| Perspectives on Texas

As Congress nears the finish line of reforming the tax code, it appears to have made the choice to put the issue of sick children on the backburner until tax legislation has been resolved.

As a pediatric cardiologist, I know firsthand: This is a risky game to play.

Earlier this fall, Congress allowed the Children’s Health Insurance Program (CHIP) to expire. The program provides health insurance for about 394,000 children in Texas, plus another 249,000 who CHIP helps fund through Medicaid, according to the Texas Tribune. It also provides coverage to about 36,000 pregnant women.

Initially, the situation was concerning, though not completely alarming. So far, states have cobbled together money from various sources to keep the program running, despite Congress’s failure to renew it.

But now, we’ve entered new territory. Texas officials have said they may need to close down the CHIP program by January if Congress fails to renew it. Texas already has more uninsured people than any other state. Without CHIP, our state’s count of uninsured will rise by another 15 percent.

These are staggering numbers that represent real people, For example, I first met one of my absolute favorite patients, a five-year-old, when I began treating her for a congenital heart condition. She went into cardiac arrest three times the first night I encountered her. I thought she was going to die, but amazingly she survived, and I was able to see her grammar school graduation and later her high school graduation. She died suddenly at age 19, after she stopped taking expensive medication when state-funded coverage ran out. Programs like CHIP and Medicaid are real lifelines to people whose very lives depend on them to function as intended.

Her death spurred me into a new career in public health to see what could be done to change our policies.

CHIP covers a variety of treatments beyond illness. For example, it allows kids to get help with mental health and substance abuse issues, to hopefully get teens on track as adults. It covers dental work, which is critically important because a third of children miss school due to dental problems. When that happens, parents wind up missing work.

But CHIP is running out of time, and Texas — along with other states — will soon send out notices telling parents that their children’s health insurance is about to end. This is a pending disaster for ill children and pregnant women.

The good news is Congress likes CHIP. The bad news is Congress has been preoccupied, and the CHIP reauthorization has been eclipsed by other legislative priorities.

If CHIP is stopped, government workers who administer it will find other work. It will take a long time to rebuild a program that functions well.

There’s no debate: CHIP saves lives. Consequently, when you jeopardize CHIP, you jeopardize kids’ lives. It’s time for Congress to reauthorize CHIP before Texas and other states start winding the program down and going down a path that may be impossible to reverse.