By Bill Zeeble, KERA 90.1 reporter
Dallas, TX – Bill Zeeble, KERA 90.1 reporter: Texas already ranks last in the nation when it comes to the percentage of uninsured children. Now, children's advocates say things are getting worse. Because of budget cuts, the Children's Health Insurance Program recently raised enrollment fees, imposed stricter eligibility requirements, and dropped some benefits. Dallas Children's Medical Center Advocacy Manager Julia Easely says at a time when the No Child Left Behind law is a high priority, it makes no sense to drop vision and dental benefits. But that's what CHIP has done.
Julia Easely, Advocacy Manager, Children's Medical Center of Dallas: Dental problems is one of the main reasons kids miss school. So today, we have about half a million kids on CHIP and they no longer have dental benefits. They also have cut vision benefits. So those half-million children now aren't eligible to have their eyes checked and get a pair of eyeglasses if they need that to stay in school.
Zeeble: Carmen Lara, a medical assistant whose 15-year-old daughter is enrolled in CHIP, says she doesn't know what she'll do about her child's eye problems. Lara is the family breadwinner. Her injured husband is currently out of work.
Carmen Lara, mother: I can't really afford insurance; it's so expensive. If I have to go through private insurance, it would just cut my pay in half. I haven't been able to get her eyes examined, or a to see a dentist. Eventually, I have to figure out a way to take her. I wish they could put those programs back for the children.
Zeeble: That won't happen, according to the state, even if the child is in the middle of treatment. And parents cannot appeal. So Angie Hernandez, whose three young children were enrolled in CHIP, opted out. She and her husband cut their family budget to buy private vision and dental coverage.
Angie Hernandez, mother: We were paying only $15 a month. Now it's $245 a month and we have to make arrangements on how to pay bills, just to work around the children having insurance. I want my kids to have the best that they can.
Zeeble: The new policy now consumes 11% of the family's total income of about $35,000 a year. But the fact they can pay for it means the state plan is working, according to Representative Arlene Wohlgemuth. One of the architects of the CHIP budget cuts, Wohlgemuth says many private insurance holders dropped coverage for children when CHIP appeared a few years ago.
Arlene Wohlgemuth, Texas State Representative: That phenomenon is called "crowd out," where the government is crowding out the private sector insurance. It's an undesirable feature. We want the employers to cover as many of these kids as possible. The design of our plan, for those who can take care of themselves, to do so, and for the government to take care of only those unable to take care of themselves.
Zeeble: Yet there are families now denied CHIP who still can't get private coverage, because of pre-existing medical conditions. Cindy Brown, a divorced receptionist in Dallas, has that problem. Her 10-year-old son suffers from a serious, pre-cancerous disease that's already prompted thirteen hospital visits. He also has Attention Deficit Disorder.
Cindy Brown, single mother: It would cost me over $350 a month. That's just for insurance. Also, he's on Aderol for his A-D-D. The reason it would be so high is because of all of his pre-existing conditions.
Zeeble: Representative Wohlgemuth acknowledges the revamping of CHIP did not account for situations like Brown's.
Wohlgemuth: I don't know that we did discuss that. A bill as large as HB 2292, with the magnitude of the changes made, I'm sure there'll have to be considerations re-examined that were not looked at during the regular session.
Zeeble: But fixes for CHIP will likely have to wait until the next legislative session, in 2005. For KERA 90.1, I'm Bill Zeeble.
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