Texas Officials Consider Enrollment Limit, Other Changes to Cover CHIP Budget Deficit

Officials with the Texas Health and Human Services Commission are considering reducing enrollment and delaying services in the state's CHIP program in order to cover a $29 million shortfall, the Houston Chronicle reports (Hughes, Houston Chronicle, 1/8). The deficit stems primarily from higher-than-anticipated enrollment and renewal rates in the program since its inception in May 2000. More than 500,000 children have enrolled, exceeding what lawmakers expected when they completed the budget for the 2002-03 fiscal year. If the shortfall is not covered, it could grow to more than $100 million by August 2003 (AP/Ft. Worth Star-Telegram, 1/9). State officials are now considering several options to reduce the deficit, including capping enrollments, limiting enrollments to "specified times," requiring children to enroll twice a year and "delaying" the start of services after enrollment (Houston Chronicle, 1/8). Officials also are considering an enrollment "freeze" and starting a waiting list. "If we don't at least consider some program design changes, we're going to be in a deficit spending pattern over the next two years," HHSC spokesperson Charles Stuart said (AP/Ft. Worth Star-Telegram, 1/9). He added that HHSC has not set a "time frame" to make a decision on how to cover the shortfall for the program, which has a two-year budget of $1.4 billion (Houston Chronicle, 1/8).

Advocates Push for Funding
According to advocates, instead of cutting back on enrollment and services, which could lead to a greater number of uninsured children, the state should allocate funds to cover the deficit. Dr. Fernando Guerra, director of health for the San Antonio Metropolitan Health District, said, "The state has to find the resources to make it work. ... You don't entice people who for the first time have some hope, and then take it away" (AP/Ft. Worth Star-Telegram, 1/9). Advocates also said the enrollment numbers are not the sole reason for the budget problem. Eva DeLuna Castro, a policy analyst with the Center for Public Policy Priorities, said that lawmakers shifted $33 million in CHIP funds to cover Medicaid expenses during the last legislative session. Stuart, the HHSC spokesperson, said that if the state finds a way to cover the $29 million "based on actual demand for the program," the federal government would distribute an extra $69 million in matching funds. Lisa McGiffert, a health policy analyst with Consumers Union, said, "Hopefully (CHIP's) success won't be its demise" (Houston Chronicle, 1/8).