TEXAS MEDICAL ASSOCIATION HOUSE OF DELEGATES
Resolution 405 (A-06)
Subject: Health Care of Texas Children
Introduced by: John R. Asbury, MD
Referred to: Reference Committee on Socioeconomics
Whereas, Texas continues to lead the nation in uninsured health care for children; and
Whereas, The Children's Health Insurance Program (CHIP) in Texas has had decreasing enrollment over the past several years; and
Whereas, The future of Texas depends upon healthy, well-educated young Texans; and
Whereas, Access to health care requires adequate financial resources for patients and adequate reimbursement for physicians; and
Whereas, The low reimbursement rate that physicians receive for care of Texas Medicaid and CHIP patients is causing a significant access-to-care problem for many children; therefore be it
RESOLVED, That the Texas Medical Association House of Delegates commend TMA leadership for its ongoing efforts to improve the care of Texas children and, in particular, the efforts of TMA President Robert T. Gunby Jr., MD; and be it further
RESOLVED, That the TMA House of Delegates encourage TMA leadership to continue working for reasonable reimbursement so that the excellent health care that physicians provide will be accessible to all Texas children.
Relevant TMA Policy
55.029 Children's Health Insurance Program . The following policy principles guide the Texas Medical Association's advocacy on the Children's Health Insurance Program (CSE/CM-CAH Joint Rep. 1-I-98):
(1) CHIP eligibility should be offered to the highest extent allowed by federal law;
(2) CHIP should be administratively simple for patients, physicians, and health care providers;
(3) CHIP should promote parental responsibility for health care services by setting fair, but simple cost-sharing arrangements;
(4) Information about CHIP should be readily available to parents and providers;
(5) CHIP's benefit package should address the physical and mental health care needs of children. Appropriate medical specialists, such as pediatricians and child psychiatrists, should guide the benefit package's design;
(6) CHIP should benefit children with special health care needs;
(7) CHIP participants must have access to physicians and facilities trained in pediatric health care, including pediatric subspecialists and children's hospitals;
(8) Texas should actively explore using a private sector model for CHIP, including options to allow families to enroll in existing employer-sponsored health care plans, medical savings accounts, and other private insurance vehicles;
(9) Children enrolled in CHIP should be assured a choice of physicians and health plans;
(10) CHIP participating plans should establish appropriate incentives to encourage patients' use of a "medical home;
(11) Texas should simplify Medicaid eligibility standards and enact presumptive eligibility for children in CHIP and traditional Medicaid;
(12) Texas should implement 12 month continuous coverage for CHIP and traditional Medicaid participants;
(13) Mechanisms should be implemented to protect safety-net facilities' patient bases;
(14) Health care providers participating in CHIP should be assured adequate reimbursement;
(15) Texas should allocate dollars to secure federal CHIP funds;
(16) Standards governing health plan access, quality, and financial stability should be applied to participating CHIP health plans;
(17) CHIP should be overseen and reviewed by a state interagency advisory committee;
(18) Oversight of CHIP should include a clinical advisory committee to advise the state on emerging pediatric services, procedures and pharmaceuticals and to recommend changes to the benefit package; and
(19) Texas should establish a mechanism for timely, appropriate, and ongoing provider and public input into CHIP.
TMA House of Delegates: TexMed 2006