State Representative Garnet F. Coleman



Dear Friend,

The Dallas Morning News had a story yesterday about some deceptive talk from Rick Perry and Republicans around the state about the Children's Health Insurance Program (CHIP). As someone who cares deeply about children's issues and public health, the kind of misleading campaign-year rhetoric about CHIP is almost as frustrating as the consequences of the cuts the Republican-led legislature and governor made in 2003. I've included here the newspaper article as well as a release from my office on CHIP. I would encourage you to read them both and remember that providing quality health care for our children starts with electing leadership who make that a priority.

Sincerely,

Garnet F. Coleman
State Representative District 147



Foe disputes Perry on CHIP

Bell backer says funds unused, enrollees down; GOP aide defends plan

08:22 AM CDT on Wednesday, October 25, 2006

By ROBERT T. GARRETT / The Dallas Morning News

AUSTIN – A Democratic lawmaker Tuesday accused Gov. Rick Perry and Republican candidates of spreading "lies and half-truths" to disguise their rollback of children's health coverage.

The governor and some of the GOP's House candidates have made "bogus" statements about government health insurance for children, said Rep. Garnet Coleman, D-Houston.

He disputed a Perry campaign spokesman's comments last week that enrollment of young Texans in the Children's Health Insurance Program and Medicaid is up and that the state has "fully funded" CHIP and not let federal matching dollars slip through its fingers.

"Frankly, they think people are stupid," said Mr. Coleman, a key House health-care policy writer when Democrats ran the chamber and a supporter of Democratic gubernatorial hopeful Chris Bell.

Perry campaign spokesman Robert Black stood by his statements and defended recent changes as necessary to prevent abuse of CHIP by undeserving families.

"Garnet Coleman is a typical liberal Democrat who does not care one bit about spending taxpayer funds wisely," he said.

Mr. Coleman said the two health programs that cover poor children made strong gains early in Mr. Perry's tenure but have been crippled by budget cuts in 2003 and last year's switch of contractors who enroll families in CHIP.

Among the "Republican myths" cited by Mr. Coleman:

•Enrollments are up. The Perry campaign chooses 1999 as a starting point, to say the number of youngsters covered "has increased by over 1 million."

But CHIP, designed for children of working-but-poor adults, didn't crank up until 2000. Since Mr. Perry and lawmakers cut CHIP in 2003, combined enrollment in it and Medicaid has declined by about 130,000 children.

•"The CHIP program is fully funded," Mr. Black said last week, rebutting a Bell TV spot.

Mr. Coleman said that's technically true but misleading. He said lawmakers last year set aside
enough money for children expected to enroll, but it is a much diminished program with enrollment down 41 percent because of changes in CHIP eligibility and enrollment rules made in 2003.

•"No federal funds go unused," Mr. Black said.

"Ridiculous," Mr. Coleman said. "We're not using all the federal funds allocated to Texas, and those are going to other states."

Depending on which years one looks at, both could be right.

Independent analyses of federal data show that from 2000 to 2005, Texas passed up $832 million of federal funds it could have spent on CHIP.The pile of unspent federal funds is likely to grow, after Texas reports data for the budget year that ended Aug. 31.

Mr. Black insisted Texas soon will "use up our remaining federal funds." It's possible, though only for this and future budget years.

Ted Hughes of the Health and Human Services Commission said state use of federal CHIP matching money will surge if a new initiative to have the program cover costs of prenatal and after-birth care begins in January, as scheduled.

E-mail rtgarrett@dallasnews.com



FOR IMMEDIATE RELEASE Contact: Phillip Martin
October 23, 2006 (512) 463-0524

Rep. Coleman: Perry Created Permanent Wall for CHIP Families

CHIP Policies enacted in 2003 make it impossible for CHIP enrollment to increase

( Austin )--State Representative Garnet F. Coleman (D-Houston) announced today that Governor Perry and the Republican leadership purposefully enacted policies to strip away children's health care for thousands of Texas children. The budget cuts in House Bill 1 and the policies implemented in House Bill 2292 during the 78th Regular Session created obstacles that automatically disqualify hundreds of thousands of children from ever receiving coverage under CHIP.

"Governor Perry and the Republican leadership outlawed children's health care for two-hundred thousand Texas families," Rep. Coleman said. "They built a permanent wall to ensure that hundreds of thousands of hard-working Texas families that had received CHIP coverage prior to 2003 could never receive CHIP coverage again."

The "permanent wall" built in 2003 created restrictive requirements -- including a new "assets test," a more frequent enrollment process, an enrollment fee, the elimination of certain deductions, and more -- that made it harder for families to stay on CHIP and made it difficult for any new family to enroll in CHIP.

Much has been made of Governor Perry's awarding an $899 million contract to Accenture to allow them to, among other things, take over processing CHIP applications. However, prior to Accenture taking over, more than 184,000 children had already lost their CHIP coverage since the Republican policies were enacted in September 2003. Today, 200,000 fewer children are enrolled in CHIP than in September 2003.

"It's campaign season, and they want to create an illusion that everything is okay," Rep. Coleman said. "But numbers don't lie. In the last year alone, the state has allowed a lmost $400 million in state funds appropriated for CHIP & Medicaid to go unspent. That extra money -- which is now just sitting in the state's bank account -- would have easily covered every Texas child that lost CHIP coverage since May 2002."

"The only reason Texas has more uninsured children than any other state in the country is because Governor Perry and the Republican leadership don't consider our children's health a priority."

Please find the following supporting materials in this packet:

A chart detailing CHIP enrollment figures from May 2000 through October 2006
A detailed chart on the policies enacted during the 78th Regular Session in 2003, including an explanation of the restrictive "assets" test
A fact sheet on the FY 2006 CHIP and Medicaid funds that went unspent
A fact sheet on the amount of dollars the state has lost by not fully funding CHIP, as well as information debunking Governor Perry's claims about CHIP

Republicans' Failed Policies Create Permanent CHIP Barrier for Hard-Working Families


The legislation enacted during the 78th Regular Session in 2003 permanently cut hundreds of thousands of children from the Children's Health Insurance Program.

Since the cuts enacted by House Bill 1 and House Bill 2292 took effect on September 1, 2003, over 200,000 children have lost their health care coverage.

Though increased outreach spending and firing Accenture would help, over two-hundred thousand children will never be able to regain access to CHIP until the legislation signed by Governor Perry and the Republican leadership is repealed.



Chip Enrollment Figures from May 2000 - October 2006

High Point , 5/02: 529,271
9/03: 507,259
12/05: 322,898

10/06: 300,685


Source: Health and Human Services Commission and Center for Public Policy Priorities.


Changes in CHIP Enrollment Policies Made in 2003

Policy
Pre-September 2003
September 2003 - Present
New Restriction

Policy prior to Republican Changes
Policy with Republican changes
How the change added restrictions
Renewal Rates
Apply for renewal annually
Apply every 6 months
Families automatically kicked off if they forget to renew annually.
Income Requirements
Income requirements based on "net" income calculation. Allowed for reductions such as child care and work-related expenses.
"Gross" income assessed, which doesn't account for income deductions such as child care costs.
Eliminating deductions automatically disqualified thousands of needy children.
Family Asset Test
None
Assets test for families with incomes of 150% FPL with a limit of $5000 in liquid assets which includes any bank accounts and vehicles.
Working families are punished for attempting to save money for college, retirement.
Proof of Income
Submission of proof of income required only if there was a change in income; single box to check on application, renewal form.
Submission of proof of income and deductible expenses at every renewal by submitting pay stubs from employer.
New requirement not clearly explained
Waiting Period to Enroll Child in CHIP
No waiting period
90-day waiting period. If child enrolls after the 15th of the month, then the waiting period does not begin until the first of the next month, extending wait to 105 days.
Limits children's access to health care for an additional 3-4 months.
Enrollment Fees
No enrollment fees
Enrollment fees up to $50 per 6-month period; co-payments for doctor services and medications.
Stricter cost sharing policies make it more difficult, expensive.
Application
Length of instructions less than half a page
Application is much more cumbersome, w/ 3 pages of instructions and notices
Increases difficulty to enroll/renew at every step.
Renewal Forms
Renewal forms were pre-populated with previously submitted information and only required the family to cross out inaccurate information and make corrections.
Renewal forms are blank so the entire application must be completed anew every 6 months, including income, vehicle information, and bank balances.
Increases difficulty to enroll/renew at every step.
Defining the "A ssets Test"


A family with a gross monthly income greater than 150% of the federal poverty level (FPL) must own $5000 or less in countable liquid assets and excess vehicle value combined to be eligible for CHIP.

CHIP is meant to assist working families that can't afford health insurance for their children. These restrictive policies -- put in place in 2003 -- punish families that attempt to put money away in a savings account, even if it's for their children's college tuition, for personal retirement, or to purchase a home.

Should a family that already owns a vehicle come into ownership of any additional vehicle over $4,650 -- even if it's given to them by a friend or inherited from a deceased relative -- that family would be kicked off the CHIP program.


· Liquid Assets:
o cash on hand
o cash value of checking and savings accounts
o money remaining from the sale of a homestead
o cash value of stocks, bonds and savings certificates

· Excess vehicle value calculated:
o Countable vehicles include any operable and licensed automobile, truck, motorcycle, SUV, van, boat or motor home (including campers and RVs).
o The value of the vehicle will be based on the Hearst Corp./NAR Division Black Book.
o The family can exempt the first $15,000 of the highest valued vehicle and $4650 of the value of each additional vehicle.



Fact Sheet: CHIP, Medicaid Budget Funds Left Unspent

Almost $400 million in unspent CHIP & Medicaid funds would have covered every Texas child that lost CHIP coverage since May 2002, and covered those that lost Medicaid coverage in FY 2006.

$394.9 Million Left Unspent in FY 2006 Medicaid and CHIP

$4.8 billion in state funds was appropriated for Medicaid in Senate Bill 1
$328.3 million in state funds appropriated for Goal B (Medicaid) for fiscal year 2006 was left unspent and has been carried forward into fiscal year 2007

$199.9 million was appropriated for CHIP Services in Senate Bill 1
$66.6 million in state funds appropriated for Goal C (CHIP Services) was left unspent and has been carried forward into fiscal year 2007

71,412 Fewer Children Enrolled in Medicaid During FY 2006
· September 2005 - 1,980,389 children enrolled
· September 2006 - 1,908,977 children enrolled

35,027 Fewer Children Enrolled in CHIP During FY 2006
September 2005 - 326,557 children enrolled
September 2006 - 291,530 children enrolled

State Dollars Left Unspent Could Have Paid for Health Care Coverage for Medicaid and CHIP Children that Were Kicked Off the Rolls

Number of children that lost CHIP coverage from May 2002 - Today 228,406
Average state dollars needed to cover a child on CHIP: x $450
Amount of state funds needed to cover all children that
have lost CHIP coverage since May 2002 ( #1) $102,782,700

Number of children that lost Medicaid coverage in FY 2006: 71,412
Estimated state dollars needed to cover a child on Medicaid: x $700
Amount of state funds needed to cover all children that
lost Medicaid coverage in FY 2006 ( #2) $49,988,400

Amount of unspent FY '006 state funds for Medicaid and CHIP: $394,000,000
Cost in state funds of restoring CHIP ( #1) - $102,782,700
Cost in state funds of restoring Medicaid ( #2): - $49,988,400

Total Amount of Unspent State Dollars,
after CHIP and Medicaid coverage is restored: $241,228,900

Source: HHSC Response to Inquiries made by the Office of State Representative Garnet Coleman

Fighting the Myth: The Truth About CHIP

Election season campaign announcements from Governor Perry and the Republican leadership cannot cover up three years and nine legislative sessions of neglect. Here's a sampling of lies and half-truths purported by Governor Perry and the Republican leadership:

Republican Myth

Truth About CHIP


CHIP is 100% fully funded at the state level.

CHIP is fully funded at the rate set by the Republican leadership in the 79th Regular Session. Since 2003, the Republican leadership has cut state funds for CHIP by over $50 million, and cut all general revenue funds by over $150 million.

We aren't losing federal funds, or any money, from CHIP or Medicaid.

$1 in net cuts in funding for Medicaid and CHIP results in1:

$3.66 in total health care funding losses

$13.18 in total expenditure losses

$4.80 in personal income losses

$6.92 in gross state product losses

$1.59 in increased insurance premiums

$1.81 in retail sales losses

$0.58 in local government cost increases

$1.52 in out-of-pocket and other private health care costs

New $3.5 million outreach shows commitment to CHIP

Prior to 2003, the state was spending $9.9 million on outreach to assist families that were enrolling and renewing for CHIP.
Hurricane Katrina evacuees have inflated the numbers
9,805 children that are Hurricane Katrina evacuees have enrolled in children's Medicaid (1% of total enrollment).2

316 children that are Hurricane Katrina evacuees have enrolled in CHIP (1% of total enrollment).3

1 Source: The Perryman Group. " The Perryman Report: Special Report. An Assessment of the Impact of the Health Care Sector on the Texas Economy, with Emphasis on the Situation Confronting Hospitals and the Effects of Medicaid and Children's Health Insurance Program (CHIP) Funding Reductions." February, 2005.

2 Source: Health and Human Service Commission response to inquiries made by the Office of State Representative Garnet Coleman. October 16, 2006.

3 Source: Health and Human Service Commission response to inquiries made by the Office of State Representative Garnet Coleman. October 20, 2006.

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