Childrens Defense Fund of Texas

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The Story That Made A Difference A Successful
Campaign to Expand CHIP Coverage for Uninsured
Texas Children
Childrens Defense Fund of Texas
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(No Transcript)
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CHIP and Medicaid

• Of the 1.4 million uninsured Texas children, half
  are eligible for but not enrolledin CHIP and
  Medicaid.
• But 200,000 Texas children have lost coverage
  since 2003 budget cuts.

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The Environment

• CHIP families drive Lexuses and Escalades
  Governor Rick Perry
• Declining enrollment is a positive thing that
  reflects a growing economy.  Governor
  Rick Perry
• I don't think most people in Texas have a lot of
  sympathy for someone that can't fill out a
  two-page application every six months.
  Lt. Gov. David Dewhurst
• CHIP re-enrollment is easier than ever. Asset
  tests and shortened enrollment periods are
  necessary to prevent families from using
  resources fraudulently. Rep. John Davis
  Chairman, House HHS Subcommittee on
  Appropriations

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And, yet Texas advocates restored health coverage
to 127,000 children during the 2007 Texas
Legislature!!
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How did we do it?
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Putting a face on the issue
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ABOVE THE LIMIT
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Everett Family

• Family earns 35,000 a year in pest control.
  Winter months are slow.
• Mother is wheel-chair bound with MS and
  significant healthcare expenses.
• New CHIP guidelines do not count children over 18
  as family members. Even though their full-time
  student daughter lives at home, she is not
  counted as part of the family size. As a result,
  they are 50 over the income limit for a family
  of 3.
• The entire Everett family is uninsured.

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ASSETS
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Dumas Family

• Single mother works full time and attends school
  part time through the GI Bill as a veteran.
• Her three children ages 8, 6 and 4 were
  disqualified from CHIP because she co-signed for
  a friends vehicle.

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Garcia Family

• The 2 parent family lives in Beaumont. Their old
  home suffered extensive damage from Hurricane
  Rita.
• The family received an insurance check to rebuild
  their home, which was counted as an asset. Ten
  year old Gabriela lost CHIP after 7 years of
  continuous coverage.
• Gabriela missed 29 days of school last year
  because of severe migraines and skin allergies.

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CHIP provides confidence and peace of mind.
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RED TAPE
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Devante Johnson, age 14 Diagnosis Advanced
Cancer of the Kidneys

• Mother submitted renewal 2 months before Medicaid
  expiration.
• Medicaid renewal sat for 6 weeks without
  processing.
• Devante determined eligible for CHIP -
  application transferred to Accenture.
• Paperwork was lost in the system and despite
  numerous calls and faxes, Devantes mother was
  unable to track the application.
• State Representative intervened to restore
  coverage.

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• When he lost coverage, he could not receive
  regular treatment and relied on clinical trials
  for care.
• Eligible child was uninsured for 4 months while
  tumors grew.
• Devante died on March 1, 2007 of complications
  from cancer.

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Documenting Local Impact of Cuts to CHIP and
Medicaid
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Source Center for Medicaid and Medicare Services
with 2.63
900 million
900 Million
2.63
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Source National Hospital Ambulatory Medical Care
Survey, March 1994.
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Preventive vs. Crisis Care
Source Harris County Hospital District
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Building Unlikely Alliances-- Business Support
for CHIP
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Chamber Endorsements of CHIP restoration

• Greater Austin Chamber of Commerce
• Greater Dallas Chamber of Commerce
• Greater Houston Partnership
• Greater San Antonio Chamber of Commerce
• Metro 8 Chamber of Commerce
• Represents the Business Chambers of the 8 largest
  Texas cities (Arlington, Austin, Corpus Christi,
  Dallas, El Paso, Fort Worth, Houston and San
  Antonio)
• 60 of the Texas population!

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Business Support
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CHIP Regional Coordinators Network

• Austin
• Beaumont
• Corpus Christi
• Dallas
• Fort Worth

• El Paso
• Houston
• Rio Grande Valley
• San Angelo
• San Antonio

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The Impact

• HB 109 passes the Texas House, 128-17
• HB 109 passes the Texas Senate, 30 1
• Result CHIP coverage restored to 127,000 Texas
  children!

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House Bill 109by Rep. Sylvester Turner
(D-Houston) and Sen. Kip Averitt (R-Waco)

• Restores outreach through community based
  organizations
• Uses net, not gross income to calculate income
  and offsets for childcare expenses
• Doubles the asset test limit from 5,000 to
  10,000.
• First vehicle increased from 15,000 to 18,000.
• Second vehicle increased from 4,650 to 7,500
• Waives 90 day waiting period for uninsured
  children.
• 12 months eligibility families will fill out
  one paper application a year. Children above
  185 of the federal poverty level (38,203 a year
  for a family of four) would have their income
  reviewed after six months to be implemented in
  Sept., 2008.

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Other CHIP Medicaid Reforms

• The budget includes several riders by Reps.
  Garnet Coleman and Elliott Naishtat to improve
  the eligibility process and eliminate barriers,
  delays and wrongful denials.
• HB 3575 by Patrick Rose creates a Legislative
  Oversight committee for the HHSC eligibility
  system and sets goals to improve customer service
  and reduce processing time.
• Provider reimbursement will be increased for CHIP
  and Medicaid. As a result of the Frew lawsuit,
  Medicaid reimbursement will increase
  substantially to improve access to medical and
  dental care.

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A Changing Environment

• I have been increasingly persuaded to go to a
  one-time paper application for 12 months CHIP
  eligibility. I want and I believe my colleagues
  want to ensure that any and all children eligible
  under the CHIP program are covered. Lt.
  Gov. David Dewhurst
• CHIP is fiscally responsible because it allows
  children to seek care in doctors offices rather
  than costly emergency rooms. Health insurance
  today is just too costly for the common man.
  Rep. John Davis (R-Houston)
• I think HB 109 is an excellent opportunity for
  the state to enroll a significant number of new
  children into the program. Senator Kip
  Averitt (R-Waco), Senate bill sponsor

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Looking Forward

• Working with policy makers to rebuild CHIP
  enrollment partnerships with HISD, Clear
  Channel Outdoor and McDonalds.
• Building support for 2009 legislative priorities
  CHIP buy-in program and Medicaid simplification.

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100 Campaign Outreach partnership with Houston
hospitals and HISD
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Responses to 2005 HISD Enrollment Form

• 51 responded to the questionnaire (119,038)
• 22.4 have no healthcare coverage (26,646)
• 39.6 Medicaid
• 25.6 Private
• 9.2 CHIP
• 3.3 Gold Card

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100 Campaign Partners

• Memorial Hermann Healthcare System Gulfton (Lee
  and Sharpstown feeder patterns)
• St. Lukes Episcopal Health Charities East End
  (Austin, Chavez, Furr and Milby feeder patterns)
• Texas Childrens Hospital/Texas Childrens Health
  Plan/Texas Childrens Pediatric Associates
  South Central (Jones, Madison, Sterling and
  Worthing feeder patterns)
• HISD North and Central regions

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100 Campaign Goals Get it, Use it, Renew it!

• Get it Identify every uninsured child and link
  them with a health resource.
• Use it Develop small group educational modules
  to teach parents to renew and use preventive care
  rather than ERs.
• Renew it Ensure that parents renew their
  coverage so that childrens coverage does not
  lapse.

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Local Business Partnerships Back-to-School
Campaign
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• Do it for Devante
• Do it for Texas

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Childrens Defense Fund
Barbara Best Texas Executive Director 4500
Bissonnet, Suite 260 Bellaire, Texas 77401 T
713-664-4080 F 713-664-1975 bbest_at_childrensdefens
e.org www.cdftexas.org