Campaign to Restore CHIP Calls for State Leaders to Address CHIP Enrollment Loss

Campaign to Restore CHIP Calls for State Leaders to Address CHIP Enrollment Loss

250 organization coalition calls for state leaders to suspend policy changes that have caused enrollment loss of over 20,000 children since December 1, 2005

The Campaign to Restore CHIP, representing 250 organizations and 2000 individuals across Texas, called on state officials today to suspend policy changes that have caused enrollment in the Texas Children’s Health Insurance Program (CHIP) to drop by over 20,000 children since December 1, 2005. This enrollment loss brings the decrease in children on CHIP since state budget cuts took effect in September, 2003 to more than 200,000.

The coalition is calling on state leaders to take immediate action to suspend policy changes to prevent further CHIP enrollment loss. Organizations are also calling on the Texas Health and Human Services Commission to quickly establish a workgroup of community stakeholders to work with THHSC to identify and remove barriers to the application and renewal process, resolve ongoing data problems with the new CHIP enrollment broker Accenture, and communicate policy changes to families so that children do not lose coverage unnecessarily.

Barbara Best, Texas Executive Director of the Children’s Defense Fund, said: “This is a crisis. We cannot afford to lose more children from the Children’s Health Insurance Program. The intent of the Texas Legislature in 2005 was to partially restore CHIP. CHIP enrollment should be growing, not shrinking.”

The 2005 Texas Legislature restored dental, vision, hospice and mental health benefits to the CHIP benefits package, reduced the cost of premiums for low-income families and allocated additional funds to increase enrollment.

However, nearly 28,000 children lost health coverage from December 1, 2005 through March 1, 2006, bringing CHIP enrollment down to 295,000 children. The Texas Health and Human Services Commission announced on Friday, March 3 that it would seek to restore coverage immediately to 6,000 of those children who were disenrolled because they did not receive proper notice of a new enrollment fee. Enrollment consistently exceeded 500,000 children until budget cuts took effect on September 1, 2003.

Policy Changes and Processing Mistakes

Reasons for the CHIP enrollment decline are complex, but appear to be the result of policy changes and processing mistakes since eligibility determination for CHIP was transferred to the private contractor Accenture on December 1, 2005.

Policy changes include the following:

  • Reinstating the collection of enrollment fees for families without adequate notice
  • Increasing the documentation requirements that families must provide with applications
  • Complicating the EZ renewal process by requiring families to fill out a new application every 6 months. Previously, the renewal form was pre-populated with information about the family. Families noted changes and returned the form to the state. Now, families receive a blank application that must be completed and turned in with documentation of income and assets.
  • Policy changes were not communicated to enrollees or community based organizations. As a result, families and community groups were not aware that enrollment fees had been reinstated or that additional verifications were required to complete renewal applications.

Based on stories from families and CHIP health plans, it also appears that mistakes have been made during the transition to the new CHIP enrollment broker Accenture:

  • Families report that applications were lost and parents are having to reapply 2-3 times to receive coverage
  • Families report that they turned their paperwork in on time, but were not renewed and that the contractor lost paperwork that parents had submitted
  • Families also report that premium payments were not credited to a child's account and that parents had been told incorrect premium amounts by the contractor.
  • Some families say that they have denied because they were told that their children were non-citizens, when the children were in fact citizens and had been on CHIP for a long period of time.
  • Most families have been terminated with very little notice. Many families received notices on Friday, February 24 that their coverage would be terminated on Tuesday, February 28. Some parents found out that their children’s coverage was terminated when they went to doctor’s appointments. Others have to cancel doctor’s appointments now that their coverage has ended.

Anne Dunkelberg, Assistant Director of the Center for Public Policy Priorities stated, “These reports seriously question the integrity of the CHIP eligibility and reenrollment process. Policy changes are not the only reason that children are losing coverage. Based on family stories from across the state, we have reason to believe that there have been erroneous terminations.”

As a result of these problems, thousands of Texas children are losing health coverage. Many of them have chronic health problems requiring ongoing medical care and medications. Children who lose health coverage often go to local emergency rooms at a much higher cost to local taxpayers.

The Importance of CHIP in Reducing the Number of Uninsured in Texas

Texas has the highest rate of uninsured children in the nation, with 21.6% of children—approximately 1.4 million children—lacking health coverage. Approximately 700,000 of these children are eligible for, but not enrolled in the Children’s Health Insurance Program or Children’s Medicaid.

For every $1 invested in CHIP, Texas receives $2.63 in federal matching funds. Advocates cautioned that more cuts to CHIP will place additional strain on local health care delivery systems already struggling to meet the needs of the uninsured.

Rosie Valadez McStay, the Director of Government Relations at Texas Children’s Hospital stated, “Texas has the ability to insure thousands of uninsured children through a program that has strong bipartisan support. Yet, children are being dropped and new policies are being enforced without adequate communication of data and coordination of strategies to stem disenrollment. Long term, this hurts local communities, providers, and most importantly, children across Texas.”

About CHIP

CHIP provides low-cost health insurance to uninsured children in families that earn too much to qualify for Medicaid but cannot afford private health insurance. A family of three can earn up to $32,180 a year—200% of the federal poverty line—and still qualify. Services covered include: doctor visits, prescriptions, hospitalization, vaccinations, specialty care, vision and mental health services. Dental services were restored by the Texas Legislature in 2005 and are scheduled to be reinstated in April, 2006.

Some of the state and local organizations supporting CHIP restoration include:

Children's Defense Fund of Texas • Center for Public Policy Priorities • Texas Hospital Association • Texas Pediatric Society • Texas Nurses Association • Texas Association of Community Health Centers • Mental Health Association of Texas and local affiliates • Texas Catholic Conference and Catholic Bishops • United Methodist Women of Texas • Texas Association of Public & Nonprofit Hospitals • Children’s Hospital Association of Texas • Methodist Healthcare Ministries • National Council of Jewish Women • Texans Care for Children • Texas Counseling Association • Consumers Union • AMERIGROUP • Texas Dental Association • Texas Dental Hygienists Association • Texas Impact • The Freedom and Justice Foundation • March of Dimes, Texas Chapter • Mission Presbytery • American Jewish Congress, Southwest Region • American Jewish Committee, Dallas Chapter • Coalition of Health Services, Inc. Amarillo • Dallas Area TexCare Outreach Coalition • Driscoll Children's Health Plan • Harris County Hospital District • St. David's Community Health Foundation • South Plains Rural Health Services • UT Dallas Center for Brain Health

The Campaign to Restore CHIP represents more than 250 organizations and 2000 individuals statewide and is committed to the full restoration of benefits and eligibility to the Texas Children's Health Insurance Program.