Emergency Resuscitation

CHIP expansion makes a last-minute recovery

Rep. Kolkhorst:
Rep. Kolkhorst: "[Medical costs] cannot become 40% of our GDP. It's just not acceptable" (Photo by Richard Whittaker)

When it comes to conference committees, never count a bill as dead until the ink on every possible vehicle is dry.

With the midnight deadline for filing conference committee reports bearing down last night, somehow CHIP expansion made it on to Senate Bill 2080, Sen. Carlos Uresti's child welfare bill.

Having already voted against it when it was a stand-alone bill, conferee Rep. Lois Kolkhorst, R-Brenham, said she was not asked to sign the committee report. She called the proposal "a casualty" of last weekend's chubbing, and added, "I certainly don't blame [fellow conferees Rep. Ruth Jones Mclendon and Garnet Coleman] for trying to resurrect that, as we're all trying to do with all the bills that are important to us."

But with SB 2080 up for a vote tonight, Kolkhorst said she had "mixed feelings" about its fate. "My concern is the payer mix in the rural areas," she explained. Expanding CHIP to 300% of the Federal poverty level will place an extraordinary strain on rural medical services and pediatricians.

"When you start to bump those salary levels up to $66,000, or at 400% it's well north of $80,000, that takes in a vast proportion of people living in rural areas." Push that too far, she argues, and practices in already under-served areas may just not be financially viable.

Hers is not a blanket resistance to CHIP expansion, because she knows how bad the insurance coverage in this state is. "We rank horribly in our employee sponsored insurance." She had worked on a proposal for a pilot program to expand reimbursements for physicians, "but that was a victim of the five day slow-down," she said. Since then, her attention had been on saving SB7, her major healthcare review bill (which ended up attached to Rep. Donna Howard's medical record sharing bill.) While she said she is open to pretty much any idea of how to get people coverage, something, she admits, has to give. "[Medical costs] cannot become 40% of our GDP. It's just not acceptable," she said.

Even though she was originally a 'nay' vote on expansion, she said she was not sure how she would vote on SB 2080 if it makes it to the floor in time. She also had no clue whether Gov. Rick Perry would go ahead with his threat of a veto if it would take so much other legislation with it.

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81st Legislature, Texas House of Representatives, Health Insurance, Chubfest '09, CHIP, SB 2080, Lois Kolkhorst

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