back at home in Texas, please let our U.S. Senators and Congressmen and women know you want them to support full funding of CHIP. Learn what makes a good CHIP bill.

Breakfast is the Most Important Meal of the Day, but Not on the Schedule for Many Students (08/7/2007)

Kids need pens and notebooks to get through the school day, but they also need a healthy breakfast. Yet, a new report from the Food Research and Action Center (FRAC) in Washington, D.C., finds that in many large urban school districts, including the Houston Independent School District (HISD), most of their low-income students are not getting breakfast on a daily basis. HISD is working to change that by making breakfast part of the school day with its “First Class Breakfast” program.

Overview of Major Actions on CHIP, Medicaid and Child Protective Services (08/1/2007)

CPPP Associate Director Anne Dunkelberg and Policy Analyst Tiffany Roper presented an overview of major actions on the Children's Health Insurance Program, Medicaid, and Child Protective Services to the San Antonio Nonprofit Council.

Amid Controversy, Farm Bill Set for a House Vote Today (07/26/2007)

Today, the U.S. House of Representatives will vote on the 2007 Farm Bill (H.R. 2419), which includes $4 billion over five years in improvements in the Food Stamp and The Emergency Food Assistance Program (TEFAP). Texas would receive an additional $278 million dollars over the next five years. However, controversy over how to pay for the new investments may delay passage of the bill. In Texas, 2.3 million people"over 10% of the state’s population"rely on Food Stamps to afford an adequate diet. More than half of these recipients would see an increase in their Food Stamp benefits as a result of the farm bill’s increased investment in the program. Texas receives almost $2.5 billion per year in federal funding for Food Stamps, providing a significant boost to the state’s economy.

Texas' CHIP Funding in Jeopardy at the Federal Level (07/23/2007)

The 2007 Texas legislative session saw important health care victories for Texas children through the Children’s Health Insurance Program. Now it’s up to Washington to reauthorize enough money so that Texas children can receive the quality coverage they deserve. This week will see a full Senate vote on SCHIP and important decisions about the House bill in the Energy and Commerce Committee. Ultimately, this legislation will fund Texas’ CHIP program for the next 5 years. More than any other state, Texas needs a strong CHIP reauthorization to allow our program, which has dropped by more than 200,000 children (over 40% of enrollment) to recover, and then to grow with the population. CHIP is effective and saves the state money, yet the President is threatening to veto the developing legislation, claiming that it would expand the program dramatically, reduce private coverage of low-income children, and pave the way for “government-run health care.” It's time for you to act!

Farm Bill to be Marked Up Tomorrow: What You Can Do Today! (07/16/2007)

Starting tomorrow, the House Agriculture Committee will begin mark up on the 2007 Farm Bill. One of the most important issues in this year's Farm Bill is the future of the Food Stamp Program, which 2.3 million Texans rely on every day. Unfortunately, because of cuts made 10 years ago, the Food Stamp Program’s buying power has diminished every year. The bill to be considered tomorrow includes a $20 billion “reserve fund” to undo these cuts and increase investment in other areas of the Farm Bill, but the financing needed to make these changes in the FY 2008 Budget has not yet been identified. A straight reauthorization of the Farm Bill"with no new money for the Food Stamp Program"is essentially a cut to the program. Call your congressperson today and urge him/her to support Chairman Peterson’s “mark” and make greater investments in the Food Stamp Program.

Texas' CHIP Progress Now Depends on Congress! (07/9/2007)

The 2007 Texas legislative session saw important victories for Texas children. Legislators improved the Children's Health Insurance Program (CHIP) program by restoring annual renewal, eliminating delays in coverage, and streamlining the enrollment process so that more children can receive affordable, cost-effective health care. None of this matters, however, unless Congress reauthorizes the federal CHIP block grant at a high enough funding level to implement these improvements. The House and Senate have preliminarily budgeted the necessary $50 billion for the State Children's Health Insurance Program, known in Washington as SCHIP, in their 2008 Budget Resolutions. The Administration, however, has not been enthusiastic about funding the full $50 billion. Over the next two weeks, House and Senate committees will begin writing the bills that determine how much money states can get for CHIP in the next five years, including whether the necessary $50 billion is budgeted.

The Texas Food Stamp Program (07/1/2007)

Get valuable background on the Texas Food Stamp Program.

Act Now: The Farm Bill is on the Table (06/11/2007)

This week the U.S. House Agriculture Subcommittee is expected to mark up the nutrition title of the Farm Bill. One of the most important issues Congress will address in this year's Farm Bill is the future of the Food Stamp Program, which 2.3 million Texans rely on every day. Please call your Congressperson TODAY and ask him to co-sponsor the “Feeding America’s Families Act” (H.R. 2129.

Session Wrap Up (06/6/2007)

We hope you found our research and analysis helpful during the 80th Legislative Session. We are reviewing what the legislature did and didn't do in the session, and waiting to see what the governor may sign or veto. Over the next several weeks, we will release analyses of where Texas stands, including 1) an overview of the budget for 2008-09, 2) where we stand with regard to public benefits, particularly Medicaid and CHIP; 3) what has happened to public benefits eligibility determination, 4) where we are with Child Protective Services, 5) how we fared with regard to workforce and economic development, and 6) what the state's fiscal condition will be going forward. Please keep an eye open for these updates over the summer. If you have thoughts you would like to share with us, e-mail kluever@cppp.org; we welcome your insights.

Report: Hunger Costs Texas $9 Billion a Year; This Hunger Awareness Day, Too Many Texas Kids at Risk of Hunger (06/5/2007)

According to a report released today, Hunger Awareness Day, hunger doesn’t just take a toll on the 1.3 million Texas families who experience food insecurity, but it costs the state more than $9 billion a year. The study, by the University Center on Hunger and Poverty at Brandeis University, estimates this cost by calculating the annual cost for charity, illness and lowered productivity for the nation related to food insecurity. Children are at the highest risk of hunger, especially during the summer, when they can no longer eat breakfast and lunch at school. More than 2.1 million low-income Texas kids rely on free or reduced-priced meals during the school year.

Update on CHIP Bills (05/24/2007)

We are waiting for the Senate to name conferees for the conference committee on HB 109, where a compromise will hopefully be ironed out and sent to the Governor for passage. In the meantime, we have prepared an update of the House conferees and the costs and caseloads estimated in both bills.

Today: Fight Hunger by Making a Call! (05/22/2007)

In Texas, 2.3 million people rely on Food Stamps and more than 1.3 million people--the third highest in the nation--are food insecure. All day today, May 22, support a strong nutrition title in the 2007 Farm Bill by urging your U.S. senators and representative to support H.R. 2129.

Comparing the House and Senate CHIP Bills: House Would Cover More Children (05/21/2007)

The House passed HB 109 by a 128-17 vote on April 3. This bill would reform the Children's Health Insurance Program by allowing children to re-apply for CHIP once a year instead of twice, eliminating a 90-day waiting period for coverage, and letting families deduct child care expenses when determining their eligibility. On Thursday, May 17, the Senate Finance Committee passed a different bill that would make most of the same improvements to CHIP but modify the 12-month coverage. As a result, HHSC projects the Senate bill would cover 33,351 fewer kids than the House bill. Higher CHIP enrollment is also needed to avoid future forfeiting of millions of dollars in federal CHIP funds. The full Senate will vote on HB 109 this week, and a conference committee to negotiate a compromise is likely.

Why the Farm Bill Matters for Texas (05/15/2007)

At the end of May, Congress will begin debating the 2007 Farm Bill, legislation that affects not just farmers, but the 2.3 million Texans who rely on Food Stamps to make ends meet. Statewide, 25% of Texas children receive Food Stamps. Nationally, roughly half of all Americans between the ages of 20 and 65 will use Food Stamps at some point in their lives when they fall on hard times. Due to program cuts in 1996, the purchasing power of Food Stamps has eroded. Families now get $40 less a month. This means that Food Stamp recipients get just $1 per meal per day, increasing their risk of running out of food before the end of the month or forcing them to buy cheaper, less healthy food. The 2007 Farm Bill is an opportunity to increase the value of Food Stamps. Read on to learn more about Food Stamp erosion and to get Food Stamp enrollment data by county.

Plenty of Food for Thought: Austin American-Statesman (05/13/2007)

Due to cuts in 1996, the purchasing power of Food Stamps has eroded. Food Stamp recipients now get just $1 per meal per day, which increases families’ risk of running out of food before the end of the month or forces them to buy cheaper, less healthy food. But don’t just take our word for it. For the week of May 15- May 21, Congressman Lloyd Doggett, the Capital Area Food Bank, and the Center for Public Policy Priorities challenge Central Texans to eat and drink only what $1 a meal"or $21 a week"can buy.

Call to Action to Preserve Access to Higher Education for Texas Children (05/9/2007)

HB 159 by Zedler is on the House's Major State Calendar for today. HB 159 would repeal current law that permits Texas children who graduated from a Texas high school pay the in-state tuition rate for state colleges and universities, regardless of immigration status. To ensure Texas prosperity, we must help these children realize their full potential. We do not want to create barriers to their education. Pick up the phone right now and call your representative to tell them to vote NO on H.B. 159. Find your representative at http://www.fyi.legis.state.tx.us/.

Update on the Integrated Eligibility System (05/7/2007)

The committee substitute for House Bill 3575 (CSHB 3575), by Rep. Patrick Rose, would prescribe goals for the integrated eligibility system, create an independent review team, and establish a legislative oversight committee. The bill would not address the shortage of state workers, which is perhaps the most critical challenge facing the rebuilding of the eligibility system, and neither the House nor the Senate budget includes funds to increase staff. However, both versions of the budget would give the Health and Human Services Commission (HHSC) the authority to increase staff in the event that HHSC decides to use fewer contractor staff when it restructures the eligibility system.

Record Number of Children Dropped From CHIP in May (05/3/2007)

Today the Health and Human Services Commission (HHSC) announced that 17,078 fewer children will be covered by the Children's Health Insurance Program (CHIP) in May than in April. This is the second largest number of children ever to be disenrolled in one month, second only to immediately after state budget cuts in 2003.

Analyses to Help You Prepare for the Conference Committee Budget Debate (05/1/2007)

CPPP has revised its overview of the differences between House and Senate state budget proposals for 2008 and 2009. More detailed side-by-side comparisons for Education, Protective Services, Medicaid/CHIP, Public Health, Assistive & Rehabilitative Services, and Department of Aging and Disability Services (DADS) are also available. Texas can afford to meet all its needs. Texas has at least $3 billion more in General Revenue that the legislature could appropriate. In addition, the legislature could redirect $1.4 billion in the House and Senate proposals that would only undo past payment deferrals. Undoing these payment deferrals has no purpose except to shelter money to pay for tax cuts after 2009. If the legislature appropriated this entire $4.4 billion to meet today's needs, Texas would still have another $4.3 billion in its Rainy Day Fund to meet an emergency of any sort.

TANF Legislative Update (04/24/2007)

We wanted to share with you the latest developments on the various Temporary Assistance for Needy Families (TANF) bills making their way through the 80th Legislature. All are scheduled to be heard this week--take action!

CPPP Statement on Tiers/IE System Recommendations (04/20/2007)

Yesterday, April 19, 2007, the Subcommittee on TIERS and Integrated Eligibility, chaired by Representative Abel Herrero and including Representative Tan Parker and Representative Bryan Hughes, presented its unanimous recommendations to the House Human Services Committee for addressing the problems in the TIERS/IE system and establishing a more efficient and effective eligibility system. The Center for Public Policy Priorities applauds the work of the subcommittee and urges the full committee to adopt its recommendations in their entirety and move quickly to incorporate the recommendations into legislation.

Testimony on CSHB 3759 (04/19/2007)

Celia Hagert provided testimony before the House Human Services Committee on CSHB 3759. CSHB 3759 would improve outcomes for families on and leaving welfare by increasing work participation rates, improving Texas' ability to help parents overcome barriers to employment, and improving the integrity and effectiveness of sanction practices.

Oppose SB 1096: Senate Likely to Vote This Week (04/18/2007)

Tomorrow, April 19, the Senate may consider SB 1096, a TANF bill that would hurt vulnerable families. We’re urging Senators to vote no on the bill and we encourage you to call your Senators with that message. SB 1861 is a much better alternative. We have also prepared a comparison of the two bills.

Texas CHIP Rolls Must Grow FAST to Avoid Losing Federal CHIP Dollars Permanently— 12-Month Coverage the Best Way (04/18/2007)

Between 2000-2006, Texas gave up over $900 million in federal CHIP dollars. Congress had designated these dollars for Texas, but because we did not spend them, they went to other states. Congress is now reauthorizing the SCHIP Block Grant, and will write new rules governing how much federal matching money Texas can receive for CHIP in the next decade. The good news for Texas is that Congress is proposing substantial new CHIP funding, designed to allow states enroll uninsured children who meet CHIP qualifications but are currently not enrolled. The bad news for Texas is that Congress is proposing to determine a state’s CHIP allocation based on how much a state is spending on CHIP in federal fiscal year (FFY) 2009. The Texas legislature must move quickly to remove barriers to CHIP enrollment growth by providing for 12-month coverage. Otherwise, our federal allocation will be permanently reduced.

CSHB 3759: Improving Outcomes for Welfare Recipients (04/17/2007)

Texas is facing greater challenges meeting federal requirements in the Temporary Assistance for Needy Families (TANF) program as a result of rules enacted by Congress in the Deficit Reduction Act of 2006 (DRA). The committee substitute for House Bill (CSHB) 3759 by Representative Elliott Naishtat would help Texas meet federal requirements while improving the outcomes for families on and leaving welfare. CSHB 3759 would increase work participation rates, improve Texas’ ability to help parents overcome barriers to employment, and improve the integrity and effectiveness of sanction practices. CSHB 3759 will be heard in the House Human Services Committee on Thursday, April 19.

Testimony on Free School Lunch and Breakfast (04/17/2007)

Celia Hagert testified on CSHB 454 before the House Education Committee. CSHB 454 relates to the provision of free lunch and breakfast to all enrolled students in certain school districts and campuses.

Two Chances to Support Better Nutrition for Texans (04/16/2007)

The committee substitutes for House Bills 2629 (Senate companion: SB 1497 by Zaffirini) and House Bill 454 by Representative Eddie Rodriguez would improve the nutrition of low-income Texans. On April 17, CSHB 2629 has a hearing in the House Agriculture and Livestock Committee and CSHB 454 will be heard by the House Public Education Committee. Please contact the members of these committees and urge their support for these bills.

Testimony on a Pilot Program for Small Fresh Produce Retailers (04/11/2007)

Celia Hagert testified before the House Agriculture Committee on HB 2629, relating to a competitive grant pilot program for certain small retailers of fresh produce.

Comparing SB 1096 to SB 1861: Two Different Welfare-to-Work Approaches for Texas (04/9/2007)

Texas is facing greater challenges in meeting federal requirements in the Temporary Assistance for Needy Families (TANF) program as a result of new rules enacted by Congress in the Deficit Reduction Act of 2006 (DRA). Under the new federal rules, states are required to engage more TANF recipients in approved work activities or face financial penalties to their TANF block grants. SB 1096, by Senator Kyle Janek, is an attempt to help Texas meet these requirements, but it does so at the expense of the most vulnerable families. In contrast, SB 1861, by Senator Zaffirini, would increase work participation rates, protect vulnerable families, and improve the outcomes for families on and leaving welfare. This Policy Page analyzes the impact SB 1096 would have on TANF recipients and explains why SB 1861 is the better alternative to help Texas meet the federal requirements.

Support HB 854--Lift the Lifetime Ban on Food Stamps for Drug Felons (04/2/2007)

House Bill 854 by Representative Elliott Naishtat removes the lifetime ban on Food Stamps for people convicted of a drug felony. Please urge all members of the House Human Services Committee to support HB 854.

Testimony on Immigrants and Public Benefits in Texas (03/29/2007)

Anne Dunkelberg provided invited testimony on immigrants and public benefits in Texas at an Immigration and Border Security Hearing before the House Committee on State Affairs and the House Committee on Border and International Affairs.

Testimony on the Negative Impact of Full-Family Sanctions on the Temporary Assistance for Needy Families Program in Texas (03/28/2007)

Celia Hagert provided invited testimony about Texas' experience with full family sanctions before Subcommittee #1 on Health & Human Services and the California Assembly Budget Committee.

Devil's in the Details: Six Essential Things Medicaid Reform Should Not Do (03/27/2007)

A number of bills aimed at making changes to Texas Medicaid are scheduled for hearings this week. While the bills as a group do include concepts with merit, there are also provisions which raise grave concerns from the perspectives of both client advocacy and fiscal responsibility. There are still opportunities to revise these bills to preserve and protect both client access to care as well as prudent stewardship of Texas taxpayer dollars. This Policy Page identifies the major themes in the bills needing revision to protect the interests of Medicaid recipients and taxpayers, and makes several recommendations.

Support HB 75: Administrative Appeal of a Denial of Food Stamps or Medicaid (03/26/2007)

On March 22, House Bill 75 by Representative Elliott Naishtat was favorably voted from the House Human Services Committee. HB 75 authorizes a person denied Food Stamps or Medicaid to appeal the decision to state court. Next, HB 75 goes to the House Calendars Committee, which must decide whether and when to schedule the bill for a vote by the full House. We are asking for your help in ensuring that HB 75 gets on the House calendar as soon as possible. Please contact all members of the House Calendars Committee today and urge them to calendar HB 75 as soon as possible.

Testimony on HB 854 – Relating to the Eligibility of and Requirements Applicable to Certain Persons for Food Stamps (03/22/2007)

The Center for Public Policy Priorities supports HB 854 by Representative Naishtat, which removes the lifetime ban on Food Stamps for people convicted of a drug felony. Food stamps are 100% federally funded and can be a lifeline to ex-offenders in their attempts to rehabilitate themselves and reintegrate into society.

A Fist Full of Dollars or A Frew Dollars More? (03/13/2007)

Wild rumors are circulating about the cost of complying with the settlement Texas agreed to in Frew v Hawkins in 1995. Some are saying Frew will require the state to identify and enroll every eligible Texas child in Medicaid (not true), or require the state to spend as much as $5 billion more annually on children in Medicaid (also not true). This Policy Page provides a brief summary of key facts about Frew and the upcoming April hearing.

CPPP Statement on Texas' Termination of Accenture Contract (03/13/2007)

The Texas Health and Human Services Commission announced today that it is terminating its contract with Accenture to enroll low-income Texans in critical programs, including the Children’s Health Insurance Program, Medicaid, Food Stamps, and Temporary Assistance to Needy Families (TANF). The contract will officially end in November 2007. Privatization was supposed to save Texas hundreds of millions of dollars and improve services to clients through better use of technology and a more modern enrollment process.

Testimony on TANF Employment Programs and Participation in Those Programs (03/6/2007)

Celia Hagert testified before the Senate Committee on Health and Human Services on TANF employment programs and participation in those programs by certain parents who are not TANF recipients.

Testimony on the Nuts and Bolts of the Texas CHIP Coalition/Insure Texas Kids Campaign (03/1/2007)

Anne Dunkelberg delivered invited testimony before a House Committee on Human Services hearing on CHIP. She discussed ways that the legislature can build on the success of Texas Medicaid and CHIP.

Testimony on Problems Enrolling Texans in Public Benefits (02/23/2007)

Celia Hagert and Anne Dunkelberg provided invited testimony at a public hearing on problems with Texas' system for determining eligibility for public benefits, including Food Stamps, CHIP, and Medicaid.

House Appropriations Subcommittee on Health and Human Services Testimony on SB 1 (02/12/2007)

Celia Hagert testified before the House Appropriations Subcommittee on Health and Human Services on SB 1, General Appropriations Act for 2008-09 (HHSC). She specifically addressed HHSC’s integrated eligibility and enrollment system and the use of TANF funds in the 2008-2009 budget.

CPPP Files Letter Brief with Attorney General About Governor’s Authority (02/12/2007)

Today the center filed a letter brief with the Attorney General about the Governor’s authority to make executive orders. We filed this brief in response to a pending legislative request for the Attorney General's legal opinion on this issue.

Governor's HPV Order is Unconstitutional: Austin American-Statesman (02/7/2007)

Conservatives are complaining about the Governor’s executive order that parents must vaccinate all female children for the Human Papillomavirus (HPV) before the sixth grade. They instinctively feel that the governor has exceeded his authority. The conservatives are right. He has. This is not the first time, though. Just a little more than a year ago, the governor issued an executive order requiring elected school boards to spend 65 percent of their budgets in the classroom. Then, conservatives applauded. Both the vaccination order and the 65 percent order, however, violate the law in the same way. Under our constitution, the governor administers the law; the governor doesn’t make the law. This principle is textbook civics. Making law is for the legislature.

A New Welfare-to-Work Approach for Texas (02/5/2007)

Recent changes to the federal Temporary Assistance for Needy Families (TANF) block grant place new pressures on states to reduce their welfare caseloads and increase the number of families participating in work activities or face financial penalties. At the same time, the new rules make it harder for states to design effective welfare-to-work programs, particularly for those recipients who face the greatest barriers to employment. This policy brief analyzes these challenges in the context of Texas’ welfare program and proposes a set of policy changes designed to help Texas meet the federal requirements while improving outcomes for welfare recipients.

CHIP and Children’s Medicaid Briefing: Texas CHIP Coalition/Insure Texas Kids Campaign (02/1/2007)

Anne Dunkelberg, CPPP's Associate Director, teamed with Dr. Gary Floyd, President, Texas Pediatric Society; Chris Born, CEO, Texas Children’s Health Plan; and Barbara Best, Director, Children’s Defense Fund, to update staff and legislators of the 80th Legislative Session on health care issues.

Senate Finance Committee Testimony on Utility Bills (01/30/2007)

The center filed testimony with the Senate Finance Committee urging the Legislature to restore funding for the Public Utility Commission’s utility bill discount program for low-income households.

Leading National Health Care Organization Has Named CPPP's Anne Dunkelberg Consumer Health Care Advocate of the Year (01/26/2007)

Today, January 26, Families USA, a national nonprofit organization committed to affordable health care, awarded Anne Dunkelberg, Associate Director of the Austin-based Center for Public Policy Priorities, Consumer Health Care Advocate of the Year.

Texas' Challenge as Congress Reauthorizes CHIP: Federal Block Grant Funding Must Grow to Avoid Future Texas CHIP Cuts and Allow for Coverage of Eligible but not Enrolled Children (01/10/2007)

Steep caseload declines and unspent federal funds have other states eyeing Texas’ share. Congress is scheduled to debate reauthorization of the State Children’s Health Insurance Program (SCHIP, known in Texas as CHIP) block grant in 2007. Despite strong public support for CHIP and new Congressional leadership, winning additional funding for the block grant is not expected to be easy, given the strong commitment to fiscal restraint from both sides of the aisle.

CPPP Statement on HHSC's New Strategy for Enrollment in Public Benefits (12/21/2006)

Austin, TX"Today, the Texas Health and Human Services Commission announced a new strategy for enrolling needy Texans in public benefits, including Medicaid, Children’s Health Insurance (CHIP), Food Stamps, and temporary cash assistance (TANF). Over four million low-income Texans rely on these services to meet their basic needs. F. Scott McCown, Executive Director of the Center for Public Policy Priorities, said: “We applaud this new strategy. HHSC is moving in the right direction. Commissioner Hawkins and his team worked hard to learn from the pilot and make needed changes. We are particularly encouraged that HHSC will increase the number of permanent state staff and resume the integrated-eligibility pilot only when the necessary technology is in place. Still, the workload is growing, and the legislature needs to add more state staff.”

More Texas Children Eating Breakfast at School, but State Could Do More to Increase Participation and Federal Funds (12/7/2006)

According to a report released today by the national Food Research and Action Center (FRAC), 33,140 more Texas students have participated in the federally-funded school breakfast program since 2004. Yet despite these gains, millions of Texas school children still don’t take advantage of the program.

Answers to Summer Food Challenges: An Advocate’s Perspective (12/5/2006)

At the USDA Southwest Region's Task Force Meeting, Celia Hagert discussed the barriers involved in providing summer meals to children and the role of advocacy in helping communities overcome these barriers.

Advocates Want to Know: Why Were 3,800 Texas Medicaid Applicants Denied Benefits in First 3 Months of New Federal Policy? (12/1/2006)

Since July 2006, the federal government requires that states make U.S. citizens prove their status in order to receive Medicaid. Three months later, Texas Health and Human Services Commission (HHSC) data reveal that nearly 3,800 applicants"two-thirds of them children"have been denied Texas Medicaid strictly for lack of citizenship documentation.

Important Update on New Medicaid Citizenship Documentation Requirements and Texas (11/30/2006)

Some recent media reports have erroneously stated that the new federal Centers for Medicare and Medicaid Services (CMS) rules deny Medicaid coverage to newborns of “Emergency Medicaid” non-citizen mothers. In fact, the new federal law and rule did not change eligibility for Medicaid in any way. It is critical that Texas health care providers and social service agencies understand the correct policy so that (1) eligible U.S. citizens are not wrongfully denied Medicaid, and (2) health care providers do not incur avoidable uncompensated care. Providers and community-based organizations should also make certain that Texas Medicaid policies are being followed correctly in their facilities and communities, because these policies should minimize Medicaid denials and delays for U.S. citizens of all ages" not just newborns. Please share this important information with your staff who work with Medicaid applications.

Outsourcing Issues and Concerns in Public Benefits Administration (11/30/2006)

Celia Hagert presented an overview of the concerns and issues raised by privatizing enrollment of public benefits before the Texas Association of Area Agencies on Aging.

Health Care Briefing, University of Texas at San Antonio (11/17/2006)

Eva DeLuna Castro presented the latest on Texas health care--what happened to Medicaid, CHIP, and state-funded public health services in the 79th legislative session, and what work remains heading into the 80th--at a UTSA-Downtown breakfast briefing.

Making the Case for an Adequately Funded Eligibility System (11/14/2006)

Celia Hagert presented on the need for an adequately funded state eligibility system at the Funding State Services Conference held by the national Center on Budget and Policy Priorities.

Updating and Outsourcing Enrollment Public Benefits: The Texas Experience (11/13/2006)

Outsourcing was supposed to save the state hundreds of millions of dollars and improve services to clients, but so far, the state has not saved a penny in administrative costs. The children, elderly, and persons with disabilities who rely on these services have suffered through a frustrating enrollment process, been caught in long backlogs, and often been wrongly denied benefits. In May 2006, the state delayed further rollout of the system indefinitely and asked state staff to take over. This report shares the Texas experience.

New Report on Texas' Troubled Outsourcing Experiment Tells Cautionary Tale for Sister States (11/13/2006)

A report released today on Texas’ experiment with outsourcing enrollment in key health and human services tells a cautionary tale about the state’s attempt to modernize the system that determines eligibility for health care, food, and cash assistance benefits. Over four million low-income Texans rely on these services to meet their basic needs.

Presentations at the United Way of Metro Tarrant County's Pre-Legislative Health and Human Services Public Policy Forum (11/13/2006)

Celia Hagert and Tiffany Roper presented on outsourcing public benefits administration and privatizing the Texas Department of Family and Protective Services at the United Way of Metro Tarrant County's public policy forum.

Immigrants and Food Stamps: Separating the Facts from the Fiction (11/7/2006)

Celia Hagert presented on immigrant access to food stamps at the Texas Association of Community Action Agencies' training for food stamp outreach subcontractors.

Texas Medicaid and CHIP Enrollment Update for Children’s Hospital Association of Texas (10/24/2006)

Anne Dunkelberg presented the latest on Medicaid and CHIP enrollment at a briefing on children's issues hosted by the Texas Pediatric Society and the Children's Hospital Association of Texas.

Proof of Citizenship for Medicaid: Tell Us Your Stories! (10/19/2006)

Federal law now requires that states make U.S. citizens prove their status to get Medicaid. If you, or someone you are helping, has had Medicaid delayed or denied because of this new requirement, we want to know. If you or your client need help getting the documents required, or are not sure what is required, we will try to help you, or connect you with the help you need. If you are an agency or health care provider and want to track how this law is affecting your clients or patients, we would be happy to have your input.

Texas Doing Right by its Kids on School Lunch: Austin American-Statesman (10/12/2006)

This week marks National School Lunch Week, a time to commemorate a program that makes it possible for every child in America to have a school lunch. It is also a time to celebrate the fact that Texas leads the nation in providing these healthy meals.

Medicaid and CHIP Update (10/10/2006)

This powerpoint provides the latest information on CHIP and Medicaid.

An Advocate’s Perspective: Texas Medicaid Reforms (10/9/2006)

CPPP presented this invited testimony related to Medicaid cost containment options before the Texas Health and Human Services Subcommittee, House Committee on Appropriations.

People Coming and Going at CPPP (09/28/2006)

September has brought exciting board and staff changes. Learn who's joined the board, who's rotated off, who's been promoted, and who just joined the CPPP team.

Welfare Reform Statements Miss the Mark: Austin Business Journal (09/22/2006)

Diane Rath, chair of the Texas Workforce Commission, is misguided in her statement that welfare reform has been “one of the most successful social reforms of the last 50 years” (Austin Business Journal, Sept. 8-14). We agree that it is preferable for families to work"especially since families on welfare receive an average of less than $150 a month in cash assistance. However, in Texas, work alone is rarely enough to pull a former welfare family out of poverty.

Poverty Continues to Plague Texas (08/29/2006)

Today the U.S. Census released its latest numbers which find that for another year, Texas ranks towards the bottom in overall poverty, child poverty, elderly poverty, uninsured Texans, and the percent of people who receive cash assistance.

Katrina Series (08/29/2006)

CPPP research on resources to help the victims of Hurricane Katrina in the areas of food and housing, health care, cash assistance, and unemployment insurance and employment services.

Katrina One Year Later: What Has Happened and What Work Remains (08/28/2006)

Tomorrow, August 29, marks the one-year anniversary of Hurricane Katrina. Just over 250,000 evacuees have made Texas their home. Learn what has happened over the past year and what work remains.

Now Texas Must Begin to Beat off its Poverty: Galveston County Daily News (08/28/2006)

Nearly one year ago, Hurricane Katrina ripped through the Gulf Coast, wreaking havoc while exposing the vast poverty that pervades our nation. It lent a human face to a story of widespread economic hardship that is usually told by numbers and data, not images of human suffering. Hundreds of thousands of our Louisiana neighbors fled to Texas for dry land and a chance at a better life. According to a recent statewide survey, about 250,000 of these evacuees still live in Texas.

TANF at 10: Was Welfare Reform a Success in Texas? (08/22/2006)

Ten years ago today, Congress overhauled the nation’s welfare system with the promise of helping poor families become self-sufficient by replacing welfare with work. Known as “welfare reform,” the Temporary Assistance for Needy Families (TANF) block grant replaced the entitlement program Aid to Families with Dependent Children (AFDC). Caseloads have fallen 75% in Texas over the last decade, but has welfare reform been a success?

Want Welfare? Don't Count on Texas' New, Inadequately Staffed System for Help: Dallas Morning News (08/4/2006)

Most of us have never had to think about how families in need sign up for public help such as health care and food stamps. Right now, however, an important debate is brewing in the Capitol over the question"how should we sign people up for help?

CPPP Urges Comments on Medicaid Citizenship Rules (08/1/2006)

Until August 11, the federal government is accepting comments from organizations and individuals concerned about a new rule that requires U.S. citizens who apply for or receive Medicaid prove their citizenship and identity. This rule threatens to block or delay access to health care for many Texas citizens, including pregnant women and children in foster care. CPPP encourages you to submit your comments by following the attached form. Our comments are attached.

Recent Trends in Texas Children's Medicaid and CHIP Coverage (07/26/2006)

Anne Dunkelberg delivered testimony before the Texas House Committee on Government Reform about the current state of Medicaid and CHIP.

Staffing and Training Challenges in the Integrated Enrollment and Eligibility System (IE&E) (07/26/2006)

Celia Hagert delivered testimony before the Texas House Committee on Government Reform on the challenges faced by the state's privatization of social services.

CPPP Legislative Letter on Integrated Eligibility and Enrollment (07/19/2006)

Last week two groups of House Members wrote to HHSC Executive Commissioner Albert Hawkins regarding continuation of the Texas Integrated Eligibility and Enrollment Services (IE&E) project. These letters express two competing views. In this letter to the legislature, CPPP offers a different perspective relating to inadequate staffing for the project.

Don’t Turn Off the Air on Texans (07/19/2006)

This summer, companies will disconnect electricity for many low-income Texans unless the Public Utility Commission acts tomorrow to pass an emergency rule. To learn more, read our letter to the Commission. Please add your voice to ours by e-mailing or calling the commissioners to show your support for the emergency rule.

HHSC Request for Proposals: Community Based Outreach and Application Assistance (07/18/2006)

The Texas Health and Human Services Commission (HHSC) released a Request for Proposals for Community Outreach and Assistance on June 6. CPPP wants to make sure that Texas community-based organizations are aware of this important opportunity. We believe that it is important that Texas organizations serving low-income workers and families, the elderly, and people with disabilities join forces to create robust networks capable of helping eligible Texans access the services they need--and helping keep them enrolled.

July 1: Proof of Citizenship Required for Medicaid, Federal Guidance Flawed (06/26/2006)

In just a few days, a new federal law will begin to change the way Texans apply for Medicaid and renew their coverage. On July 1, all U.S. citizens applying for Medicaid or renewing their Medicaid eligibility will have to prove their citizenship by presenting certain documentation. Texas has proposed a sensible approach to implementing the new requirements, but initial federal guidance could prevent prompt access to health care for new applicants, create a paperwork nightmare for the aged and disabled, and dramatically increase the state’s administrative costs.

Outsourcing Hurts the Poor: Austin American-Statesman (06/26/2006)

The state's attempt to change the way Texans in need get health care, food, and temporary cash assistance has been a disaster.

Texas Health Care: What Has Happened and What Work Remains (06/19/2006)

Do you want a user-friendly guide to understanding what happened to health care in the 2005 legislative session and where things stand leading into the next session? CPPP, in partnership with Methodist Healthcare Ministries, is pleased to release this new report.

Rocky Road for Children's Health Care (06/13/2006)

This past November, the state began changing the way Texans enroll in public services. From the beginning the system has been troubled, and children’s health care has been especially hard hit. The number of kids receiving health care through Medicaid and the Children’s Health Insurance Program has dropped by over 108,000 since the new contractor took over.

Today is Hunger Awareness Day (06/6/2006)

Today is National Hunger Awareness Day, the grassroots movement to raise awareness about the hunger crisis in America. In Texas, it is a solemn reminder that we suffer the highest rate of “food insecurity” in the nation, with 16.4% of households at risk for hunger and 4.9% of households experiencing hunger " well above the national average of 11.4% (food insecure) and 3.6% (hungry).

Problems Enrolling in Public Benefits? (04/19/2006)

Texas is using a new system to sign up for or renew Food Stamps, Children’s Medicaid/CHIP, and TANF. Some people may be having problems getting benefits using the new system, or you may be helping someone who is having a problem signing up. CPPP is not a state or federal agency and we cannot sign you up for benefits, but we can tell you who to report your problem to...

TANF Reauthorization--Texas' Choice: The High Road or the Low Road? (04/18/2006)

As part of budget reconciliation, Congress recently reauthorized Temporary Assistance for Needy Families (TANF) after numerous short-term extensions. The reauthorization makes several programmatic changes while providing a minimal increase in child care funding. TANF reauthorization provides an opportunity for states to upgrade their TANF work-based programs to deliver better workforce services, engage more recipients in education and training, and improve outcomes. The question is what Texas can do to help families acquire skills and attain self-sufficiency.

Food Stamp Issues and Challenges (04/18/2006)

Celia Hagert presented invited testimony on food stamp changes at the federal level as well as food stamp access in the new integrated eligibility system.

Statement on HHSC’s Decision to Put Social Service Call Centers on Hold (04/7/2006)

The Center for Public Policy Priorities supports the difficult decision the Texas Health and Human Services Commission made Wednesday to delay for at least 30 days the next phase of a new system that uses privately run call centers to help people apply for food stamps, Medicaid, and TANF. Since the January launch of pilots in Travis and Hays counties, the new system has been marked by technical difficulties, staffing shortages, and inadequate training of private call center staff. These problems have delayed services to clients, caused thousands of children to lose their health insurance, and frustrated both clients and staff.

Three Congressional Threats to Texas Health Care: Issues to Watch and Speak Out On (04/7/2006)

Learn the latest on three issues in Congress that are threatening health care right now: the Fiscal 2007 budget resolution, the Health Insurance Marketplace Modernization Act, and immigration bills.

CPPP's Comments on HHSC's Proposal to Develop a Medical System for Children in Foster Care (03/20/2006)

CPPP prepared comments in response to the Texas Health and Human Services Commission's draft proposal to develop a medical system for children in foster care.

CHIP is Not Alone: Children's Medicaid Numbers Also Dropped Statewide (03/7/2006)

A CPPP analysis of new official Medicaid enrollment figures shows that problems with Texas' new partially-privatized benefit eligibility system are not limited to CHIP. Statewide, the number of children insured by Medicaid dropped for an unprecedented three consecutive months from November to February. The magnitude of the drop is also unprecedented, with nearly 79,000 fewer children enrolled in February 2006 than in November 2005. The state’s new benefit eligibility contractor assumed responsibility for processing new children’s Medicaid applications, along with CHIP, in November 2005.

The Latest Developments in Medicaid and CHIP (02/28/2006)

Anne Dunkelberg delivered three presentations: one providing an update on Medicaid and CHIP, another discussing lessons learned, and the other detailing the Texas Medicaid and the Breast And Cervical Cancer Prevention and Treatment Act.

Integrated Eligibility/Call Center Update (02/7/2006)

On January 20, the Health and Human Services Commission (HHSC) launched a three-month pilot of a new system for enrolling Texans in public benefits. The pilot is in Travis and Hays Counties and will test a new online application and the use of privately-run call centers to help people apply for Food Stamps, Medicaid, the Children’s Health Insurance Program (CHIP), and Temporary Assistance for Needy Families (TANF cash assistance). If the pilot is successful, the system will be expanded to other areas of the state on a geographic basis beginning in April. This Policy Page provides an overview of the new system, explains how HHS clients will be affected during the rollout, and suggests ways for nonprofit and community-based organizations to make the transition to the new system as smooth as possible for their clients.

Last Chance to Oppose Federal Medicaid Cuts (02/1/2006)

In what is expected to be a very close vote, the U.S. House will vote today, Wednesday, February 1, on budget reconciliation--whether to cuts billions in essential services. There is still time to call 1-800-426-8073 (courtesy of American Friend’s Committee) and ask to speak with your representative’s office. If the lines are busy, please be patient and try again, or visit &&http://www.capitol.state.tx.us/fyi/fyi.htm to find contact information for your Congressional representative.

Feb. 1: U.S. House to Decide Once and For All Whether to Cut Billions in Services (01/25/2006)

On Wednesday, Feb. 1, the U.S. House of Representatives is scheduled to vote on a budget reconciliation bill that would cut billions of dollars from Medicaid, child support enforcement, child care, foster care, Medicare, disability assistance, student loans, and other vital services for families to help fund $70 billion in new tax cuts. The reconciliation bill would also reauthorize the federal welfare block grant (Temporary Assistance for Needy Families) through fiscal year 2010, but with changes to the program that could hurt Texas. Act now to oppose the budget cuts!

It Ain't Over Until the Fat Lady Sings/Go See the Fat Lady While She is at Home (12/22/2005)

With the Vice President casting the tiebreaking vote, the Senate voted 51 to 50 for a budget reconciliation bill designed to cut programs for low-income Americans, while catering to the pharmaceutical and managed care industries. Now the bill goes back to the House for another vote after the holiday recess. We need you to raise a delegation to go visit your Member of Congress at home during this recess.

CPPP Urges Calls to U.S. Senators Right This Minute to Stop Budget Reconciliation (12/19/2005)

The U.S. Senate will vote late today (Monday 12/19/05) on budget reconciliation. A very close vote is expected. We urge you to call our Senators to tell them to vote no.

U.S. House Bill Could Criminalize Safety Net for Immigrants (12/14/2005)

On Thursday, December 15, we expect the U.S. House of Representatives to vote on the “Border Security and Terrorism Prevention Act” (H.R. 4437). The bill includes some very harmful provisions, while making no attempt to address comprehensive immigration reform. Of special concern from CPPP's perspective, HR 4437 threatens to reverse current federal law that protects safety net providers of health care, hunger aid, shelter, disaster relief and other safety net services from having to screen out or discriminate against undocumented persons.

76,000 Texans Estimated to Lose Food Stamps Under Federal Budget Proposal (12/14/2005)

Congress will soon decide whether to eliminate food stamp benefits for about 255,000 low-income Americans, including about 76,000 Texans. The cuts are contained in the U.S. House of Representative’s budget reconciliation bill passed on November 18. This bill would cut more than $700 million in food stamp benefits over the next six years, making Texas the hardest hit among the states, with Texans shouldering approximately 30% of the food stamp cuts. Most of the families who would lose benefits are low-wage workers with children. By contrast, the Senate’s version of the bill makes no cuts to the Food Stamp Program. This policy analysis examines the proposed food stamp cuts and their impact on Texas.

Special CPPP Message on Federal Budget Reconciliation (12/5/2005)

Uncle Sam needs you to enlist in a national effort to stop “budget reconciliation” by contacting your congressional representative and Texas senators. We have prepared a short message in Q&A form to explain how very much is at stake for low-income Americans in this battle.

Letters from Texas Organizations Regarding the Call Center Rollout (12/5/2005)

Letters sent from Texas advocacy and service organizations to USDA’s Food and Nutrition Service regarding its monitoring of the Texas call center rollout.

Legislative Update on Health Care in Texas (12/1/2005)

A Texas health care legislative update delivered by Anne Dunkelberg at the University of Texas at San Antonio.

Texas and the TANF Block Grant (11/11/2005)

The Temporary Assistance for Needy Families (TANF) block grant is the sixth largest source of federal funds in the Texas state budget. TANF is second only to Medicaid in the support it provides for state health and human services. This Policy Brief analyzes Texas’ fiscal and policy choices regarding TANF, in light of pending federal reauthorization and mounting federal deficits.

Take Action: U.S. House to Decide This Week Whether to Cut Billions in Services (11/7/2005)

During the week of November 7, the U.S. House of Representatives will vote on a budget reconciliation bill that would result in $50 billion in spending cuts to Medicaid, Food Stamps, and other vital services for vulnerable families and children to help fund $70 billion in tax cuts. (Other cuts include child support enforcement, SSI disability benefits, child care, foster care assistance, and student loans.) All this week, please join a national campaign to oppose these cuts by calling your representative toll-free at 1-800-426-8073.

Fact Sheets: Accessing Medications and Vision Care in Texas Medicaid and CHIP (11/2/2005)

Authored by Amanda Navarro and Barbara Best of the Children's Defense Fund-Texas and CPPP's Anne Dunkelberg, these materials were developed by the Houston/Harris County Covering Kids and Families Access Initiative as part of a two year grant by the The Robert Wood Johnson Foundation to the Children's Defense Fund of Texas. Houston is one of 17 national projects in the initiative, and one of two Texas projects. CPPP provided Technical Assistance to both of the two local Texas projects, and worked with CDF and the Texas Health and Human Services Commission to review these materials for accuracy. In research with 300 families and over 50 pharmacists and providers, CDF uncovered a number of difficulties families face in getting prescriptions filled through CHIP/Medicaid, as well as questions and concerns among providers and pharmacists. A number of questions also arose about vision beenfits in Medicaid and CHIP. The CDF team developed several informational flyers for parents, pharmacists, and health care providers based on this work. Please feel free to distribute.

U.S. House Votes to Cut Food Stamps at the Same Time USDA Finds Texas Leading Nation in Rate of Households at Risk of Hunger (10/31/2005)

On Friday, the House Agriculture Committee terminated food stamp assistance for 300,000 vulnerable people on the very day that the USDA announced that Texas leads the nation in the percentage of households at risk of going hungry (16 percent). Nationwide, 4.4 million people suffered food insecurity last year, almost a million people more than the previous year. “Food insecure” households are those that had difficulty buying enough food because they could not afford it.

Keep the Pressure on Congress (10/25/2005)

Both the House and the Senate plan to make committee budget decisions over the next two weeks with possible final votes on cuts in the Senate the week of October 31 and in the House the week of October 31 or November 7. We urge you to contact again both your Texas senators and your congressional representative with a simple message: No cuts to vital help for low-income Americans, including Medicaid and Food Stamps.

Letter and Background on Federal Budget Reconciliation (10/10/2005)

CPPP has prepared a backgrounder on federal tax cuts, federal spending, the cost of Katrina relief, and federal budget deficits, as well as a letter to Texas' Congressional delegation on these issues.

Call to Action to Stop Spending Cuts for the Poor and Tax Cuts for Wealthy (10/10/2005)

One month ago, as part of a national effort, we asked you to urge your senators and congressional representative not to cut federal spending on critical health and human services such as Medicaid and Food Stamps. Because of your efforts, Congress delayed taking action, but congressional committees are again moving ahead with plans to mark up cuts during the week of October 17, with the Budget Committees slated to package the cuts around October 26, and Congress to consider bills making the cuts shortly thereafter. Please join us and other citizens across the country in a National Call to Action by telling our senators and representatives what we want.

Update on Children's Health Care and More (10/4/2005)

Presentation that Anne Dunkelberg delivered before a meeting of the Department of State Health Services in Harlingen, TX.

CPPP Statement on Draft State Auditor’s Report (09/29/2005)

Today's story in the San Antonio Express-News, “State savings don't add up," makes public the findings of a draft report by the State Auditor’s Office critical of the methodology behind the Health and Human Services Commission’s decision last year to outsource its human resource and payroll functions to a private contractor. The auditor’s report says the savings from outsourcing are not $45 million over five years as claimed by HHSC to justify the contract, but only $1.1 million. The report also determined that HHSC does not have adequate performance measures in place to monitor contactor performance and ensure people’s needs are met.

U.S. Senate Passes Amendment Prohibiting Privatization of Food Stamp Program Operations (09/26/2005)

Last week, the U.S. Senate passed the 2006 agricultural appropriations bill with an amendment that prohibits states from using federal funds if they privatize more than 10% of their Food Stamp Program operations. If the amendment is successful, it would prevent Texas from going forward with its plans to privatize Food Stamp enrollment under the contract it signed with Accenture in June (which also includes enrollment in CHIP, Medicaid, and TANF cash assistance).

Power Struggle Over Katrina Funding: CPPP's Analysis (09/22/2005)

There are two deals on the table about the best way to pay for Katrina health care relief. This Policy Page describes the differences between the Texas waiver and the bipartisan relief bill, identifying the provisions of the bill that the Medicaid waiver does not address and discussing possible ramifications of the waiver approach versus the relief bill.

Two Wins (09/20/2005)

We are happy to report that acting together, we moved Congress. The Senate has now delayed the deadline for budget cuts to late October and the deadline for tax cuts to early November. On another front, we are pleased to announce that our state leadership has given the green light to the Health and Human Service Commission to restore mental health benefits for adults on Medicaid.

Call to Action: Tell Congress to Oppose Funding Cuts (09/8/2005)

By September 16, congressional committees have instructions to cut $35 billion from Medicaid, Food Stamps, Medicare, the Earned Income Tax Credit, TANF, and SSI for the elderly and disabled. Medicaid could be cut by as much as $10 billion. This doesn't have to happen.

B Rapoport, President Clinton, Hurricane Katrina, and You (09/7/2005)

The Center for Public Policy Priorities is pleased to announce that we will honor Bernard Rapoport as a Texas legacy at our annual legacy luncheon. Mr. Rapoport (known to most as B) is a noted entrepreneur, founding the American Income Life Insurance Company; a public leader, serving as a regent for The University of Texas System; and a great philanthropist, heading the Bernard and Audre Rapoport Foundation. B is truly a Texas"indeed a national"legacy. We also want to share the exciting news that President Clinton has agreed to deliver the keynote address in honor of his good friend, Bernard Rapoport.

State & Local Gov: Challenges of the Fiscal Relationship (08/5/2005)

Presentation in Dallas by Eva De Luna Castro to National Association of Latino Elected Officials (NALEO) Policy Institute on Sustainable Communities, on changes in state and local government sources of revenue/taxes/federal aid.

CPPP Celebrates Medicaid's 40th Birthday (07/28/2005)

On Thursday, the Center for Public Policy Priorities and more than 50 other Texas organizations hosted a birthday party press briefing to celebrate 40 years of Medicaid. In conjunction with the event, the Texas Senate passed a resolution recognizing Medicaid's birthday and the "critical role it plays in the health care of this state's most vulnerable citizens."

Look Who's 40: Medicaid Clients & Experts to Celebrate Program's Birthday and Urge Congress to Keep Program Healthy (07/28/2005)

Join Medicaid clients and health care experts for a Happy Birthday Medicaid press briefing/party in the Lt. Governor’s Reception Room on Thursday, July 28 at 11 a.m. Medicaid turns 40 on July 30.

Call to Action: Tell Congress to Oppose Cuts to the Food Stamp Program (07/19/2005)

Congress is considering making $3 billion in cuts to the Food Stamp Program and other federal food programs over the next five years. These cuts would be achieved through policy changes that would restrict access to Food Stamps, either across the board or for certain populations, such as immigrants or working families. The Agriculture Committees in charge of the food programs are expected to make recommendations to Congress for achieving these cuts by September 16, 2005. Sign onto a national letter circulating in opposition to the proposed Food Stamp cuts and to get Food Stamp enrollment and benefits data for your area. Deadline to sign on is Friday, July 22, 2005.

Partial Restoration of Programs Cut in 2003, Some New Investment: How Medicaid, CHIP, other Health Services Fared in SB 1, the 2006-2007 State Budget (07/11/2005)

The Regular Session of the 79th Texas Legislature has ended and SB 1, the state budget bill for 2006 and 2007 has been passed. The Governor has vetoed certain line items in the budget. The bill incorporates funding to restore some of the Medicaid, CHIP and other health care programs cut by the 2003 Legislature, but leaves some major 2003 cuts unrepaired, and the fate of others up in the air.

HHSC Awards Call Center Contract (07/7/2005)

On June 30, the Health and Human Services Commission announced a 5-year, $899 million contract with Accenture, LLP to revamp and take over operation of the state’s eligibility and enrollment systems for Medicaid, CHIP, Food Stamps, and TANF cash assistance. The contract is the latest development in the state’s plans to move to a more automated system for enrolling people in these benefits and will lead to the use of four call centers and an Internet application, with fewer eligibility staff and local offices. This Policy Page shares what we know so far about these latest developments in the state’s plans to use private call centers to enroll people in public benefits.

Texas: The Big Picture (07/7/2005)

Scott McCown delivered the keynote address, "Texas: The Big Picture," before hundreds at the 20th Annual Texas Community MHMR Centers' Staff and Trustee Training Conference.

Texas Makes Better Use of Federal Resources for Summer Meal Programs; More is Needed to Reach Needy Children (06/16/2005)

Texas has increased the number of low-income children served by federally funded summer nutrition programs since 2000, but still lags far behind the performance of most states, according to a new report released today by the Food Research and Action Center (FRAC) in Washington, D.C. Texas uses two federally funded meal programs to feed children for free during the summer: the Summer Food Service Program (SFSP) and the National School Lunch Program (NSLP).

Houston KIDS COUNT Conference on Children Powerpoint Presentations (06/15/2005)

The following presentations were given at the Houston KIDS COUNT Conference on Children, a half-day conference on children's issues in the wake of the 79th Legislative Session.

Hunger Awareness Day Comes at a Vulnerable Time for Texas (06/6/2005)

Tomorrow, June 7, is National Hunger Awareness Day, a day designed to increase awareness of the need to protect America’s nutrition programs. Hunger Awareness Day is particularly timely this year, given that funding to Food Stamps and other nutrition programs is in jeopardy. Food Stamps are particularly important in Texas, given limited funding for food and other social services at the state level.

Call Now to Expand Health Care for Uninsured Women (05/16/2005)

On Tuesday, May 17, the House Committee on Public Health will hear testimony on SB 747 by Senator John Carona, “Relating to establishing a demonstration project for women's health care services,” also known as a Medicaid Women’s Health and Family Planning “waiver.” This is a rare opportunity to support a program expansion that could provide basic medical check-ups and birth control services to uninsured adult Texas women up to 185% of the poverty line (that’s $2,481 per month pre-tax income for a family of 3 in 2005). Best of all, this program will actually save Texas money right away. The federal government will pay 90 cents on every dollar of family planning care, and Texas Medicaid will save a projected $135 million in 2006 and 2007 because of fewer pregnancies covered by Medicaid.

CHIP Update: Legislature Considering Only Partial Restoration of 2003 Cuts (05/11/2005)

There are two ways in which the changes and cuts to CHIP imposed by the 78th Legislature in 2003 can be reversed: through the budget bill, and through separate bills designed to restore the original CHIP program policies. So far, the conference committee on SB 1 (the state appropriations bill for 2006-2007) has agreed only to restore CHIP vision and dental benefits, and to allow a new (less expensive) CHIP premium policy to be implemented. No bills have been passed to reverse the remaining 2003 CHIP cuts. This Policy Page sums up what is “on the table” for CHIP restoration, what is at risk in terms of NEW cuts, and which of the 2003 cuts seem likely to remain, and recommends top-priority changes.

School Lunch, Food Stamp Bills Moving in the Legislature (05/10/2005)

HB 2578"School Meals (Rep. Eddie Rodriguez) and HB 420"Food Stamps (Rep. Elliott Naishtat) are moving in the legislature. HB 2578 would make determining eligibility for free or reduced price school lunch easier for schools and families. It would ensure that as many eligible children as possible receive lunch at school. HB 420 would lift the ban that currently bars persons convicted of drug felonies from ever receiving Food Stamps.

ALERT: Support Needed NOW to Restore Hearing Aids, Eyeglasses and Vision Care, and Podiatry for Aged and Disabled Medicaid Clients (05/5/2005)

The conference committee on SB 1 (the state appropriations bill for 2006-2007) has so far NOT agreed to restore Medicaid podiatry, eyeglasses, or hearing aid benefits for adults on Medicaid, which were cut by the 78th Legislature. Messages to the House’s budget conferees are needed NOW to urge them to “finish the job” and approve funding to allow these impoverished and predominantly elderly or disabled Texans to access vital services.

HB 420--Lifting the Ban on Food Stamps for Drug Felons (05/5/2005)

The Center for Public Policy Priorities urges your support of HB 420 by Representative Naishtat. The lifetime ban on food stamps for people convicted of a drug felony harms Texas communities. By taking away the supports former prisoners need to make the transition from prison, we encourage recidivism, break up families, and perpetuate a discriminatory system of imprisoning the poor, who are disproportionately people of color. Texas also loses out on federal funds that could be used to help people with drug felon convictions reestablish themselves as productive, lawful members of our society. Without the support of Food Stamps, these people must rely on state, local, or privately funded services, which are limited.

Testimony and Information in Support of HB 122 by Naishtat: Restoring Mental Health Professional Services for Adult Medicaid Clients (05/4/2005)

Q: Can adult clients get their mental health professional services from Medicare? A: More than 60% cannot. In April 2005, there were 864,894 adults on Texas Medicaid. Of these, 670,157 (77%) were elderly or disabled (353,537 elderly, and 316,620 disabled or blind).

Federal Court of Appeals: TWC Violated Federal Law by Rewriting Rules to Terminate Poor Mothers’ Medicaid (05/2/2005)

On Friday, April 29, the U.S. Court of Appeals for the Fifth Circuit unanimously affirmed U.S. District Court Judge Sam Sparks’ earlier ruling that the Texas Workforce Commission (TWC) violated federal law by adopting regulations to cut off health care to poor mothers in the state’s Temporary Assistance for Needy Families work program, called the Choices program. As long as the women meet work requirements, the Circuit found, they are entitled to Medicaid. A copy of the opinion is attached.

HB 2578 - Relating to the School Meals Program (04/26/2005)

The Center for Public Policy Priorities supports HB 2574. Why encourage school districts to offer free meals to all students? The link between adequate nutrition and improved academic performance creates a clear incentive for Texas to increase participation in the school breakfast and lunch programs, particularly among low-income children.

Combined Impact of Medically Needy Cut and TANF Sanctions: Medicaid Coverage of Parents in Poverty has Dropped by 30 Percent with 78th Legislature’s Changes (04/25/2005)

Absent the changes enacted by the 78th Legislature (i.e., elimination of Medically Needy coverage for impoverished parents, and the new Medicaid and full-family sanctions in TANF), we would expect AT LEAST 44,900 more parents to be covered in FY 2005. (This is a conservative estimate, because it does not attempt to capture the GROWTH in overage above 2003 levels that might have occurred without the cuts and TANF policy changes.)

Can Aged and Disabled Medicaid Clients Get Eyeglasses, Hearing Aids, and Services of Podiatrists, Mental Health Professionals, and Chiropractors Through Medicare? (04/21/2005)

In March, there were 863,391 adults on Texas Medicaid. Of these, 670,062 (78%) were elderly or disabled (353,932 elderly, and 316,130 disabled or blind). About 316,700 of the aged and disabled were full Medicaid-Medicare dual eligibles (47% of the aged and disabled). Thus about 353,800 of our aged or disabled adults (53%) DO NOT QUALIFY FOR MEDICARE, AND HAVE NO OPPORTUNITY FOR MEDICARE TO PICK UP THE BENEFITS THAT WERE CUT.

How the Senate and House Budgets Compare on Medicaid, CHIP, Other Health Services (04/20/2005)

The Senate and House versions of the state budget differ in some important respects in their proposed funding for Medicaid, CHIP and other health care programs (See Policy Page #228 for details on SB 1, the “base” General Appropriations Act for 2006-2007, as first introduced). Soon, the "conference committee" on the state budget will begin to hammer out a final compromise budget for the next two years. Proposed restorations of benefits cut in 2003, funding to reduce waiting lists, and funding simply to allow for population growth and inflation may not survive in the final budget unless the legislature adopts legislation that raises additional revenue to support state government.

HB 2447/SB 1541: Proposed Legislation Would Require a Pilot to Test the Use of Call Centers for Eligibility Determination (03/31/2005)

Representative Naishtat (HB 2447) and Senator Gallegos (SB 1541) have introduced legislation that would require the Health and Human Services Commission (HHSC) to conduct a pilot to test the use of call centers in the Food Stamp, Medicaid, TANF, and CHIP programs before a statewide roll-out or significant reductions in local human services offices and employees.

Urge Your U.S. Senators to Oppose Federal Medicaid Cuts (03/10/2005)

Both the U.S. House and Senate budget proposals would cut Medicaid and CHIP funding for the states even more than the President’s recent budget proposal.

What's Happening with TANF Caseloads: Strict Rules Force Thousands of Kids Off the Rolls (03/9/2005)

This Policy Page analyzes the TANF caseload decline and the impact of strict sanction policies on program recipients and recommends a more reasonable sanction policy that helps rather than hurts poor children.

Can Adult Medicaid Clients Access Mental Health Care Despite Benefit Cuts? (03/2/2005)

Q: Can adult clients get their mental health professional services from Medicare? A: More than 60% cannot.

Senate Bill 47 by Nelson: Medicaid Biometric Finger Imaging Fraud Reduction Pilot Program (02/28/2005)

The Center for Public Policy Priorities appreciates this opportunity to comment on SB 47 by Chairman Nelson. CPPP has approached the biometric imaging with a goal of promoting and protecting ease of access to health care for Medicaid clients. We also support ease of use by Medicaid health care providers, because access to care requires that we not create disincentives for provider participation in Medicaid.

Can Aged and Disabled Medicaid Clients Get Eyeglasses, Hearing Aids, and Services of Podiatrists, Mental Health Professionals, and Chiropractors Through Medicare? (02/21/2005)

In January, there were 862,452 adults on Texas Medicaid. Of these, 667,561 (77%) were elderly or disabled (353,910 elderly, and 313,651 disabled or blind). 316,677 of the aged and disabled were full Medicaid-Medicare dual eligibles (47% of the aged and disabled). Thus 350,884 of our aged or disabled adults (53%) do not qualify for Medicare, and have no opportunity for Medicare to pick up the benefits that were cut.

House Bill 288 by Chavez: Personal Needs Allowance for Nursing Home Residents (02/17/2005)

Only 1 in 9 Texans overall is on Medicaid, yet 7 of 10 Texans in a nursing home is on Medicaid (the same is true on average across the U.S.). Clearly, Texas' Nursing Home programs serve many middle-income Texans.

House Bill 24 by Thompson: Personal Needs Allowance for Nursing Home Residents (02/17/2005)

Only 1 in 9 Texans overall is on Medicaid, yet 7 of 10 Texans in a nursing home is on Medicaid (the same is true on average across the U.S.). Clearly, Texas' Nursing Home programs serve many middle-income Texans.

House Bill 545 by Naishtat: Restore Podiatry Services for Adults on Medicaid (02/17/2005)

Who is on Texas Medicaid? As of January 2005, 2.7 million Texans were enrolled in Medicaid.

Comments on Proposed Medicaid and CHIP funding in SB 1 and HHSC Exceptional Items (02/11/2005)

Testimony before House Committee on Appropriations, Subcommittee on Health and Human Services.

Testimony on Proposed State Worker Cuts (02/11/2005)

The Center for Public Policy Priorities offers the following comments on LBB's proposed FY 2006-07 budget for the Health and Human Services Commission.

State Budget Proposes to Cut More Than 4,800 Local Eligibility Workers (02/11/2005)

Legislators began debating the proposed budget for health and human services programs this week (for fiscal 2006-2007), which includes a reduction of 4,809 eligibility staff at the Health and Human Services Commission (HHSC) by fiscal 2007. The proposed reduction represents a 60 percent cut in staff.

Health Care and the 2005 Legislative Session: An Advocate's Perspective (02/6/2005)

Presentation at IAF Conference on Education and Health Issues.

House Begins Public Hearings on HHS Agencies Monday: How Medicaid, CHIP, Health Programs Stand in the LBB's Budget (02/4/2005)

Public hearings on the budget for Article II health and human service programs in SB 1, the General Appropriations Act for 2006-2007, will begin Monday February 7, in the Health and Human Services Subcommittee of the House Appropriations Committee (HAC).

How Resources are Treated in Federal Public Benefit Programs in Texas (01/26/2005)

Cheat sheet on how resources are treated in federal public benefit programs in Texas.

CPPP Makes Texas Monthly List Twice (01/24/2005)

Steve Murdock, director of the Institute for Demographic and Socioeconomic Research at the University of Texas at San Antonio and founding board member of the Center for Public Policy Priorities, and F. Scott McCown, the center’s Executive Director, have just been named to Texas Monthly’s list of the 25 Most Powerful People in Texas Politics.

Testimony to the Transition Legislative Oversight Committee on the Draft Report on Health and Human Services Reorganization (12/20/2004)

The Center for Public Policy Priorities offers the following comments to the Transition Legislative Oversight Committee on its draft report to the 79th Legislature.

Despite Uncertain Future of New Computer System for Eligibility Determination, HHSC Moves Forward with Plans to Privatize Health and Human Services (12/10/2004)

The Texas Health and Human Services Commission (HHSC) intends to award a multi-billion dollar contract to a private company to develop and run a new model for delivering health and human services.

Texas Ranks 5th in U.S. in Number of Low-Income Students Eating Breakfast at School (11/18/2004)

Texas' School Breakfast Program serves the fifth highest number of low-income children in the United States, according to a new report by the Food Research and Action Center (FRAC) in Washington, D.C.

Capitol Forum on Integrated Eligibility (10/26/2004)

Panelists voice concerns, offer recommendations on role for community-based organizations in the Health and Human Services Commission's proposal to replace local eligibility offices with privatized call centers.

Texas Children's Medicaid and CHIP Enrollment: The Facts (10/6/2004)

In response to potentially confusing and at times conflicting assertions presented of late, CPPP has produced this Policy Page, in Q & A format, to provide up to date information about children's Medicaid and CHIP (all from official state agency and legislative sources) against which competing assertions may be judged. While some recent statements are accurate, others are questionable, and all are best understood in context, rather than as isolated "sound bites."

Health and Human Services Reorganization and the Integrated Eligibility Initiative (09/30/2004)

Presentation to Houston One Voice Collaborative.

Texans Can Do Math: Kids Are Missing From CHIP: Austin American-Statesman (09/22/2004)

The Children's Health Insurance Program has become a shuttlecock in the game of state politics. CHIP provides health insurance for children whose families make too much to qualify for Medicaid but too little to buy private insurance.

UPDATE on Medicaid and CHIP Cuts: What Was Restored in Recent Actions? (09/2/2004)

Some confusion has surrounded recent budget announcements by the Governor and actions by the Legislative Budget Board (LBB). This brief Policy Page describes how the actions taken will affect Medicaid and CHIP cuts, and explains which major cuts to those programs remain.

Children's Medicaid and SCHIP in Texas: Tracking the Impact of Budget Cuts (07/23/2004)

This case study, published by the Kaiser Commission on Medicaid and the Uninsured and co-authored by the Commission's Molly O'Malley, details the impact of Texas' legislative actions on enrollment in its Medicaid and SCHIP programs. Texas experienced the largest SCHIP enrollment decline in the nation between June 2003 and December 2003.

Comments on the Draft Integrated Eligibility and Enrollment Services Request For Proposal (06/18/2004)

The Center for Public Policy Priorities offers the following comments on the Draft Integrated Eligibility and Enrollment Services Request For Proposal (draft RFP) released on June 8, 2004.

Call Centers' Plan Allows Seven Minutes for Eligibility Determination (06/10/2004)

The integrated eligibility model developed by HHSC allocates seven minutes at the new call centers to verify each application for an array of public benefits. The current face-to-face interview to determine eligibility requires up to an hour and a half.

CPPP Presents Comments on Medicaid Estate Recovery (05/20/2004)

The Center for Public Policy Priorities has submitted comments on HHSC proposed rules for a Medicaid Estate Recovery program. HHSC held a set of informal public hearings BEFORE proposed rules were published in April, and a formal public hearing on the rules will be held on May 27, 2004.

Recommendations and Comments on HHSC Proposed Rules for Medicaid Estate Recovery (04/30/2004)

The Center for Public Policy Priorities (CPPP) appreciates the opportunity to comment on proposed rules for Estate Recovery as published At 29 TexReg 4038-4043, April 30, 2004. We commend HHSC staff for the good work that has gone into the HHSC proposal, and we offer additional suggestions we believe would enhance the policy.

State Moves Forward with Plan to Use Call Centers to Enroll People in Key Social Services (04/26/2004)

On March 25, HHSC released a report claiming to make the "business case" for moving most eligibility functions for TANF, Food Stamps, and Medicaid to three call centers. Under the current system, most people apply for these benefits at one of 381 local eligibility offices administered and staffed by the Texas Department of Human Services (DHS).

Texas Reaching Only Half of Those Eligible for Food Stamps, Says New National Study (04/21/2004)

Even while state budgets are tight and programs are being cut back to historically low levels, Texas could still take better advantage of federal dollars to serve the hungry and food insecure, says a study released today.

Immigrants and Public Benefits: Training for Community Service Providers (04/21/2004)

Presentation in San Antonio on the facts about immigrants and public benefits in Texas.

Federal Court Halts State Effort to Deny Medicaid to Certain TANF Recipients (04/14/2004)

In the latest chapter of a legal battle that has been waging for a half year, a federal court granted a preliminary injunction against three Texas state agencies, again preventing them from terminating health care for thousands of low-income Texans.

$469 Million Available Now to Restore Medicaid Benefits for Elderly and Disabled (04/2/2004)

According to the Texas Comptroller, $469.3 million in unused state dollars are available which could be allocated to reduce the health and human service budget cuts passed by the 78th Texas Legislature.

Final Section-by-Section Analysis of HB 2292 (04/1/2004)

Article 1 of HB 2292 provides for the eventual consolidation of all health and human services (HHS) agencies into five agencies, replaces agency boards with advisory councils, consolidates all policy development and rulemaking authority for HHS programs and services with the commissioner of the Health and Human Services Commission (HHSC), and creates a Transition Legislative Oversight Committee to facilitate the consolidation. An analysis of the major provisions in Article 1 follows, with our major concerns noted.

HHSC Report Proposes Using Call Centers to Determine Eligibility for HHS Programs (03/15/2004)

This report recommends a mammoth undertaking that will affect the local services network and economy of hundreds of communities, could affect the jobs of up to 10,000 state employees at DHS involved in eligibility determination, and radically alters customer access and service delivery in these programs.

Comments on Proposed Amendments to Rules for the State Children's Health Insurance Program: Asset Limits (03/7/2004)

The Center for Public Policy Priorities (CPPP) submits the following comments on proposed rules published in the February 20, 2004 Texas Register (29 TexReg 1491 1494). The proposed language would amend TAC Part 15 Texas Health and Human Services Commission Chapter 370 State Children's Health Insurance Program Subchapter A §370.4 and Subchapter B §370.44.

Ending Hunger in Our Community: Food Security Through Food Assistance (03/1/2004)

Report to better understand the conditions that lead people to access emergency and other food sources and make recommendations to improve food access.

Flyer: Food Stamp Program Income Eligibility Guidelines (01/1/2004)

Chart gives the income eligibility limits and food stamp benefits according to family size for 10/1/03-09/30/04.

Governor's Medicaid Reform Workgroup Requests Suggestions by January 16 (12/22/2003)

Perry has convened a workgroup of hospital administrators and others to review proposals for reducing Medicaid and CHIP spending for the 2005 Legislature. Recommendations are due by January 16.

Immigrants and Public Benefits: Training for Community Service Providers (12/5/2003)

Presentation in El Paso on the facts about immigrants and public benefits in Texas.

Legislature's CHIP Policy Changes Have Already Reduced Children Covered by 49,000 (11/9/2003)

This CPPP Policy Page provides updated information on CHIP program changes and how they are reducing program enrollment.

The Texas Health Care Primer (11/1/2003)

The Health Care Primer provides an introductory overview of factors shaping Texans' access to health care.

State Budget 2004-005: Implications for Health Care and Vulnerable Texans (10/29/2003)

Presentation on health care cuts made in 2003.

Testimony on Draft HHS Reorganization Transition Plan (10/20/2003)

The Center for Public Policy Priorities offers the following comments on the HB 2292 Draft Transition Plan dated October 16, 2003.

HB 2292 Update: HHS Reorganization (09/15/2003)

This Policy Page includes the schedule for the public hearings and notes our major concerns with the reorganization of HHS agencies and the privatization of state services, as well as our recommendations for mitigating the effect of these changes on clients.

Understanding Termination of Medicaid to TANF Recipients (09/12/2003)

The Texas Workforce Commission is proposing a rule that would have the effect of denying Medicaid to extremely poor parents on cash assistance who fail to do things such as meet health check up schedules for their kids or keep their teenagers in school.

Immigrant Benefits Update (08/12/2003)

In 2002, Congress passed a law that restored eligibility for Food Stamps to legal immigrants with five years of residency in the United States and to all legal immigrant children, regardless of their length of residency in the country. The first of these restorations took effect on April 1, 2003, with the restoration for legal immigrant children to take effect on October 1, 2003.

How Does the New $167 Million Affect Medicaid and CHIP Cuts? (08/11/2003)

This brief update recaps the uses of the added funds, and the enormous cuts that remain. To supplement this brief update, CPPP is posting a revised spreadsheet modeling the county-level impact of Medicaid and CHIP cuts for 2004 and 2005, reflecting the impact of the additional $167 million GR.

Status Report: State Funds That Could Reduce the Impact of Medicaid Cuts in the State Budget (08/1/2003)

The Governor, Lt. Governor, and Comptroller have all in recent days identified about $800 million in state dollars that could be used to reduce the size of Medicaid cuts approved by the Legislature for the 2004-2005 budget. Read the essential facts.

Federal Medicaid Relief Funds Could Stop the Elimination of Medicaid Mental Health Services, Other Services (07/18/2003)

This Policy Page describes the expected impact of the proposed cuts, and explains what readers can do to try to stop them.

Texas Awarded $29.1 Million for Food Stamp Program Management (07/16/2003)

This Policy Page explains the enhanced funding process and the impact that ending these important outreach efforts will have on low-income families and Texas.

Comments on Proposed DHS Rules Regarding TANF and Medicaid (07/11/2003)

Comments on Proposed Rule Changes to the Temporary Assistance for Needy Families (TANF) program (and related Medicaid Changes).

Texas, U.S. Face Paradoxical Nutrition Problems (07/10/2003)

In the richest nation on earth, 13 million children do not always get enough to eat. At the same time, in an alarming, paradoxical trend, childhood obesity has joined childhood hunger on the list of serious threats to kids' nutritional health.

78th Legislature-1st Special Session (07/7/2003)

This Policy Page summarizes the primary charges of the special session, with CPPP's major concerns noted.

Flyer: More Legal Immigrants Than Ever Are Eligible to Buy Food Stamps (07/1/2003)

Details on immigrant food stamp eligibility.

Flyer: More Legal Immigrants Than Ever Are Eligible to Buy Food Stamps (En Espanol) (07/1/2003)

Details on immigrant food stamp eligibility.

Testimony in Support of HB 107 (07/1/2003)

The Center for Public Policy Priorities appreciates the opportunity to testify in support of this bill. We provide the following background information for your information.

State Health Care and TANF Budget Cuts for 2004-05 (05/30/2003)

As the 78th Regular Session draws to a close, House Bill 1--the state budget for 2004-05--is nearing the stages of final approval by the House and Senate. This Policy Page describes some of the major social services cuts contained in the budget, which will spend less General Revenue than the 2002-03 budget spent.

HHS Funding: Senate vs. House Proposals for 2004-05 (05/13/2003)

Many programs and services for the neediest Texans remain unfunded in the Senate Finance or House budget proposals, or in both. While the Senate Finance Committee has invested significant amounts in Health and Human Services above what was included in the House Budget, major program and client cuts remain.

CSHB 2292 Analysis (04/23/2003)

This Policy Page provides a short analysis of CSHB 2292 (with a link to a more detailed section-by section analysis on our web site) with a summary of our major concerns and recommendations for improving the bill or, in many cases, limiting the negative impact to the health and human services infrastructure in Texas.

Information on Medicaid Simplification (04/10/2003)

Prior to SB 43 (in April 2001), 67% of the families of children subject to simplification reported earned income (the remainder were dependent on SSI disability, SSDI, or child support). As of January 2003, that percentage has increased to 79%. The children who lose out when bureaucratic hurdles are used to reduce caseloads are the children in working families " the ones we all want to reward.

Testimony on School Nutrition Programs (04/1/2003)

I am here representing the Center for Public Policy Priorities, a nonprofit, nonpartisan, research organization that works on behalf of low and moderate-income Texans, to testify in support of SB 474. While the center supports all of the provisions in this bill, my testimony focuses on the sections relating to expanding, supporting, and maintaining participation in the School Breakfast Program.

Testimony on Finger Imaging for Food Stamps (03/31/2003)

Mr. Chairman and members of the Committee, I am here representing the Center for Public Policy Priorities"a non-partisan, non-profit policy research organization seeking sound solutions to the challenges faced by low- and moderate-income Texans. Thank you for the opportunity to testify before you today in favor of House Bill 712.

Medicaid and CHIP Cuts Would Reduce 04-05 Texas Health Spending by at Least $10 Billion (03/28/2003)

On March 17, the Center for Public Policy Priorities released estimates of the local impact of $9.3 billion in Medicaid spending cuts proposed in the HHSC and DHS agency budgets, and posted all that information on our web page. We have now added to that information county-by-county estimates of various proposed cuts to CHIP.

Testimony on 12-Month Children's Medicaid Eligibility (03/18/2003)

The Center for Public Policy Priorities appreciates the opportunity to comment on HB 728, which would postpone the extension of 12-month continuous eligibility for Children's Medicaid until June 2005.

Simplified Eligibility for Children's Medicaid in Texas: A Status Report at Nine Months (03/5/2003)

This Policy Page presents the executive summary of a new report by the Center for Public Policy Priorities on the impact of Senate Bill 43 of the 77th Texas legislature, Children's Medicaid Simplification. The Center gratefully acknowledges the support of the Kaiser Commission on Medicaid and the Uninsured in producing this report.

Testimony on Congressional Conversion of Medicaid to Block Grant (02/25/2003)

The Center for Public Policy Priorities appreciates the opportunity to comment on HCR 58, urging Congress to convert Medicaid to a block grant. While we share Chairman Delisi's belief that health care costs for all Americans " not just Medicaid " are out of control, we respectfully disagree that eliminating the federal commitment to share in the costs of health care for the poorest Americans will be beneficial for Texas.

Handouts to Accompany Testimony on Congressional Conversion of Medicaid to Block Grant (02/25/2003)

Handouts to accompany testimony on HCR 58.

TANF and Child Care Reauthorization -- Deja Vu Redo? (02/4/2003)

This Policy Page offers an update on the current status of TANF and child care and key issues affecting both the timing and substance of reauthorization this year.

House Bill 1868 by Coleman: Medicaid for Recent Legal Immigrants (02/1/2003)

HB 1868 would ensure that Texas exercises all available options under federal law to option to draw federal Medicaid and CHIP matching dollars for otherwise-eligible LEGAL immigrants who entered the U.S. on or after 8/22/96.

Simplified Eligibility for Children's Medicaid in Texas: A Status Report at Nine Months (02/1/2003)

In 2002, Texas implemented a number of changes to its Medicaid program designed to make it simpler and easier for families to apply for coverage on their children's behalf, as well as to renew their children's coverage after they are successfully enrolled.

Update on Co-Payments for Adults in Medicaid (01/9/2003)

Provides a synopsis of changes.

Food Stamp Demand on the Rise, Over 3 Million Still Getting Benefits (11/26/2002)

This Policy Page examines recent trends in the Food Stamp Program, the economic impact of improving program access and participation, and the effect caseload growth will have on the state budget. County estimates of the number of Texans eligible for Food Stamps and the potential benefit revenue Texas would receive if more eligible families participated are also included.

Co-Payments for Adults in Medicaid (10/31/2002)

The Texas Health and Human Services Commission (HHSC) published proposed rules pertaining to "Cost Sharing Requirements for Medicaid Recipients" in the October 11, 2002, issue of the Texas Register. The proposed rules would create co-pay requirements (described below) for most adult Texas Medicaid recipients. A firm start date for the co-payment policy does not appear to have been set, but HHSC has indicated the earliest possible date would be December 16, 2002.

Critical TX Medicaid and CHIP Issues Before U.S. Senate (09/25/2002)

The U.S. Senate soon will consider the Medicare provider "givebacks" bill that is being negotiated in the Senate Finance Committee. Action is expected to begin in the next few days. Three (3) important provisions may be included in this legislation that could greatly benefit all Texas Medicaid programs (from children to the elderly and disabled), as well as the Children's Health Insurance Program (CHIP). Taken together these provisions would help substantially reduce Texas' Medicaid and CHIP funding challenges both immediately and over the long term.

Immigrant Benefits Update (07/25/2002)

As part of its work to support the restoration of benefits to legal immigrants, CPPP surveyed emergency services providers to assess how restrictions on the use of federal and state funds to serve immigrants have affected these providers' ability to help immigrants. This Policy Page summarizes these developments and the results of our survey.

Farm Bill Gives States New Food Stamp Options (07/12/2002)

This Policy Page summarizes the nutrition provisions in the Farm Bill and the options for states to simplify access to Food Stamps.

TANF/Child Care Reauthorization Moves to U.S. Senate (06/20/2002)

Texas' Senators and Senate Finance Committee members need to hear from YOU about the reauthorization of the Temporary Assistance to Needy Families (TANF) block grant and the Child Care and Development Fund (CCDF).

Good News, Bad News for Food Stamps in Congress (05/15/2002)

On Monday, May 13, President Bush signed the 2002 Farm Bill (The Farm Security and Rural Investment Act of 2002), which includes significant improvements in the Food Stamp Program. The nutrition title of the Farm Bill simplifies enrollment in the Food Stamp Program, increases benefits for larger families, restores benefits to many legal immigrants, reforms the Quality Control system by which state performance is evaluated, and authorizes an increase in funding for The Emergency Food Assistance Program (more detail on these changes is forthcoming). The nutrition title of the Farm Bill is being referred to as the most important piece of Food Stamp legislation since the landmark 1977 Act, 25 years ago. Unfortunately, this victory for antihunger advocates has been overshadowed by two proposals in the welfare reauthorization bill (H.R. 4700) that would do major damage to the Food Stamp Program and potentially undercut all the positive changes made in the Farm Bill. This Policy Page explains these proposals and urges our readers to contact their Representatives immediately to ask them to vote against H.R. 4700.

TANF Reauthorization Proposal Goes to House Floor Tomorrow (05/14/2002)

Problematic provisions mark a step backwards in welfare reform debate.

Clarification on Food Stamp Resource Test (05/14/2002)

In Policy Page #149, which addressed new Food Stamp Program rules regarding vehicle limits and the resource test, we incorrectly reported that an IRA (Individual Retirement Account) would no longer be counted as a resource in determining a family's eligibility for Food Stamps. In fact, because they are considered a liquid resource, IRAs are still counted toward the new $5,000 resource limit established in February. Under the new policy, most non-liquid resources are not counted, while most liquid resources are. This Policy Page provides additional detail on how resources are now treated in the Food Stamp Program.

Workforce Investment Act (WIA) Comment Period Until June 30 (05/2/2002)

The United States Department of Labor is soliciting comments on implementation of the Workforce Investment Act. DOL is particularly interested in the effectiveness of One-Stop centers and the integration of WIA and TANF programs.

More Support Needed for Nutrition Funding in Farm Bill (04/12/2002)

Before the Easter recess in March, House and Senate conferees agreed to $6.4 billion over 10 years for the nutrition title of the Farm Bill. When they started meeting again earlier this week to decide which specific provisions to fund, the debate on legal immigrant benefit restorations really heated up. Consequently, these restorations are in jeopardy.

Conferees Agree to $6.4 Billion for Farm Bill Nutrition Title (03/28/2002)

Congressional House and Senate conferees on the 2001 Farm Bill (H.R. 2646) have set funding for the nutrition title at $6.4 billion over the next 10 years. While lower than the $8.9 billion proposed in the original Senate version of the bill, this is a definite victory for anti-hunger advocates, who fought to increase funding for the nutrition title from the $3.6 billion allocated in the House bill. The fight is far from over, however, with conferees set to make final decisions over specific Food Stamp and other nutrition program provisions when they return from the Easter recess on April 8. This Policy Page outlines steps readers can take can take between now and April 8 to support nutrition program improvements.

Medicaid and State Budgets: A Case Study of Texas (03/1/2002)

Like most state governments, Texas has recently marked the end of several-year interlude during which slow Medicaid growth briefly suspended the program's image as a top state budget growth driver. Substantial caseload declines from 1996 to 2000 have now been replaced with a steady upward trend, matched with highly robust enrollment in the state's separate SCHIP program. With these trends afoot, it is helpful to pause and review Medicaid's place in Texas' state budget.

Food Stamp Reauthorization Moves Forward (02/27/2002)

This Policy Page summarizes the nutrition provisions in the Farm Bills and urges readers to contact their Members of Congress immediately in support of positive changes in the Food Stamp Program.

DHS Seeking Comments on Texas Works (02/20/2002)

On February 6, the Department of Human Services held a public hearing on the 2004-2005 budget needs of the Texas Works program. Interested advocates can find out more about this hearing in this brief Policy Page, which also contains information about how to submit written comments on Texas Works needs by February 25, 2002.

New Food Stamp Rules Take Effect (02/5/2002)

At its December meeting, the Texas Board of Human Services approved final Food Stamp rules that 1) raise the vehicle limit on one car from $4,650 to $15,000, 2) exempt all other NON-liquid resources, and 3) establish a higher resource limit of $5,000 for liquid resources (i.e., bank accounts). The new standards apply to all applications completed after February 15. Exemptions from the finger imaging requirement for certain seniors and persons with disabilities are also now in effect. This Policy Page explains the changes and contains links to education materials that can be used by service providers and community-based organizations to publicize the new rules to clients.

TANF & Immigrants in Texas: Lessons for Reauthorization (02/2/2002)

The 1996 federal welfare law created the Temporary Assistance for Needy Families (TANF) block grant and contained sweeping changes to immigrants' eligibility for basic cash assistance and other social support programs. Significant restrictions on eligibility were imposed and additional requirements for access to benefits were added.

Why Talk of a CHIP Shortfall So Early? (01/17/2002)

Presumably, it was never the intent of the Legislature to under-fund CHIP. There is every indication that legislators believed they had adequately funded the program in May 2001. When SB 1, the appropriations act for Texas' 2002-2003 budget was adopted, there were no public discussions at all suggesting that freezing or capping CHIP enrollment was anticipated, despite the fact that the program was allocated $14 million state dollars (general revenue: GR) less than had been requested by the Texas Health and Human Services Commission (HHSC). HHSC asked stakeholders in August for input on CHIP cost-cutting approaches, but indicated that the information was for long-term planning rather than any nearterm concern. In October 2001, there was statewide press coverage when increased premium rates for CHIP health plans were negotiated. Nowhere in the discussion of these increases by state agency staff or Legislators was there any mention of a threat to cap or freeze CHIP enrollment.

Flyer: You May be Able to Apply for Food Stamps Over the Phone (En Espanol) (01/1/2002)

Usted puede calificar para una entrevista por telefono, si usted no puede venir a la oficina para aplicar para estampillas de comida.

Flyer: Rules Regarding Food Stamps and Vehicles Have Changed (01/1/2002)

In February, the rules changed. You may now qualify for....

Flyer: Rules Regarding Food Stamps and Vehicles Have Changed (En Espanol) (01/1/2002)

En febrero 2002, las reglas han cambiado. Ahora usted puede calificar para . . .

Flyer: You May be Able to Apply for Food Stamps Over the Phone (01/1/2002)

You may qualify for a telephone interview, if you cannot come to the office to apply for food stamps.

Texas Board of Human Services to Consider Eliminating Nearly All TANF Work Exemptions (12/20/2001)

On December 28th the Board of the Texas Department of Human Services (DHS) will be considering a rule to eliminate nearly all work exemptions for recipients of Temporary Assistance for Needy Families (TANF). This would be a major change in state policy and does not take advantage of federal flexibility which allows states to provide appropriate exemptions from mandatory work requirements. The board has the option of proposing an alternative rule that would retain some of the current work exemptions.

Implementation of New Food Stamp Rules Delayed (12/19/2001)

This Policy Page explains the proposed rules and urges readers to contact the Texas Department of Human Services' (DHS) board in support of the immediate implementation of these important policy changes.

Texas is At Risk of Losing $52.7 Million in Federal TANF Funds (12/17/2001)

Texas is At Risk of Losing $52.7 Million in Federal Temporary Assistance for Needy Families (TANF) Block Grant Funds. Call to action to contact congressman or woman.

Comments Due on Proposed DHS Rules Implementing SB 43 (12/13/2001)

IMPORTANT DEADLINE: Comments Due on Proposed DHS Rules Implementing SB 43 (Children's Medicaid Simplification).

Sen. Baucus' Bill Would Give Texas $448 Million More in Federal Medicaid Funds in 2002 (11/13/2001)

On Thursday November 8, the Senate Finance Committee voted out Sen. Baucus' "Economic Recovery and Assistance for American Workers Act of 2001." This should go to the Senate floor this week. The bill has a number of important provisions that can help states maintain health insurance coverage during the recession.

New Food Stamp Rules Will Improve Access to Benefits (11/1/2001)

At its August meeting, the Texas Board of Human Services approved rules to implement a provision, which provides for new telephone interview options for Food Stamp applicants and recipients. This Policy Page explains the new rules as well as steps the anti-hunger community can take to publicize the telephone interview options to low-income Texans in need of nutrition assistance.

TIERS of Relief (09/13/2001)

Continuation of the Texas Integrated Eligibility Redesign System (TIERS) project, which looked somewhat uncertain during the 77th Legislative Session, was finally approved at $137 million in Senate Bill 1 (SB 1), the General Appropriations Act for 2002 and 2003.This Policy Page provides information on the status of TIERS, prominent features of the system"including "STARS," the newly available online self-screener for benefits"and the timeline for future development and rollout of the system.

The Straight Story: Health Care for Undocumented Immigrants in Texas (08/14/2001)

This Policy Page describes the collision between federal, state, and local law and policy which has resulted in the recent legal questions over inclusion by Texas county hospital districts of undocumented, uninsured residents in their health care programs.

Welfare, Workforce and the 77th Legislature (08/8/2001)

This Policy Page discusses the problem of inadequate funding for the Choices program and reports on the welfare and workforce bills enacted during the 77th Legislative Session.

Food Stamp Reauthorization on Fast Track (07/21/2001)

This Policy Page discusses possible improvements to Food Stamps that could be made as part of the Farm Bill and lists IMMEDIATE steps anti-hunger advocates should take to weigh in with members of the Texas Congressional delegation in charge of these decisions.

Medicaid and CHIP Funding in Final Appropriations Act (07/16/2001)

This Policy Page summarizes some of the major funding in the final state budget bill, reporting on state funding for Medicaid programs that is above the levels included in the original filed version of SB 1 (the "base budget" as drafted by the Legislative Budget Board according to the instructions of the Legislature's leadership). For a thumbnail background sketch on Texas Medicaid, see Policy Page 126.

Wrap-Up of Anti-Hunger Legislation in the 77th Session (06/7/2001)

The 77th legislature passed several important pieces of legislation this session. These bills will significantly improve access to the Food Stamp Program, provide funding for nutrition programs outreach, and assist food banks in their efforts to feed the hungry. The purpose of this Policy Page is both to inform you about these developments and to thank everyone whose hard work and support contributed to these gains in the fight against hunger.

Omnibus Medicaid Bill, SB 1156, Sent to Governor (06/4/2001)

On Sunday, May 27th the Senate concurred in House amendments to SB 43, the Children's Medicaid Simplification bill. Later that afternoon, both houses adopted the Conference Committee report on SB 1156, an omnibus bill encompassing a wide range of Medicaid policy changes. This Policy Page provides a brief description of the final version of SB 1156; a separate issue detailing SB 43 was released earlier.

Children's Medicaid Eligibility Simplification Bill, SB 43, (05/31/2001)

On Sunday, May 27th the Senate concurred with House amendments to SB 43, the Children's Medicaid Simplification bill. Later that afternoon, both houses adopted the Conference Committee report on SB 1156, an omnibus bill encompassing a wide range of Medicaid policy changes. This Policy Page provides a brief description of the final version of SB 43; a separate issue detailing SB 1156 will follow shortly.

Child Care Funding Could Fall Short (05/11/2001)

With House-Senate state budget conferees about ready to wrap up work on Senate Bill 1, the Appropriations Act for 2002-03, final funding for child care will soon be known. This Policy Page explains why more state and federal funds for child care are needed to continue serving working poor families, and provides links to proposed legislation that would affect child care in Texas.

House Amends Medicaid Simplification Bill (05/4/2001)

On Wednesday May 2, The House Committee on Public Health held a public hearing on SB 43 by Zaffirini, and adopted a committee substitute for the version approved by the full Senate (see Policy Page #125 for background on the Senate Bill). This Policy Page describes the bill that will be voted on by the full House, and provides an update on the process.

Medicaid Funding in the House and Senate Budget Bills (04/20/2001)

The Texas Senate voted out an appropriations bill (SB 1) on March 28, 2001, and the House of Representatives voted out their version on April 11. While a number of important questions about Medicaid funding were left unresolved by both houses, each house did recommend some additional state funding for Medicaid, above the levels included in the original filed version of SB 1.

O TANF, Where Art Thou? (04/20/2001)

The Texas House and Senate have approved their versions of the state budget for 2002 and 2003, setting the stage for conferees to work out major differences in the weeks ahead. One set of issues to be resolved is the use of the Temporary Assistance for Needy Families (TANF) block grant, which will bring at least $973 million in federal funds to Texas in the coming biennium. This Policy Page highlights significant differences in House and Senate proposals affecting TANF spending and the TANF balance that would remain by August 2003.

Status Report on Chidren's Medicaid Simplification (04/9/2001)

As many readers know, the Texas Legislature is considering a number of bills designed to simplify and streamline the process of applying for (or re-certifying for) Medicaid coverage for children (under age 19). Put simply, the goal of the bills is to make the process for children's Medicaid identical to that for CHIP, so that parents could submit CHIP's TexCare Partnership application to enroll their children in either program, with no additional steps needed.

Lege Ponders Immigrant Families Bills (04/3/2001)

The Texas Legislature is considering several bills which could improve the prospects for children by improving legal immigrants' access to safety net benefits. A brief description of the bills is provided.

Food Stamp Access Will Impact Medicaid Simplification (03/22/2001)

This Policy Page describes the Food Stamp bills, how they complement the Medicaid simplification bills, and what you can do to support Food Stamp simplification.

Food Stamp Decline Means Loss of Federal Funds (03/20/2001)

County Estimates of Actual vs. Potential Food Stamp Benefit Revenue in 1999.

House Set to Vote on Food Bank Bill (03/17/2001)

On Tuesday, March 20, the House will vote on whether to fund a grants program at the Texas Department of Agriculture (TDA) to assist food banks in collecting surplus or unmarketable fresh produce offered by Texas farmers for distribution to low-income families across the state. This policy page provides background on this legislation and its importance to private, charitable efforts to feed hungry families in Texas.

Further DHS Staff Cuts Unjustifiable (02/9/2001)

The primary goal of eligibility policy reform is to minimize barriers for working families and ensure that clients receive the supports necessary to make a successful transition to self-sufficiency. Although early analyses of eligibility streamlining (by the Legislative Budget Board and the Comptroller's office) have proposed significant staff cuts for the Texas Department of Human Services (DHS), the center strongly recommends that these policy changes not be paired with any new reductions in DHS eligibility office staff.

Enhanced Food Stamp Funding (01/23/2001)

In August 2000, the Texas Department of Human Services (DHS) received $27.9 in enhanced federal funds from the United States Department of Agriculture (USDA) for its success in improving payment accuracy and reducing fraud in the Food Stamp Program in fiscal 1999. An additional $4.9 in unspent enhanced funds received in 1999 is also available for a total of $32.9 million. Last session, the legislature directed DHS to spend $2 million of the enhanced funds received in 1999 on nutrition programs outreach. DHS' proposal to the legislature for spending the $32.9 million does not include any funding for initiatives to improve access to nutrition assistance for low-income families. This Policy Page summarizes DHS' proposal and the center's recommendations for using these funds.

Keeping Budgetary Commitments to the Poor? Texas and the Welfare Block Grant, 1996-2000 (11/6/2000)

Keeping Budgetary Commitments to the Poor? Texas and the Welfare Block Grant, 1996-2000, a presentation at an international conference on Texas’ use of the federal Temporary Assistance for Needy Families (TANF) block grant.

Food Stamp Developments (10/9/2000)

New data from USDA show Texas has seventh worst Food Stamp participation rate; Food Stamp vehicle exemption likely to pass before Congress adjourns. This Policy Page summarizes these developments and the next steps state policymakers can take to increase Food Stamp participation among eligible families.

Every Child Equal: What Texas Parents Want from Children's Medicaid (09/1/2000)

The State of Texas has taken some important steps in the past four years to try to address the growing problem of uninsured children in Texas. As the report explains, now is the time to take the next step and make children’s eligibility requirements in Medicaid exactly the same as for CHIP.

TIERS Progress Report (05/12/2000)

The 76th Legislature was debating how much funding to appropriate to the Texas Department of Human Services (DHS) to implement the proposed Texas Integrated Enrollment and Services (TIERS) project. This Policy Page summarizes the progress made thus far in implementing TIERS and points out opportunities for public input in future project planning and roll-out.

Block Grant Hearings (04/4/2000)

Public Input Needed on State Uses of TANF, Social Services Block Grant, Title X (Public Health Services Act), and Maternal and Child Health Block Grant.

Federal Welfare-to-Work Grants (12/3/1999)

In this Policy Page we describe early welfare to work program implementation problems, recent changes aimed at making the program less cumbersome, early program innovations, and give examples of Texas' programs.

Food Stamps Not Reaching Many Poor (09/30/1999)

County Estimates of Number of Poor Texans Receiving Food Stamps: 1995 vs. 1999.

TANF Spending for 2000-01 (09/3/1999)

This Policy Page sums up the policy decisions that led to the TANF spending plan included in the General Appropriations Act for 2000 and 2001, with a focus on how the TANF surplus was allocated. It also describes developments, such as the final TANF regulations issued by the federal government, that will influence how state agencies use TANF funds in the next two years and beyond.

Wrap-Up of 76th Legislative Session (07/9/1999)

This summary takes a quick analytic glance at the major issues affecting low-income families considered by the 76th Session: school finance, tax cuts, welfare, health care, and nutrition. Upcoming Policy Pages will elaborate on each of these issues individually in much more detail.

INS Issues Crucial Guidance on 'Public Charge' Policy (07/1/1999)

Many immigrants, both those with legal status and the undocumented, have avoided using basic public health services and emergency care due to fear, confusion, and misinformation about whether they would be denied a green card, denied naturalization, deported, or asked to repay the value of benefits. The new guidance establishes several important principles outlined in this policy page.

CHIP Bill Signed into Law (06/15/1999)

This policy page is a detailed summary of the new CHIP law and the related state employee coverage.

Summer Food Legislation Passes (06/2/1999)

This policy page outlines how this new legislation will help improve low-income children's access to the SFSP and what steps service providers and advocates can take to ensure families are aware of the summer food programs in their communities.

Whither Welfare as the Session Withers (05/20/1999)

With only days remaining in the current legislative session, the fate of an array of welfare policy changes will soon be told. This Policy Page provides a quick snapshot of where things stand on the various welfare policies and TANF funding issues we have been following this session.

House Passes Amended CHIP Bill (05/5/1999)

This Policy Page describes the amendments offered on the House floor, and how the adopted amendments may alter the bill as a whole.

TIES Progress Report (05/4/1999)

Although the ultimate design of the proposed Texas Integrated Enrollment and Services (TIES) project will depend on how much funding, if any, is appropriated by the Legislature, the TIES agency team continues to make progress. In response to legislators' concerns over the high cost of TIES and its impact on employee reduction and relocation, agency staff have developed several alternatives to the original TIES proposal. This Policy Page outlines these options and summarizes new developments and progress in the TIES project.

Omnibus Welfare Overhauled, Heads to Calendars (04/29/1999)

An update on CSHB 3639 by Chairman Elliott Naishtat.

Senate Sends CHIP Bill to House (04/23/1999)

This Policy Page summarizes the Senate and House Committee bills, highlighting the most significant changes made by the House.

76th Legislative Session: TIES Developments (04/13/1999)

This Policy Page describes funding proposals made by the House and Senate that will have to be decided by the budget conference committee later this session, and summarizes TIES-related legislation.

Everything You Always Wanted to Know About HB 3639 (04/9/1999)

A brief but thorough guide to the Omnibus Welfare Reform Bill by Chairman Naishtat.

Welfare Bills Begin to Move (03/26/1999)

Summary of welfare "reform" proposals.

Anti-Hunger Bills in the 76th Legislature (03/23/1999)

Food Assistance for Legal immigrants, Funding to Expand the Summer Food Service Program, Nutrition Education and Outreach Opportunities to address childhood hunger and ensure nutrition assistance for needy families and communities.

Legislators Hear Center's TANF Proposals (02/12/1999)

TANF Investment Plan Presented to House Appropriations HHS Subcommittee.

Texas Will Submit State Plan for CHIP in February (01/21/1999)

Plan caps program far below potential.

Food and Nutrition Update (10/29/1998)

Child nutrition and WIC reauthorization bill passes Congress. Spending levels for nutrition programs for FY 99 decided in Omnibus Appropriations Act.

State Agencies Set Public Hearings on the Future of CHIP (10/22/1998)

The Texas Health and Human Services Commission (THHSC) and the Texas Department of Health (TDH) are planning a series of hearings to hear public comment on options for creating "Phase II" of Texas' Children's Health Insurance Program (CHIP). Dates have been set for seven hearings, though locations have not been finalized. Due to the short notice, we are providing this incomplete information to you now, so that you can reserve time on your calendars until final location information is available.

Agriculture Bill Restores Food Stamp Benefits to Some Legal Immigrants (08/28/1998)

In June, President Clinton signed the Agriculture Research Bill, legislation that restores federal Food Stamp eligibility for legal immigrants with disabilities and most children and elderly legal immigrants who lost their benefits under the 1996 federal welfare reform law. These restorations will cover roughly 250,000 immigrants, less than one-third of the legal immigrants originally cut off from Food Stamps. The restorations will go into effect on November 1.

FY Appropriations for Federal Nutrition Programs Underway (07/31/1998)

Critical deliberations regarding funding levels for food and nutrition programs are currently underway in Congress. Several key actions on child nutrition programs reauthorization and FY 1999 agricultural appropriations are expected before Congress leaves for the August recess.

Legislative Committees Consider Children's Health Insurance Program (CHIP) (06/19/1998)

The new federal Children's Health Insurance Program (CHIP) is well underway in many other states. However, despite the availability of $564 million in federal funds and ample state matching funds in fiscal year 1998, Texas has taken only a few small steps toward implementation.

US House Budget Proposal Cuts Non-Defense Discretionary Spending Well-Below Balanced Budget Levels (06/12/1998)

Cuts hit Welfare-to-Work, Safety Net Programs hardest. Cuts Would Also Affect Economic Development, Environment, Law Enforcement, and Education.

Nonqualified Immigrants Face September 1998 SSI Termination (05/1/1998)

A small group of elderly or disabled immigrants who are lawfully present and currently receiving Supplemental Security Income (SSI) cash assistance remain at risk of losing their SSI benefits at the end of the current federal fiscal year.

TIES Public Hearing in El Paso (04/2/1998)

The Texas Integrated Enrollment and Services Project (TIES) Legislative Oversight Committee (LOC) will hold a public hearing in El Paso at 9:00 AM on April 7, 1998.

Special Policy: TIES Public Hearing Coming to Dallas Next Week (03/19/1998)

The Texas Integrated Enrollment and Services Project (TIES) Legislative Oversight Committee (LOC) will hold a public hearing in Dallas at 10:00 AM on March 25th, 1998.

Many Federal Programs May Be Forced to Verify Citizenship, Exclude Undocumented for First Time (12/19/1997)

The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), included language directing that "unqualified" immigrants would no longer be eligible for "federal public benefits."

Welfare-to-Work Grants: New Funding Available to Texas and Local Communities (10/31/1997)

With the passage of the Balanced Budget Act (BBA) of 1997, $3 billion in new federal money is available to help states and communities move families from welfare to work. The state of Texas is eligible to receive up to $75 million of these funds in federal fiscal year (FFY) 1998 and at least $70 million in FFY 1999.

Childless Adult Food Stamp Recipients: Old Rules, New Rules, and New Options (10/1/1997)

This policy page will review the policies impacting childless adults who receive food stamps, examine what Texas is doing, and offer some options for better serving clients.

The Balanced Budget Act of 1997: Highlights of Child Health Block Grant and Medicaid Provisions (09/24/1997)

On August 5, the President signed into law the federal budget reconciliation act for federal FY 1998, officially titled the Balanced Budget Act of 1997. The Act includes a wide variety of important provisions; this Policy Page describes in a summary way important changes in Medicaid and Medicaid Managed Care policy, as well as the new child health block grant.

The Balanced Budget Act of 1997: Immigrant Policy Provisions (09/19/1997)

On August 5, the President signed into law the federal budget reconciliation act for FFY 1998, officially titled the Balanced Budget Act of 1997. The Act includes a wide variety of important provisions; this Policy Page describes in a summary way important changes in immigrants' eligibility for public benefits.

Privatization of Health and Human Services Eligibility Determination (09/1/1997)

With a now defunct proposal to privatize its eligibility determination system for health and human services, Texas has been a national leader in the arena of social services privatization. Since 1995, Texas has been developing a plan to award a seven-year, $2.8 billion (estimate) contract to a private company (or a public/private partnership) to operate the state's eligibility system.

"Diversion" Ruling to Add Hurdles to Applying for TANF Assistance (08/12/1997)

On July 18th the Texas Department of Human Services (TDHS) considered and adopted as a proposed rule a significant change to TANF cash assistance eligibility policy. The proposed rule would require that all applicants for TANF assistance attend a "work orientation" session at the Texas Workforce Commission (TWC) to become eligible for assistance.

Food and Nutrition Update (08/6/1997)

Almost a year after the passage of Welfare Reform, members of Congress managed to retain some of the benefits lost during lost year's welfare overhaul. Congressional members will adjourn for recess (August 2-September 2) and return in September to conclude appropriations for FY98 food and nutrition programs. Here is a brief look at what has passed and what is pending.

The TANF Block Grant and the State Budget (08/1/1997)

This Policy Page will report on the final decisions on allocation of the TANF block grant and provide details of how the TANF surplus was finally allocated.

More Key Medicaid and Health Issues in Senate and House Budget Bills (07/24/1997)

This Policy Page provides additional updated information on House and Senate budget proposals to add to the information included in PP #52 of 7/9/97. Negotiations are underway, and a compromise bill is sought before the August 2 break.

Health and Immigrant Benefit Issues Update (07/9/1997)

This Issue of Policy Page provides information on immigrant SSI changes, DSH cuts, and child health proposals included in the House and Senate Federal Budget Bills, and a status report on implementation of federal benefit cuts for legal immigrants in Texas.

U.S. House Ways and Means Committee Retreats from Bipartisan Budget Agreement (06/13/1997)

Shaw proposal would deny SSI to more disabled legal immigrants.

Welfare Reform Legislation in the Last Days of the Session (05/22/1997)

This policy page will report on the status of key welfare reform legislation as the end of the session nears.

TANF Workgroup to Present Plan to Conference Committee (05/5/1997)

The TANF Workgroup of the Budget Conference Committee completed its deliberations on April 24th and produced a report of their recommendations last week. Read a summary of TANF Workgroup Recommendations (dollars in millions).

Key Programs Need Funding as Conference Committee Considers Welfare, Health and Human Service Issues (05/2/1997)

The Conference Committee on the State Budget, which has the job of taking the House and Senate adopted budgets and coming up with a final compromise budget, will discuss allocation of funds for Health and Human Service programs the week of May 5. Planning for the allocation of the Temporary Assistance for Needy Families (TANF) block grant has been underway for several weeks. However, many major issues regarding HHS funding are expected to be left pending until HB 4, the property tax bill, is finalized.

TANF Workgroup Begins Deliberations (04/16/1997)

Last Thursday the TANF Workgroup met for the first time to begin deliberations on the Senate and House TANF plans. This Workgroup will decide how Texas will allocate its TANF surplus. While many important initiatives are contained in both the House and Senate plans, pressures to supplant general revenue with TANF funds and to hold aside a contingency fund threaten to dramatically reduce the TANF funds available.

Welfare Bills are Moving (03/27/1997)

Thirteen bills are scheduled to be heard and public testimony taken. The bills scheduled for hearing include some very problematic provisions and some that would be positive changes to public assistance. Among them is HB 3431, the companion bill to SB 1067, the only legislation offering direct assistance with the impact of benefits cuts to legal immigrants.

House and Senate TANF Spending Plans Fall Short in Meeting Needs of TANF Recipients (03/14/1997)

The House and Senate are discussing proposals for spending the $393 millioni Temporary Assistance for Needy Families (TANF) surplus. Although both are good starting points, neither represents the final product. We anticipate further work on these plans, particularly in the Senate since the Finance Committee has not yet debated allocating TANF.

Alert: Waiver for 18-50 year-old Food Stamp Recipients Reduced (03/10/1997)

The federal Welfare Bill (H.R. 3734) contains new limits on food stamp benefits for able-bodied, childless adults between the ages of 18 and 50.

Health and Immigration Issues & the Federal Welfare Act: Texas Update (02/18/1997)

In this Policy Page we provide an update on the latest information regarding the provisions of the Welfare Act. The ultimate impact of a number of health-related provisions is not yet clear.

House and Senate Budget Committees Consider TANF Surplus (02/8/1997)

There is an estimated $358.2 million in excess TANF funds in the coming biennium. There is also the potential of excess state general revenue as well.

Texas Moves to Implement New Food Stamp Provisions (11/27/1996)

The federal Welfare Bill (H.R. 3734) contains new limits on food stamp benefits for able-bodied, childless adults between the ages of 18 and 50. Under the new provisions, these individuals will be eligible for only three months of food stamp benefits in a 36 month period unless they work 20 hours per week, participate in a work program for 20 hours per week, or participate in a workfare program.

Critical Food Stamp Decision Are Pending (10/22/1996)

Thousands of adult recipients could lose benefits.

Immigration Provisions Less Harsh as Bill Combined with Budget Bill (10/1/1996)

Over the weekend, the President and Democrats in Congress negotiated the removal of several of the harshest provisions included in the Illegal Immigration conference bill approved by the House September 25th. The revised immigration bill has been folded into an Omnibus Continuing Resolution designed to keep the federal government operating as we enter a new federal fiscal year. This spending bill was approved October 1 and will be signed by the President.

Congress Votes This Week On "Illegal Immigration Reform Act (09/26/1996)

This bill cuts access to health and human services for both legal and undocumented immigrants even deeper than Welfare Act.

Texas Moving Quickly to Submit State Plan for Welfare Block Grant (09/21/1996)

Since the passage of the federal Welfare Act last month, the governor and state agencies have been assessing the fiscal and policy implications of moving quickly to accept the new block grant funding and the policy changes that come with it. The first step in the process is the development and submittal of a state plan for the new Block Grant for Temporary Assistance for Needy Families (TANF).

Analysis of Federal Welfare Reform (08/22/1996)

Analysis of Federal Welfare Reform.

Only Your Calls Will Stop the Terrible Welfare Bill Now in Conference (07/26/1996)

The President is leaning toward signing the welfare reform legislation, but he is watching the public reaction closely. The time is now for you to make your voice heard.

Welfare Bill Nears Votes in House and Senate, Signature by Clinton Probable (07/17/1996)

The president has been unwilling to consider Congressional welfare reform proposals as long as they were linked to Medicaid reforms with which he disagreed. Last week, Congressional leaders decided to de-couple their welfare and Medicaid proposals and work to get a welfare reform bill to the president's desk before the August recess.

The Kassebaum -Kennedy Health Insurance Act: What Would It Do? (06/12/1996)

The U.S. Senate and House have passed different versions of an insurance bill under the same number,H.R. 3103.The bills do not address the problem of affordability, which is the primary barrier preventing 4.5 million Texans -- over 26% of the population under age 65 -- from getting health coverage. These uninsured Texans do not qualify for Medicaid. The bills would create market reforms designed to ensure that Americans who can afford average-priced health insurance do not lose their coverage or face permanentlimits on coverage when they change jobs.

Welfare and Medicaid 'Reforms' Are Moving Again in Congress (06/7/1996)

Federal redesign of Medicaid, welfare, and related social services programs remains a hot topic in Washington. In recent weeks, several Medicaid and welfare bills have been announced and/or filed.

State Officials to Hold Medicaid Managed Care Public Hearings (05/17/1996)

The focus of the Washington Watch series has been analyzing the impacts of federal proposals on Texas. Major changes to welfare, Medicaid and other important social programs have largely been delayed, but spending reductions have occurred and state-level reforms and other initiatives are continuing.

Immigration Bills Limit Access to Health and Human Services (05/10/1996)

Both houses of Congress have now passed bills that would make major changes in access to public programs by both legal-status and undocumented aliens.

Food and Nutrition Programs and EITC (02/20/1996)

This edition will provide an update on current Congressional action and negotiations affecting food and nutrition programs and the Earned Income Tax Credit.

Still Watching (02/9/1996)

In this Washington Watch we hope to bring you up to date on the general status of the federal budget and recent developments on welfare and Medicaid. Updates on food and nutrition programs, EITC and other issues will follow in the next WW.

Medicaid Update (12/22/1995)

This issue of Washington Watch summarizes major points of the Medicaid provisions of the vetoed budget bill and the administration proposal. Also provided is a brief description of some major differences between the President's Medicaid proposal and the Coalition alternative.

Your Congressperson Needs Support in Voting NO on the Welfare Reform Bill (12/13/1995)

Both houses of Congress recently passed separate bills to reform the nation's welfare and social services programs. Since then, the House and Senate have been working to produce a compromise "conference" bill. When an agreement over whether to convert child nutrition programs (e.g. school lunch) into a block grant is reached, the bill will be sent to both houses for final approval (a House vote may be Dec. 14th or 15th), and on to the President. Organizations and others who care about the needs of the poor are concerned that many members of Congress may vote for this welfare reform bill in the mistaken belief that it is dramatically better than the original House bill, and that it limits damage to poor families.

Where Are We in the Budget Process? (11/22/1995)

Details of the Budget Reconciliation Bill and specifics on Medicaid, welfare and other programs are still filtering in. This Washington Watch is meant to give you a quick update on key issues. We will provide more detailed analyses as the actual bill language becomes available.

Nonprofit Gag Amendment Added to Continuing Resolution (11/10/1995)

On November 7, the compromise version of the Istook Amendment was added to the House Continuing Resolution*(CR) by the House Rules Committee. The following day the House passed the Continuing Resolution, with Istook included by a vote of 230-170. On November 9th the Senate passed the Continuing Resolution with an alternative to the Istook Amendment offered by Senator Alan Simpson and Senator Larry Craig. At the moment we have few details about this version; however, we have been told that the basic principles of the Istook Amendment are included in the Simpson/Craig version.

Senate and House Bills Abolish Medicaid as We Know It (10/24/1995)

Senate Finance and House Commerce committee proposals to repeal Title XIX, the Medicaid Program, and replace it with the "Medigrant" block grant program are expected to be voted on this week.

House and Senate Conferees on Welfare Reform Bill Named (10/18/1995)

In the coming weeks Congress will be making final budget and policy decisions on a wide range of programs. We will be sending out more frequent analyses with more details on specific programs. This issue will focus on the House and Senate Welfare Reform bills with updates on EITC and the Istook Amendment. Later we will follow with a focused report on Medicaid and Medicare and a look at the impact of Congressional reforms on child welfare programs and various immigrant related proposals and their disproportionate impact on Texas.

Senate Welfare Bill Passes 87 - 12 (09/29/1995)

On September 19th, by a vote of 87-12, the U.S. Senate passed the Dole welfare reform bill.

Senate Welfare Bill Heads for a Final Vote (09/18/1995)

Senator Dole announced that the final vote on the welfare reform bill (S.1120) will take place Tuesday (Sept. 19) at 2:15 p.m. Whatever the final Senate Bill looks like, lawmakers are warning of a tough battle ahead in the House-Senate conference " with Democrats saying they could not support a bill that moved to the right and conservatives saying they could not support a bill that did not.

Critical Period of Congressional Action Approaches (09/11/1995)

The next few months will bring to a head all the promises and threats raised by the Republican victories in last year's election. The future size and shape of American government may be determined by critical choices being made now.

Adjustments to the Senate Republican Leadership's Welfare Reform Bill (08/21/1995)

On August 8th, Senator Bob Dole postponed debate on his welfare reform bill, S.1120, with the intention of working out differences in the legislation. Since that time, there have been a few indications that adjustments will be made to the bill.

Senate Welfare Reform Debate Postponed to September (08/10/1995)

Senate leaders have announced that action on the Senate's welfare reform legislation will be postponed until after the Senate's 3-week summer recess. This is due both to disagreements among Republicans, and to the resistance of Democratic Senators to the Dole proposal.

Welfare Reform Debate Begins on Senate Floor (08/7/1995)

Two weeks ago, disagreement among Republicans threatened to delay Senate action and force welfare reform into the budget reconciliation bill in the fall. Late last week, action on welfare reform resumed with the introduction of Senator Bob Dole's (R-KS) Republican compromise bill (S. 1120) and the Democratic bill drafted by Minority leader Tom Daschle (D-SD). The Democratic and Republican plans borrow heavily from the bill already passed by the House (H.R. 4), and differ only marginally from each other. Both plans block grant AFDC, impose a five year lifetime limit for benefits, shift responsibility for determining eligibility to states, and require beneficiaries to establish paternity. The differences between the plans are outlined below.

What's Hot (07/24/1995)

Welfare Reform Vote Delayed, Sen. Gramm Presents Competing Proposal, Other Features.

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