Texas remains No. 1 in uninsured
Pasadena father asked for a pay cut so his children would qualify for CHIP
By MIKE SNYDER
Copyright 2008 Houston Chronicle
Aug. 26, 2008, 11:02PM
How Harris County's poverty rate compares Among the nearly 6 million Texans who lacked health insurance last year was a sick, 3-year-old Pasadena girl whose father asked for a pay cut so his family could qualify for the Children's Health Insurance Program.
Josh Hebert's employer never responded to that request, said his wife, Kyla Hebert. The Heberts finally qualified by putting Katie, who suffers from brain lesions, and her older brother into day care, an expense that the program allows them to deduct from their income.
"We would much rather have them at home," Kyla Hebert said, adding that Katie missed a number of therapy appointments that her parents couldn't afford until they finally got her enrolled in CHIP.
The Heberts were among 45.7 million American families without health insurance in 2007, the Census Bureau reported Tuesday. Texas' overall uninsured rate of 25.2 percent, and its 20.2 uninsured rate for children, continued to be the highest in the country.
Nationally, the number of people without health insurance last year declined from 47 million in 2006, the Census Bureau said. Median household income — meaning half of households earned more and half less — increased by 1.3 percent to $50,233, while the nation's official poverty rate was unchanged at 12.5 percent.
While the Census Bureau didn't report health insurance coverage data at the local level, a report this year by Texas State Demographer Karl Eschbach estimated Harris County's uninsured rate at 29.8 percent.
The Texas uninsured figures likely don't include the 149,000 additional children enrolled in CHIP since the Legislature reversed cuts made in 2003, said Stephanie Goodman, a spokeswoman for the Texas Health and Human Services Commission. The restorations took effect in September 2007.
Several local and state policy initiatives could further reduce the ranks of the uninsured in Texas in the next few years, officials said. And on the national level, health care reform is a key issue in the presidential campaign and the focus of discussions at the Democratic National Convention.
In his speech Monday night, U.S. Sen. Edward M. Kennedy said expanding access to health care would be his highest priority after the November election.
"A national program would be the best way to do it," said Elena Marks, Mayor Bill White's health policy director, speaking by cell phone from the convention on Tuesday.
State legislators will debate further steps to remove barriers to enrollment in CHIP when they reconvene in January, said Rep. Garnet Coleman, D-Houston, also attending the convention.
The success of these efforts, he said, will depend on voters choosing candidates who are committed to providing coverage for every Texas child.
"Most other states, and some of the territories, have been more successful and committed to serving children," Coleman said.
Rep. John Davis, R-Houston, who chairs the health and human services subcommittee of the House Appropriations Committee, agreed that health insurance will be a key issue for the Legislature in 2009.
Making changes
A bill passed in the last session, Davis said, would subsidize insurance premium payments for low-income working adults in Texas.
But the state can't proceed with this program until it is approved by a federal agency, and that request is pending, Davis said.
The state's next goal should be to enroll every eligible child in CHIP or children's Medicaid, said Barbara Best, the Texas executive director for the Children's Defense Fund, a research and advocacy group.
This could be achieved, she said, by hiring more state workers to enroll children quickly and reducing the twice-annual required applications to once a year for children's Medicaid. The state made this change for the CHIP program last year.
The city this year began requiring its contractors to provide insurance to their employees or pay into a city fund to help defray the costs of providing health services to the uninsured. People without insurance often seek care in emergency rooms or public health facilities, and those costs are passed on to insurance ratepayers or taxpayers.
The city also established a Web site, www.houstonhealth choice.com, which helps consumers choose a health insurance plan.
Kyla Hebert said her family explored several options to get health care for Katie, whose brain lesions have triggered a host of symptoms. The child is deaf in one ear, is developmentally disabled and takes most of her nutrition in liquid form because she has trouble digesting food, her mother said.
"They're not really sure what caused the lesions," Hebert said.
Her husband's job offered a family health insurance plan, she said, but the premiums would have consumed 30 percent of his take-home pay and the policy wouldn't have covered many of the treatments Katie needs.
They considered private insurance, but an agent told them they'd never quality because of Katie's problems, Hebert said.
The family's income exceeded the CHIP guidelines by $260 a month.
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