55.029 Childrens Health Insurance Program Policy Principles


55.029 Children’s Health Insurance Program: The following policy principles guide the Texas Medical Association’s advocacy on the Children’s Health Insurance Program:

  1. CHIP eligibility should be offered to the highest extent allowed by federal law;
  2. CHIP should be administratively simple for patients, physicians, and health care providers; 
  3. CHIP should promote parental responsibility for health care services by setting fair but simple cost-sharing arrangements; 
  4. Information about CHIP should be readily available to parents, physicians, and other health care providers; 
  5. CHIP’s benefit package should address the physical and mental health care needs of children including access to all FDA-approved contraceptive medication and devices. Appropriate medical specialists, such as pediatricians and child psychiatrists, should guide the benefit package’s design; 
  6. CHIP should benefit children with special health care needs;
  7. CHIP participants must have access to physicians and facilities trained in pediatric health care, including pediatric subspecialists and children’s hospitals;
  8. Texas should actively explore maintaining a private sector model for CHIP, and examine options allowing families to enroll in existing employer-sponsored health care plans, medical savings accounts, and other private insurance vehicles;
  9. Children enrolled in CHIP should be ensured a choice of physicians and health plans;
  10. Plans participating in CHIP should establish appropriate incentives to encourage patients’ use of a “medical home”;
  11. Texas should simplify Medicaid eligibility standards and enact presumptive eligibility for children in CHIP and traditional Medicaid;
  12. Texas should implement 12-month continuous coverage for children enrolled in CHIP or traditional Medicaid;
  13. Mechanisms should be implemented to protect safety-net facilities’ patient bases;
  14. Health care professionals participating in CHIP should be ensured adequate competitive reimbursement;
  15. Texas should allocate dollars to secure federal CHIP funds;
  16. Standards governing health plan access, quality, and financial stability should be applied to participating CHIP health plans;
  17. A state interagency advisory committee should oversee and review CHIP;
  18. Oversight of CHIP should include a clinical advisory committee to advise the state on emerging pediatric services, procedures, and pharmaceuticals, and to recommend changes to the benefit package; and
  19. Texas should establish a mechanism for timely, appropriate, and ongoing provider and public input into CHIP (CSE/CM-CAH Joint Rep 1-I-98; amended CSE Rep 1-A-08; amended CSE Rep. 1-A-18). 

Last Updated On

August 20, 2018