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A July report from the Kaiser Commission on Medicaid and the Uninsured stated that the state saved a total of $1.6 billion through cuts and stricter eligibility standards.

Beth Schlechter, RN, MSN, a practicing clinic nurse in Austin and a member of the Central Texas Regional Children’s Health Insurance Coalition, said the preventive care cuts will mean that many developmental problems will go undiagnosed. “This is one of those things that will have great repercussions in the life of a child and the life of a family. It is trickle-down in the truest sense of the world.”

She said nurses are seeing more kids coming to the ED for primary care “who shouldn’t have to be there, but they don’t have a medical home now,” she said. “It is essentially the state shifting the burden. We are seeing big increases in the percentage of uncompensated care, and that burden always cycles back to the community.”

Schlechter, who is working with the statewide Campaign to Restore CHIP, said she plans to help such advocacy groups quantify how much harm the CHIP cuts are inflicting for presentation to the Texas Legislature at the January session.

In a six-county North Texas region that includes the heavily populated Dallas and Tarrant counties, CHIP rolls have been reduced by 32% since Sep-tember, according to Sara Neese, RN, vice president of administration for Cook Children’s Health Plan.

Neese adds that CHIP, for the first time, will begin removing families in September for failure to pay their premiums. “More and more, these families have a choice,” she said, “and that’s: ‘Do I put food on the table or do I pay these premiums?’”

Fighting back

Sustaining CHIP funding “is just the right thing to do,” she said. “You don’t turn your back on kids that need you. They have no voice. They are vulnerable. So we have to try to speak for them. The way things are now, they are not going to get screened for diabetes and other diseases … so the effects of this are going to be felt for years and years.”

The Texas Nurses Association has joined a bipartisan coalition of elected officials and advocacy organizations that are calling on Gov. Rick Perry and the Legislature to restore CHIP funding.

Others joining the effort include the Texas Medical Association, Texas Catholic Conference, the Mental Health Association, Cook Children’s Medical Center, The United Way, and The Texas Hospital Association.

State officials involved with the CHIP program say some issues surrounding the program have been overhyped. The steep drop in CHIP enrollment is partially due to some families’ failure to send in renewal forms, said Linda Dalton, an administrator for the East Texas CHIP Coalition, which is based in Longview. “It is the families’ responsibility to take ownership of their own health care, and we encourage that. That’s something that gets left out of a lot of the op-ed pieces and news stories.”

Additional families have been dropped off because they lost income and rolled over into the Medicaid program, or their children have aged out of the program, she added.

Russell Smith, press officer for the Texas Health and Human Services Commission, said the $15 monthly fee enables families to “insure their kids for about the price of a meal at McDonald’s. It is very much the best deal out there.”

Some families are misinterpreting the recent spate of publicity on CHIP “as a sign that it’s going to go away and it’s not worth their money,” he said. “We have tried to counter that by urging people who have CHIP coverage to stay with the program … and reinforcing the fact that we are still signing up eligible people.”