Children’s Defense FundTrue Stories of Uninsured Texas

Children

Insure Texas Kids Campaign / Texas CHIP Coalition

Coming to Texas Legislators February, 2007

ABOVE THE LIMIT

Everett Family• The father’s employment in pest

control provides about $35,000 annually. The winter months are typically slow.

• The mother is wheel-chair bound with MS and has significant healthcare expenses.

• New CHIP guidelines do not count children over 18 as family members. Even though their full-time student daughter lives at home, she is not counted as part of the family size. As a result, they are $100 over the income limit for a family of 3.

• The entire Everett family is uninsured.

ASSETS

• Single mother works full time and attends school part time through the GI Bill as a veteran.

• Her three children ages 8, 6 and 4 were disqualified from CHIP because she co-signed for a friend’s vehicle.

Dumas Family

Garcia Family• The 2 parent Garcia family

lives in Beaumont where their old house suffered extensive damage from Hurricane Rita.

• The family received an insurance payment for repair of damages and was disqualified from CHIP after 7 years of continuous coverage when that check was counted against them as liquid assets.

• Gabriella missed 29 days of school last year because of severe migraines and skin allergies.

“CHIP provides confidence and peace of mind.”

RED TAPE

Devante Johnson, age 13Diagnosis: Advanced Cancer of the Kidneys•Mother submitted renewal 2 months before Medicaid expiration.•Medicaid renewal sat for 6 weeks without processing.•Devante determined eligible for CHIP - application transferred to Accenture.•Paperwork was lost in the system and despite numerous calls and faxes, Devante’s mother was unable to track the application.•State Representative intervened to restore coverage.

• Devante is now being treated at MD Anderson in Houston.

• When he lost coverage, he could not receive regular treatment and relied on clinical trials for care.

• Eligible child was uninsured for 4 months while tumors grew.

Rohrer Family• Tried for 5 months to apply for CHIP without success.• CDF intervened to get the children covered in September 2006. • Matt suffers from manic depression and ADHD and his sister

Tasha suffers repeated fractures due to a brittle bone condition. • Paid $50 premium in September, more than the $35 required.• On October 25th, received a letter requesting they pay their

premium by July 17th or the children would lose coverage.

“The fact that children’s health insurance programs are in place but children are unjustly being denied benefits should boil every Texan’s blood.” -Karen Rohrer

Cannon Family• Teri Cannon is a stay at home

mom with 2 young boys. Her husband is a PhD student at Rice.

• 4 year old Jason receives CHIP and 1 year old Ian has Medicaid.

• Jason went without coverage for 4 months while renewing CHIP.

• Family was Medicaid income eligible but their assets made them eligible for CHIP.

• Jason has chronic asthma with a major episode every 6 weeks usually brought on by a common cold. While uninsured, his medication ran out and he was sick several times.

“I want lawmakers to know that our family is not abusing the system. Someday we’ll be professionals, earning just as much as they do. Right now we’re a student family and there’s no other affordable option out there.”

-Teri Cannon

Nedbalek Family

• Family lives in rural Granite Shoals (west of Austin) on an unpaved road with limited services.

• Long-time Medicaid clients experienced a difficult transition when children became eligible for CHIP. Children were uninsured for six months due to:

• - Lack of smooth transition between Medicaid and CHIP

• - Information was lost despite numerous mailings and faxes

• - Recorded as a family of 3, instead of 5

• - Enrollment cards never arrived in the mail

• Family purchased 2 months of private coverage at $450/month (17% of family income) through husband’s employer. During that time, the family had difficulty buying groceries. He then changed jobs for better pay and lost coverage.

• While uninsured, one child broke a tooth and the other developed a fever. The family could not afford to take the children to the doctor or dentist.

Bazile Family

• The Bazile family was forced to evacuate from New Orleans during Hurricane Katrina.• LA CHIP’s 30 day process from start to finish turned into a yearlong nightmare for Texas CHIP processing.•The family did not receive any communication for a month and a half after applying and was required to provide numerous forms of “missing information.”

Sydney and Paris Bazile remained uninsured one year after the storm because paperwork was mismanaged.

What happens when coverage ends?

Sorrels Family• Two parent working

family from Bridge City (east of Beaumont).

• Kevin went without coverage for 2 months.

• His medications for Cerebral Palsy cost $1200/ month.

• Family cut back on food and rationed medication while he went without coverage.

Shelton Family• Two parent working family lives in

Carrollton, north of Dallas.

• 9 year old Tommy suffers from Graves disease and Type I Diabetes, two auto immune conditions with high risk for developing a third.

• Lost coverage and went without medical care for 3 months, during which time his ear tubes got infected.

• Graves disease spiraled out of control because he was unable to see the endocrinologist.

• Result: rapid heart rate, unrest, nervousness and exhaustion. Lack of treatment for juvenile diabetes can result in coma, even death.

• Family struggled to provide $1000/ month in medications.

“You can get signed up but you can’t remain on the program – it is an incredibly frustrating process. There needs to be accountability on what taxpayers are spending. I deserve better. I need accountability for the way lawmakers are spending my money.”

-Barbara Shelton

Barbara BestTexas Executive Director

4500 Bissonnet, Suite 260Bellaire, Texas 77401T: 713-664-4080F: 713-664-1975www.cdftexas.org

Children’s Defense Fund