PUBLIC BENEFITS: HEALTH CARE ACCESS


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

Recent Health Care Access 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.

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.

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.

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 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.

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.

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.


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.

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.

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.

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.

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.

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.

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: 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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.”

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.

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.

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.

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.

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.

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.

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.

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.

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.

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

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.

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.

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.

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.

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.

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).

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.

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.

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.

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.

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.

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.

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.

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!

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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...

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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).

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.

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.

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.

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).

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."

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.

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.

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.

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.

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.

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.

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.

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.

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.

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).

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.

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.

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.

Handouts to Accompany Testimony on Congressional Conversion of Medicaid to Block Grant (02/25/2003)
Handouts to accompany testimony on HCR 58.

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.

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.

Update on Co-Payments for Adults in Medicaid (01/9/2003)
Provides a synopsis of changes.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Texas Will Submit State Plan for CHIP in February (01/21/1999)
Plan caps program far below potential.

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.

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.

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.

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.

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.

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.

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.

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