This week the Texas Legislature took its first steps to help Texas prepare for implementation with the naming of House and Senate committees to monitor national health reform.

Speaker Straus named a 15-member House Select Committee on Federal Legislation. The committee’s work will include, “monitoring Congress’s health care reform efforts and their potential impact on the state’s health care system, health insurance regulation statutes and policies, Medicaid and children’s health insurance programs, eligibility system, workforce recruitment and retention, and health care financing mechanisms.”  Rep. John Zerwas will serve as chair and Rep. Garnet Coleman as co-chair.  Speaker Straus’ press release lists the full committee membership.

Senate interim charges released this week by Lt. Governor Dewhurst included the following joint charge on health reform to the Senate Health and Human Services Committee and the Senate State Affairs Committee.

Upon passage of federal legislation relating to reform of the health care industry and health insurance industry, study the implication of such legislation on Texas, the health care industry, and public and private insurance.  Study and monitor the implementation of the insurance regulatory changes, changes to the high risk pool, and any other insurance mandates.  Study the health care policy changes and the impact to the Medicaid and CHIP programs and the state budget.  Assess the impact to all state uninsured and uncompensated care programs and county programs for the uninsured, including county property tax programs to pay for the uninsured. Make recommendations for the efficient implementation of programs.

Working Age Texans Most Likely To Be Uninsured

In Texas, 32 percent of adults ages 19 to 64 are uninsured compared to 19 percent of children.  It’s a bit surprising that working-age adults in Texas are so much more likely to be uninsured than children, since parents (and not children) often have insurance provided with their job.

But if you look at how children and working age adults get coverage, you see that kids fare much better because we’ve created a safety net with Medicaid and CHIP that provides access to affordable coverage for children in low-income families.  In Texas today, most of the parents whose kids get Medicaid do not qualify, and poor adults without children do not qualify at all. Only adults who are elderly, fully disabled, pregnant women, and a small handful of parents with almost no income can get Medicaid today.  The income-eligibility level for parents—$308 per month for a working parent with two children—has not been increased by the Texas Legislature since 1985.  Parents working just 10 hours a week at minimum wage will earn too much too qualify for Medicaid (but far too little to afford private health insurance).

Expanding Medicaid eligibility to everyone who is living in or near the poverty as proposed in national health reform bills will dramatically increase access to affordable coverage for low-income Texans and make roughly a million low-income uninsured adults in Texas eligible for Medicaid.