Health Care Coverage and Access for Children in Low-Income Families: Stakeholder Perspectives from Texas

An important question to ask about any health care system is how well it serves children in low-income families. In Texas, the question raises optimism as well as serious concerns. On one hand, the proportion of eligible Texas children enrolled in Medicaid or the Children's Health Insurance Program (CHIP) has increased from 75 percent in 2008 to 84 percent in 2013. The passage of the Affordable Care Act (ACA) in 2010 and the reauthorization of CHIP in 2015 helped to protect these gains. But significant uncertainties persist. Texas has not expanded Medicaid as envisioned by the ACA; the introduction of the federal health insurance Marketplace was highly contentious in thestate; and the U.S. Congress has funded CHIP only until 2017. Moreover, there is concern in Texas that access to high quality health care services for low-income children is not keeping pace with access to insurance. This issue brief was prepared as part of a small-scale qualitative study funded by the David and Lucile Packard Foundation to convey recent positive developments, remaining unmet needs, and emerging issues in children's health care coverage and delivery, from the perspective of knowledgeable stakeholders. Companion issue briefs on children's health in California and Colorado and a cross-state analysis are also available