Child Health

Op Ed: What If Texas Leaders Actually Cared About Healthcare?

July 31, 2019 | Texas

A Fairy Tale by CDF-TX Exec Director Patrick Bresette

icture this:


A vast, multicultural, technologically advanced state in a wealthy republic has found itself with a chronic problem: too many of their children are not thriving. Children are suffering from preventable illnesses, chronic conditions are going untreated, needed surgeries and other therapies are being delayed or foregone altogether.

This nightmare is not from lack of access to medical care. Doctors and medicine are plentiful. In fact, this state is home to some of the most advanced medical centers in the world. Puzzled by this, elected leaders call together panels of experts to uncover the root cause of this crisis.

What they discover is alarming. Children in the state are more likely to lack health insurance coverage than in any other state in the republic. Even more alarming, the rate of uninsured children is getting worse, not better.

The experts explain that without health insurance, children do not get the early and preventive care they need, do not stay connected to a medical home, miss necessary treatments, are sick and absent from school more frequently, and must make expensive emergency room visits far too often. The solution? Marshall all the forces of the state government to work with communities to identify uninsured children and connect them to affordable coverage options.

Fortunately, the state’s lawmakers learn all of this just before they are about to begin their legislative session. Key leaders in both the House and Senate file numerous bills to streamline access to public health care programs, fund community outreach and enrollment efforts and launch a public information campaign in partnership with health care providers and schools across the state. State leadership declares this an emergency item and the bills and funding are quickly approved. Within two years, the numbers of uninsured children are dramatically reduced and child health indicators begin to improve.

What a success story!

But of course, it’s fiction. And so is the proactive legislative body—at least in Texas.

Every other detail, however, is true.

  • Texas has the highest rate of uninsured children, uninsured women of childbearing age, and uninsured people in the nation.
  • There are more uninsured children here than in any other state.
  • Our child uninsured rate had been improving slowly for the last decade, but this trend has reversed. Now it’s getting worse.

When our legislators met in Austin this year, they saw many proposals, large and small, that would have addressed these problems in various ways. Yet they chose to reject almost all of them—even those that would have cost nothing.

The Children’s Health Coverage bill (HB 342 Cortez & SB 637 Zaffirini)—was the only legislative proposal designed to help keep children insured. It would have removed needless red tape in the Children’s Medicaid program and made sure that kids receive a full year of coverage—just like in any other insurance plan. With broad bi-partisan support it was reported out of the House Human Services Committee but stalled in the waning days. It never even received a hearing in the Senate.

Too many children and families in Texas already suffer needlessly from being unable to afford doctors and medicine. That number is likely going up. Just recently the Commonwealth Fund released their 2019 Scorecard on State Health System Performance. Texas ranks dead last in healthcare access and affordability. Yet our legislative leadership continues to pretend there is no problem.

If lawmakers think Texans are going to tolerate any more inaction from them on healthcare, they’re living in a fantasy land.


Written by CDF-Texas Executive Director Patrick Bresette,