Suffer the Little Children

Cuts to health insurance belie the real conservative agenda

Suffer the Little Children
Illustration By Doug Potter

Last week veteran Houston sportswriter Mickey Herskowitz got himself suspended from the Houston Chronicle for recycling one of his old Houston Post columns for this year's NCAA tournament. Herskowitz was duly penitent, but I know how he feels – counting a previous gig, I have now covered the Capitol beat long enough to find myself often wondering at what point do I just call up an old column on state policy with the intro, "Here we go again ..."

This week's déjô vu is the Children's Health Insurance Program, which has been in a downward spiral since September, when last year's new Lege restrictions took effect. Until then, thanks to bipartisan support in the 1999 session – more Glen Maxey than George W. Bush, but effective nonetheless – it had become a program for Texans to be proud of, with half a million otherwise uninsured children of working families provided with health insurance that kept them in school and out of emergency rooms. As of last week, roughly a quarter of those children have lost their CHIP insurance – 119,000 at last count, with a bullet – yet the Health and Human Services Commission continues to look for further cuts, despite having already reached the budgetary limits imposed by the Lege.

Even Appropriations Chair Talmadge Heflin concedes that the HHSC is not obligated to impose an assets test for CHIP, especially one designed to ensure that an applicant family is destitute – literally welfare eligible – before it can qualify for the program. CHIP is aimed at working families that still can't afford private insurance – but the commission's assets test is modeled on that for food stamp recipients. Yet on last week's op-ed pages, state Rep. Dianne Delisi, R-Temple (also the chair of the House Select Committee on Health Care Expenditures) was defending the assets test as demonstrating that state resources are being used "wisely, efficiently, and accountably."


What Do They Conserve?

Delisi should have checked her e-mail before issuing that boilerplate. The "fiscal conservative" card simply won't play on CHIP cutbacks, because not only is the money available to cover those kids, it costs more not to insure them, as the newly hatched Campaign to Restore CHIP blared across the state last week. The campaign includes some 1,200 individuals and organizations, and these are not simply the usual advocates: the list includes groups as disparate politically as the Texas Medical Association, the United Way, various hospital associations, the National Council of Jewish Women, AARP, and the YWCA.

The unlikely bedfellows include newly elected Houston Mayor Bill White and veteran Harris Co. Judge Robert Eckels. A couple of weeks ago, Eckels was flogging Gov. Rick Perry's proposed property-tax cap, especially that part of it that would ban "unfunded mandates." Now he and White point out that the CHIP cutbacks are already having devastating local economic effects – $36 million lost thus far to Harris Co. hospitals – that can only get worse. "For every $1 invested in CHIP, Texas receives $2.59 in federal matching dollars," they wrote in the Houston Chronicle. "As a result of CHIP cuts, Harris County alone will lose $139 million in state and federal matching dollars. This loss of funding shifts costs to health-care delivery systems and property tax payers." (Maybe Eckels' left hand can send a message to his right.)

Overall, Texas stands to lose more than $500 million in federal matching funds, and another $200 million in state funds will not be spent in local communities ($18.2 million total lost to Travis Co.). Even setting aside the social welfare question, that money represents a public infrastructure investment that generates thousands of jobs – yet there was Delisi lamenting, "Many counties don't have access to an adequate number of health care providers."

So it's fiscally conservative to choke off state and federal health care support for those counties?


Smoke 'Em Out

Gov. Perry, Lt. Gov. David Dewhurst, and House Speaker Tom Craddick found it in their hearts last week to donate a cool $40 million from the Texas Enterprise Fund to the needy corporations that make up Sematech. Yet there remains some $469 million in federal fiscal relief funds available, about half of which would be enough to restore CHIP to levels reasonable for a state that comfortably leads the nation in uninsured children. As Comptroller Carole Keeton Strayhorn reiterated last week (echoing the mantra of Austin Rep. Elliott Naishtat), a $1 cigarette tax would generate an additional $1 billion or more for health and human services – but the property-tax hawks have their eyes on that now for public schools. The notion does suggest an ad campaign for Altria (aka Philip Morris) aimed at high school dropouts: "Be True to Your School – Smoke Marlboros." Gives a whole new meaning to robbing Peter to pay Paul.

The truth is, the fact that the CHIP cuts – like Medicaid recomplication or undermining public education – don't really make economic sense suggests much of their real motivation: crippling government even when the government programs work well. By rights, every Texan should have real access to health care, and a living wage should at least provide affordable insurance for families that would prefer not to rely on the state. The same "conservatives" who voted to cut social services resolutely block any attempt to raise the minimum wage, let alone to create a living wage, and now they want to undermine even the "prevailing wage" required on some state contracts.

For all their rhetorical devotion to "the taxpayers," whom they truly represent are the taxpayers' bosses. end story

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KEYWORDS FOR THIS STORY

state policy, Children's Health Insurance Program, CHIP, Health and Human Services Commission, Dianne Delisi, Campaign to Restore CHIP, Bill White, Robert Eckels

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