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Children’s Defense FundTrue Stories of Uninsured Texas
Children
Insure Texas Kids Campaign / Texas CHIP Coalition
Coming to Texas Legislators February, 2007
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ABOVE THE LIMIT
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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.
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ASSETS
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• 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
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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.
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“CHIP provides confidence and peace of mind.”
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RED TAPE
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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.
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• 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.
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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.
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“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
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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.
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“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
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Nedbalek Family
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• 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.
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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.
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What happens when coverage ends?
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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.
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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.
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“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
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Barbara BestTexas Executive Director
4500 Bissonnet, Suite 260Bellaire, Texas 77401T: 713-664-4080F: 713-664-1975www.cdftexas.org
Children’s Defense Fund