If Congress Doesn't Fund CHIP, Thousands Of Pregnant Texans Will Lose Health Insurance, Too

Nov 28, 2017

If Congress doesn’t reauthorize funding for the Children’s Health Insurance Program (CHIP) soon, it's not just Texas children who could lose access to health insurance; thousands of pregnant women could lose coverage, too.

Texas doesn't run the program without federal funding, and officials say it's set to run out of money Jan. 31. By law, state officials must give families 30 days' notice that the program is shutting down, so families could be getting letters next month.

Besides the 450,000 children in Texas who receive health care through the program, about 35,000 pregnant women here also rely on CHIP for prenatal and postpartum care. These are mostly women who don’t make a lot of money, but who don’t qualify for Medicaid.

Anne Dunkelberg, an associate director with the Austin-based Center for Public Policy Priorities, says the program covers mostly immigrant women – both undocumented and documented.

“Texas is one of only six states in the United States that doesn’t provide Medicaid maternity care to our lawfully present immigrants,” she says. “So the women who have green cards – who are called legal permanent residents of the United States – we exclude them.”

Dunkelberg says federal health officials decided during the George W. Bush administration to extend CHIP to these pregnant women – or more accurately, their unborn children.

“The services that that woman qualifies for have to all be related to the child,” says Laura Guerra-Cardus, deputy director of the Children’s Defense Fund in Austin. “So, if the woman breaks her arm or she gets pneumonia or something like that – that’s actually not covered with CHIP.”

The argument behind the policy was that once the children are born, they will be U.S. citizens and probably be covered by CHIP or Medicaid. So, the program is just reaching those future U.S. citizens early.

But, if CHIP goes away, those low-income women – and their unborn children – won't have another affordable option for health insurance.

Guerra-Cardus says she asked an outreach worker in the valley what families will do if CHIP ends. "'She says, ‘They are just going to show up to the hospital on delivery day.’”

Dunkelberg says that’s not the way women should be getting care.

“We want women to get a full complement of prenatal visits," she says, "and we want to make sure they get checked up afterward, too."

Both Dunkelberg and Guerra-Cardus say getting rid of CHIP for those pregnancies could lead to bad health outcomes for the women and their babies.

Guerra-Cardus says considering what’s going on in Texas, this could make a bad problem worse.

“In our state, that’s dealing with such a high level of maternal mortality, you know, this is a wrong direction to go,” she says.

Texas has one of the highest maternal mortality rates in the country. A few years ago, the rate of women who died while pregnant or right after giving birth doubled. Experts have said access to medical care early in a pregnancy is one way to decrease those rates.

Texas officials have asked the federal government for money that would keep the program running at least through February.