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FOR RELEASE WITH A.M. PAPERS ON

FRIDAY, JANUARY 30, 2004

NATIONAL REPORT CITES TEXAS FOR

PROBLEMS AND PROGRESS IN HEALTH CARE

WASHINGTON, D.C. (January 30, 2004) – An assessment of health care in the 50 states, released here today, singles out Texas for policies that have caused the state to rank dead last on lists of children and adults who are covered by public or private health insurance. The report appears in the February 2004 issue of Governing magazine.

Texas has the highest rate of uninsured children in the country. After lagging many other states in utilizing the State Children’s Insurance Program--which receives high levels of matching dollars from the federal government--the state is now pulling back once again by putting up barriers to enrollment in its health programs. This includes instituting waiting periods for coverage, creating an asset test for new enrollees and changing the rules for income calculation in a way that makes it more difficult to qualify. All this has led to a one-year decline of 100,000 children covered.

Adults fare no better in the Lone Star State, which dropped into 50^th place in its rate of insured adults last year. Texas has low rates of employer coverage, covers parents only at very low income levels and has no coverage for childless adults. Cutbacks in Medicaid eligibility and the elimination of the state’s medically needy program in 2003 will only compound the problem.

The report included some praise for the state as well. For example, it is a model for other states in its sophisticated approach used to determine the relative benefits of various regimens of psychotropic drugs for the mentally ill. It has also been a leader in the long-term care field, by actually moving people out of nursing homes back to more independent settings, with the dollars spent on institutional care following them back to the community.

“Texas is clearly trying to make efforts to improve its state-funded health care for many,” says Katherine Barrett, co-author of the report. “But the sheer numbers of children in the state who aren’t receiving coverage is very short-sighted. Preventive care for kids isn’t only humanitarian. It saves money in the long term.”

Governing’s analysis of state-funded health care is part of the Government Performance Project, a six-year-old effort, funded by the Pew Charitable Trusts, to evaluate a wide range of state government management and policy functions. This year’s special report focuses on six critical health care problems facing states: long-term care, public health, mental health, prescription drugs, access to care for the uninsured, and care for children.

The Government Performance Project found and documented the inability of the 50 states’ health care system to deliver improvements in medicine fairly and consistently to many of their citizens. Health care in most states is not just inadequate, the study concluded--it’s deteriorating. “After exhaustive analysis and hundreds of interviews,” says Peter Harkness, Governing’s publisher and editor, “it became clear that there is a health care crisis in America. But it is in no way a medical crisis. It is a fiscal crisis.”

Governing is a policy and management magazine aimed at high-level state and local government officials. An online version of this report will be available at http://www.governing.com/gpp/2004/intro.htm as of January 29. Press releases for each of the 50 states can be found at http://www.governing.com/gpp/2004/press.htm.

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