Texas' has the highest rate of uninsured children, and it's getting worse

Contributing sentiments towards policy:

62% : This story is part of "Uninsured in America," a project led by Public Health Watch that focuses on life in America's health coverage gap and the 10 states that haven't expanded Medicaid under the Affordable Care Act.
60% : Delcid is team leader for benefits assistance at Epiphany Community Health Outreach Services, or ECHOS, a Houston nonprofit that helps residents apply for public programs like Medicaid.
59% : Research shows Medicaid expansion has a "welcome-mat" effect for children, with parents on Medicaid more likely to sign up their eligible kids as well.
59% : Bucy's bill requires parents' permission before an eligible child is enrolled in Medicaid.
57% : As of 2021, seven states had an express lane for children's Medicaid; two had it for Medicaid and CHIP.
55% : "When kids are enrolled in Medicaid, they do have better access and better health care outcomes," said Alec Mendoza, senior policy associate for health at Texans Care for Children.
54% : Providers and advocates say parents' hesitancy is one reason so many Texas children remain uninsured despite being eligible for state coverage.
54% : The idea is that states use the information that families submit for other safety-net programs, such as the Supplemental Nutrition Assistance Program, to determine kids' eligibility for Medicaid or CHIP.
53% : The state has booted more than 1 million children from Medicaid since it began reviewing recipients' eligibility again in 2023 after a pause during the COVID-19 pandemic.
53% : Alabama started express-lane eligibility in 2010 and has experienced such results, said pediatrician Marsha Raulerson, who is on the state's medical advisory committee for Medicaid.
53% : "I have patients that I beg -- I say 'Please get on Medicaid.
52% : One study, published in 2017, followed a group of 237 children in Dallas County who were eligible for Medicaid or CHIP.
52% : The policy doesn't include Medicaid, but that changed under the first Trump administration.
51% : In mid-September, the median statewide wait time for an eligibility determination for Medicaid was 83 days, state officials reported -- longer than the 45-day federal limit.
51% : "In Texas, it's mostly kids, seniors and people with disabilities on Medicaid," Park said.
50% : The long waits prompted the U.S. Centers for Medicare and Medicaid Services, or CMS, to open an investigation into the backlog last May.
49% : Texas has shunned broad proposals enacted by other states, such as expanding Medicaid for low-income adults.
47% : Texas lawmakers also have rejected or stalled proposals that typically help more children access CHIP or Medicaid.
46% : " Under federal law, people deemed likely to become dependent on public assistance can be denied lawful permanent residence.
44% : With Medicaid or CHIP, families rarely have out-of-pocket costs, said pediatrician D. Maneesh Kumar, who runs a small practice in Southwest Houston.
43% : But she said she is nervous about filling out the paperwork to apply for Medicaid or CHIP.
43% : One of the biggest impediments to enrolling eligible kids is the current "political environment around immigration," said Marcie Mir, CEO of El Centro de Corazón, referring to state and federal policies, such as Gov. Greg Abbott's 2024 order requiring public hospitals to collect information about undocumented immigrants who seek treatment.
41% : Among the issues is a backlog of thousands of families who applied for Medicaid or the Children's Health Insurance Program, known as CHIP.
41% : Their families also risk being saddled with medical bills they can't afford and that Medicaid would have covered.

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