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Wednesday, April 4th 2007

Pretending To Play Lobbyist

I was up at the state capitol with so many other medical students on Tuesday, pretending to play lobbyist and that legislative intern Johnny really wanted to be sitting around a table listening to us complain about GME funding. It was however also the day the CHIP “restoration” bill made it onto the Texas House floor. Having a few hundred medical students and doctors up at the Capitol made a nice photo backdrop for ‘press conference’:

If They’d Just Move The Camera To The Left…
I Was Right In The Front Row

CHIP was gutted in 2003 with the state facing a major budget deficit.

The bill got the nod on the House floor after lengthy debate I watched a lot of.

A bill expanding the Children’s Health Insurance Program received tentative approval on a vote of 126-16. It is expected to receive final approval today

House Bill 109 is a compromise and was supported by the medical community and advocates for low-income Texans. It is expected to add 100,000 children to the rolls at a cost to the state of $78 million for the next two years.

In addition to the 12-month enrollment, the bill would let families deduct child care expenses from their income and retain more money in savings accounts and own more expensive vehicles than allowed under existing eligibility rules.

The bill’s future is more tenuous in the Senate. That was clear even to the uninformed, like myself, after yesterday at the Capitol.

Lt. Gov. David Dewhurst has said he disagrees with a key provision of the bill — to give a year of coverage instead of requiring families to reapply every six months.

Except that is basically the biggest thing the bill does!

CHIP, like Medicaid, is a matching funds program. Even pushing aside the poor funding of the program Texas has absolutely abysmal enrollment rates for those who are eligible, in large part because of the complexity of enrolling in the program. Part of that complexity is having to reenroll every six months. In anycase, because the program is a matching program with the federal government, Texas leaves millions upon millions each year of federal monies “on the table” because we can’t get even eligible kids enrolled. This twelve month provision helps that.

I waver, certainly, from my “health care is not a right” position when we start talking about children. Not even the most cold hearted libertarian can deny the state’s responsibility to say, abandoned and orphaned children. And with strict eligibility rules applied isn’t providing for children whose parents can’t just an extension of such?

But whatever my reasoning I think we can agree that as long as Texans are going to give up income taxes to fund this program, then my God we should bring them back!

In anycase, the bill doesn’t make anyone happy, seeing as liberal bloggers chastise it for failing to raise the eligibility back to the original pre-2003 levels. See Burnt Orange Report and Off The Kuff here and here.

I don’t know enough to say when I think a family’s income truly means they cannot afford health insurance. This country carries so much non-survival debt, is so fiscally irresponsible, is growing so accustomed to entitlements (although no compared to say, europe) that it makes that line blurry. I can’t be so cold hearted to not see insuring the uninsurable children as the state’s responsibility, but I want so much for family’s that truly can (whether they believe they can or not) to insure themselves. Whether H.B. 109 rises to that level or the state needs to extend the CHIP eligibility further I just don’t know enough to voice an opinion.