WASHINGTON — Cynthia Pacheco used to rely on a government-funded children’s health insurance program to keep her twin boys healthy. Now she relies on prayer.
“We lay hands on them and we pray that God will protect them from any harm. Every morning. Every morning. We give them our blessing,” Pacheco said.
The Houston teaching assistant’s 18-year-old twins were bumped in May from the state Children’s Health Insurance Program, known as CHIP in Texas. The overtime she worked pushed the household income above the program’s limit. The boys relied for six years on the program, which covers kids to age 19.
The Pacheco twins are among thousands of children whose families’ incomes are too high to qualify for CHIP but still can’t afford private insurance. While some in Texas are hoping to raise the limits to allow more coverage, President Bush and some in Congress want to keep the income ceilings intact.
This week, the administration directed states to make children wait a year before enrolling in the program, a guideline aimed at preventing families from dropping private insurance to enroll in CHIP.
About half of the estimated 1.4 million uninsured children in Texas don’t qualify for CHIP. Some are undocumented, some have pre-existing conditions that keep them from getting private coverage, and others are like the Pachecos whose incomes prevent them from enrolling in CHIP.
Children’s advocates in Texas had hoped that one day the state would raise the income limits, which in the state is 200 percent of poverty level, or $41,300 for a family of four.
“The largest growth of uninsured has been in the middle class,” said Barbara Best, executive director of Texas Children’s Defense Fund. “Families earning $50,000 to $60,000 a year can’t afford private health insurance. Why can’t they benefit through the system as well?”
Officials also said states can’t enroll children in families who earn more than the CHIP income limit until 95 percent of children who qualify for CHIP or Medicaid are enrolled in those programs.
Last year, 41,523 children covered by CHIP left because their family income exceeded CHIP income limits, according to the Texas Health and Human Services Department.
A department study found 1 percent of the 2003 average monthly new enrollees, 21,295 kids, had dropped private insurance to get CHIP coverage.
Best and others have floated the idea of a buy-in program for families like the Pachecos. The families would pay a premium to help cover the cost. Currently each Texas child in CHIP costs the federal government $105 and the state $40.
But the administration and many Republicans in Congress, including those from Texas, fear expanding the program would lead to government-run health care and would be fiscally irresponsible.
“We should focus limited tax dollars on providing health care for children most in need of health insurance,” Rep. Randy Neugebauer, R-Lubbock, said in a statement after a House vote on the CHIP bill.
CHIP expires Sept. 30, and the Senate passed a bill providing $60 billion for the program over the next five years; the House, $75 billion. President Bush wants to spend $30 billion.
Bush has indicated he might veto legislation costing more than he wants.
Sen. John Cornyn, R-Texas, voted against the Senate bill, but voted for an alternative Republican bill that provides $10 billion over five years. The bill would have allowed Texas to keep $660 million in federal funds it hasn’t spent, Cornyn said.
Sen. Kay Bailey Hutchison, R-Texas, voted for the Senate bill, and for the alternative Republican bill that failed. All Texas House Democrats voted for the House bill, which included a cigarette tax increase to help pay for the program.
All but one of the state’s House Republicans voted against it. Rep. Sam Johnson, R-Plano, is recuperating from hip surgery and was not in the House for the vote.
States have been trying to expand the program on their own, with nearly 20 states and the District of Columbia, covering or planning to cover children in families with incomes at or below 250 percent of poverty level. New York has tried to raise the ceiling to 400 percent or $82,600.
This week, Houston health, school and business officials launched an effort with Texas Children’s Defense Fund to link all children with health care.
They’ll try to enroll all children in the Houston Independent School District who qualify in CHIP or Medicaid.
They’ll look for other programs, if they exist, for those that don’t qualify but still lack coverage.
Texas has budgeted $620 million in state money for CHIP in 2008-09. How much in federal money will be added to that depends on what Congress and the president finally work out.
On the Net:
Texas Children’s Defense Fund: http://www.cdftexas.org/