Tuesday, April 25, 2006

Fewer Kids in CHIP - Good News?

In an editorial in yesterday's Dallas Morning News, Mary Katherine Stout attributes the decline in the number of children enrolled in CHIP (Children's Health Insurance Program) to the growth of Texas' economy. As defined by the Texas Health and Human Services Commission,

The Children's Health Insurance Program (CHIP) is designed for families who earn too much money to qualify for Medicaid, yet cannot afford to buy private insurance for their children. CHIP coverage provides eligible children with coverage for a full range of health services including regular checkups, immunizations, prescription drugs, lab tests, X-rays, hospital visits and more.
CHIP is a program designed to provide access to health care for the children of the working poor. The familiy income eligibility ceiling for CHIP is 200% of the annual federal poverty rate, which is currently $20,000 for a family of four. CHIP enrollment has declined from a high of 529,211 children in May 2002 to a current enrollment of 294,189 children.

According to Stout this is a reaction to an improving economy and a lower unemployment rate. She implies that families are disenrolling because their fortunes have improved to the point where they no longer need assistance in providing health insurance for their children. A THHSC December 2004 report An Analysis of Disenrollment Patterns in the Child Health Insurance (CHIP) in Texas suggests otherwise:
  • 52% of families disenrolled did not obtain other insurance
  • 31% became eligible for and enrolled in Medicaid - hardly an indicator of improving fortune
  • 11% obtained employer-based family coverage
  • 5% obtained other insurance on their own
  • 1% did not know whether they had insurance for their children

I would suggest the possibility that the decline in enrollment might be attibuted to legislative cost cutting efforts resulting in more stringent eligibility requirments, a change in renewal timelines from every 12 months to every 6 months, longer initial waiting periods, and the use of a private vendor to handle the enrollment and renewal procedures. Hardly good news for poor working families.

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