What can cause improvements like that? No doubt, a lot is at play. But, with swings so large, public policy is often a part of the story.

Here in Texas, between 2003 and 2011, our state shored up Children’s Medicaid and CHIP, cutting red tape in two systems that help kids throughout Texas see a doctor when they need to. The result? The number of uninsured children fell by hundreds of thousands in recent years, even as our overall child population grew.

What’s more, as more kids got covered, more families reported good news about their children’s health. Check out the trends.

No surprise, Texas still has the worst uninsured ranking in the country, with 6.08 million uninsured (23.8% of all Texans).  This is a teeny bit better than last year’s 24.6% uninsured rate—just barely “statistically significant.”

But the picture remains brighter for Texas kids, whose uninsured rate is stable at 16.3% of kids under age 19 (1.2 million uninsured Texas kids).  Only in Texas could we celebrate moving to 49^th from last place, but Nevada has now solidly claimed the worst-kids’-coverage spot with their 19.3% child uninsured rate.

Of course, 1.2 million uninsured children is nothing for Texas to applaud—we have about 9 uninsured children for every one in Nevada.

Another interesting factoid:  of our 1.2 million uninsured Texas children, around 740,000 are children under the CHIP income cap who are either US citizens or legal residents.  That means—you guessed it—they could be enrolled in Medicaid or CHIP, but they aren’t!  So, clearly we still have loads of work to do educating Texas parents about their options and making it easier than ever for eligible kids to get care and keep their care.

Forgive me if I can’t resist talking a little bit about our Texas parents who lack health coverage.  Texans are much less likely to get health care through their job (or spouse or parent’s job) than in the US as a whole.  Barely over half of Texans are covered this way 50.6% (compared to US 55.1%).  And, working-age adults here have an uninsured rate that is nearly twice what our kids face: 30.9% or nearly one in three adults 19 to 64.  The why is simple; Medicaid and CHIP are there for our poor and low-income kids, but Texas adults don’t have those options.

Other signs on my deep dive of the importance of Medicaid and CHIP for children: both the number and percentage of Texas kids with private insurance has dropped in the last four years, but the number and percentage of kids with Medicaid and CHIP has taken up the slack.  The only group of Texas children whose uninsured rate went up was those kids just over the CHIP limit, in families between 200-300% FPL.

There is some good news about “really big kids, ” too: uninsured rates improved significantly for Texans 19-25 since 2010, who now have new options to stay on a parent’s health plan until they hit their 26^th birthday.  You can really see the impact in the numbers, because the uninsured rate for Texas adults 26-64 did not improve at all.

O.K., time to dive back into the numbers again.  Stay tuned for an update on how Texas uninsured would fare under the ACA’s private and public health coverage options in 2014!

Written by: Anne Dunkelberg, Center for Public Policy Priorities

In the three years since CHIP’s reauthorization, the nation has made historic gains in covering kids. Thanks to CHIP and Medicaid, over 3 million Texas children can get the checkups and preventive care they need to stay healthy and see the doctor when they get sick or injured. Children across the country have benefitted from the law. In the past year alone, 25 states have reduced the red tape in their CHIP and Medicaid programs, so that more kids can get covered. While we won’t consider the job done until every child is covered, there is progress to celebrate: between 2007 and 2011, more than 800,000 formerly uninsured Texas children gained coverage.

The McCuistion girls are among Texas kids covered by CHIP

One of the main reasons for these impressive gains in coverage happens behind the scenes: Texas’s Health and Human Services Commission, the agency responsible for processing paperwork for CHIP and Medicaid, has made great strides in improving efficiency and accuracy in the enrollment process for families. In Texas, we have cut red tape. Our state was once among the nation’s worst offenders for unnecessary processing delays and errors that left families who qualified for Medicaid or CHIP and played by all the rules, nonetheless, without access to health care for their children. Today, Texas is one of the country’s most improved states for processing benefits—something we can all be proud of. It means we are living up to our promise to families with children who need to see a doctor.

The “maintenance of eligibility” requirement in the health reform law has also helped countless Texans. The rule provides important stability for families facing economic uncertainty by ensuring states like Texas keep enrollment procedures that are already working for our families on the books.

And CHIP and Medicaid help more than just the families whose children receive care through the program. CHIP and Medicaid strengthen our economy. If Texas can make improvements to and enroll more children in CHIP, the state can begin to qualify for an annual Performance Bonus, which puts federal tax dollars back into our economy and protects local jobs.

We are encouraged by the progress that has been made but recognize that there is still more to do. We are working with state leaders to ensure that CHIP and Medicaid help even more uninsured children get the care they need to grow and thrive in 2012. Let’s celebrate this anniversary by committing to keep building on its success.

Contributed By: Christine Sinatra, Austin, TX