PUBLIC BENEFITS

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.

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.

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.

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.

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.

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.

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.

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.

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’ 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.

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’ 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.

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 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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.”

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.