AUSTIN — The non-partisan, non-profit organization Texans Care for Children released two reports this week with concerning findings: The Texas Legislature has cut funding for programs to help babies and toddlers born with disabilities and developmental delays. And Texas has the highest rate of uninsured children in the nation.
In Texas This Week, Ashley Goudeau sits down with Peter Clark, Communications Director of Texans Care for Children, to talk about the reports.
Ashley Goudeau: Texans Care for Children recently released a report about the Early Childhood Intervention funding. Talk to me about what you guys found.
Peter Clark: "Sure. So first of all, this report is available on our website TXChildren.org if people want to learn more. Our report focuses on the decisions the Legislature has made to cut funding for Early Childhood Intervention, also known as ECI. What is ECI? ECI is a great program. It focuses on kids that are under age three, so our babies and toddlers in Texas that have developmental delays or disabilities. So that might be Autism, that might be Down Syndrome, it might be speech delays, or other challenges babies and toddlers in Texas face. Through this program, the state contracts with community organizations like Easter Seals, Any Baby Can is one of the organizations here in Austin, and these organizations do a great job of providing services to these babies and toddlers to help them meet their developmental goals. And that's going to depend on each kid. It might be learning to communicate with their family, it might be learning to walk, for a lot of these kids this is about getting them ready to start school a few years later. So our report, unfortunately, found that the Legislature has been cutting funding for this program over the last several years and that's had real consequences. One of the most concerning results of those cuts is that programs are shutting down around Texas. And this is something that the state's Health and Human Services Commission has recently warned the Legislature about."
Goudeau: When you talk about a reduction in funding, how much money are we talking here?
Clark: "Great question. And there's been reductions in multiple ways. So this report looked at the amount of funding provided by the legislature per child enrolled in ECI. And we found a 15 percent reduction over the last several years. If you look at funding, the direct dollar amount provided to ECI by the Legislature, without accounting for the number of kids, that has also declined over the last several years. We'll give the Legislature a little bit of credit, they did make a small increase last session, but overall the funding has declined for ECI in terms of the direct funding provided by the Legislature. The Legislature has also cut funding for ECI in sort of an indirect way. You might recall, your viewers might recall, the last couple of years there's been a lot of controversy around the Medicaid payment rates for kids with disabilities. The Legislature, some members of the Legislature seem to regret their decision to cut those rates in 2015. There was an attempt during the last legislative session to put some of that money back in. They ended up putting a little bit back in but essentially we have a cut in funding for the Medicaid payment rates, we have a cut in funding directly for ECI and this has been a double whammy for these ECI providers. Both of them are really squeezing these organizations and it's a big part of why we've seen so many programs shut down around the state."
Goudeau: When it comes to those cuts, there are a lot of people who would say the state has a lot of things to pay for, including stuff with our education system that we're constantly hearing about, Medicare, Medicaid, so there's not always enough money to go around to fund everything. So for some people who might say why should they be funding this or why not make a few cuts there, 15 percent isn't that much. What would you say to those folks?
Clark: "So there obviously are other priorities in the budget, there are also things that the legislature has chosen to spend money on that we might argue are not as high of a priority as this. You know one example is a couple of times, over the last several years we've seen these cuts to ECI. We've also seen cases where the Legislature has passed huge tax cuts for businesses. And some people may question is that a higher priority than making sure that these babies and toddlers are getting off to a good start in life? We would argue that putting a little extra money into ECI is the higher priority."
Goudeau: Right and then some would also ask, "Why should the state be funding this? Why should the state be paying for this?"
Clark: "Great question, so I would point out kind of three reasons. For one, it's just the right thing to do, it's the compassionate thing to do. You might argue it's the moral thing to do, but even if you don't believe that argument, it's the smart thing to do. We know that when we help these kids early through ECI, we end up spending less money later on special education. It just makes sense, you help kids early on and you're going to save money down the road, the kids are going to be more successful down the road. But let me give you a third reason: We are legally required to do it. Federal law says that states have to provide these services to children under age three. And the federal government is starting to wonder if we're really doing that. The U.S. Department of Education is taking a look to see if we are meeting the state's obligation to provide these services. As these programs shut down around the state, it's become harder for families to enroll."
Goudeau: As if these cuts to ECI funding wasn't enough, you guys are also releasing this week a study that you did in joint with the Georgetown University Center for Children and Families that looked into insurance rates for children, and it doesn't look good for Texas.
Clark: "It does not look good. I wish I was here with better news today but the ECI report does not look good, and this report on uninsured kids in Texas does not look good either. Texas has the worst rate in the nation when it comes to uninsured rates for children and we actually got worst last year compared to the prior year. So that is another area to really be concerned about."
Goudeau: When we say "got worse" give us some stats, give us some numbers and what contributes to that?
Clark: "So right now, about 11 percent of Texas kids are uninsured. It was about 10 percent the prior year. We have seen this trend nationwide over the last year or two. Congress and the administration have taken a number of steps on health care that have really undermined our health care system, made it harder for people to sign up for insurance on healthcare.gov for example. Have kind of scared some families away from signing up for Medicaid or CHIP if they think that could effect the immigration status of someone in their family. So nationwide, over the last year, we've seen a decline in insured rates for kids. Here in Texas, we are doing a particularly bad job. It just hasn't been a priority for our state leaders over the last several years. Insurance for kids and insurance for adults sadly has not gotten the attention that it needs. Not only do we have the highest uninsured rate for kids in the country, but Texas has the worst uninsured rate for adults in the country. And we think it's time for our state leaders to work on a plan to reduce that uninsured rate."
Goudeau: And if you have insurance and you're thinking, "OK, that's their problem, not my problem," it is your problem because it means the rest of us have to pay more right?
Clark: "That's right. When people don't have insurance, that leads to so many problems. As you said, we all end up paying more. We end up paying more through property taxes, for example, that go to fund local health programs, local hospitals that are providing care to people who don't have insurance. Our high uninsured rate is also linked to so many other challenges. Maternal health, maternal mortality. infant health and infant mortality. That's an issue that's gotten a lot of attention. The more we can provide health insurance, the more progress we're going to make there. Mental health, substance use disorders, the opioid crisis, rural hospitals closing down. All of these issues, we will do such a better job as a state addressing them once we start bringing down our uninsured rate."
Goudeau: It's overwhelming, it can be, to take all of this kind of information in and it all seems as though it is bad news or news that's not exactly great for Texans. So what can the regular person do if they want to make a difference, if they want to try to help?
Clark: "So the Legislature meets in January. They'll be in session for five months so it's important for Texans to let their legislators know that these are priority issues and there are solutions. In the case of ECI, the state Health and Human Services Commission has told the Legislature if you can provide $71 million in additional funding during the next session, we think that will take care of it. In the case of health insurance, there are steps the legislature can take to help children directly and there are steps the Legislature can take to help adults and children. Because what we've seen in other states is that insurance for adults and insurance for children are really tied together. In the states that have accepted Medicaid expansion funding from Congress, this is funding that is used to provide an insurance option to construction workers, cooks, childcare teachers. People who don't get insurance from their jobs and don't make enough money frankly to afford insurance another way. The federal government has offered states funding to provide insurance to these folks and the states that have taken that to cover these adults, more of their kids are getting insured. As the parents connect with insurance, the kids connect with insurance. So we would encourage Texas to take that Medicaid expansion funding, cover these low-wage adults. If they don't want, if the Legislature doesn't want to do Medicaid expansion, let's come up with another strategy, let's come up with another plan, but let's bring that uninsured rate down for adults and for kids. We'll have healthier families, we're going to have a stronger economy, and we'll do a better job tackling some of these other challenges."
To find your state senator and representative and their contact information, click here.