德州的 历史 with streamlining enrollment into public benefits has been a roller coaster of ups and downs. 在90年代早期, Texas was one of the first states to take the innovative step of trying to create a single application for multiple public benefit programs. But after “welfare reform” in 1996, participation in 医疗补助计划 dropped to historic lows as families, no longer eligible for cash assistance, did not realize their children were still eligible for health care coverage. 然后在2000年, with the creation of the Texas Children’s Health Insurance Program (芯片), came a wave of energy and state investment into outreach and enrollment, which had spillover effects into children’s 医疗补助计划 and enrollment improved over所有. 然而在2006年, the entire eligibility and enrollment system came crashing down as Texas Health and Human Service Commission (HHSC) was transitioning to a newer system which would integrate 所有 programs. It took years but eventu所有y the Texas Integrated 招生 Redesigned System (TIERS) became the modern, 非常高效。, eligibility system promised by the state. In 2014, the 负担得起的医疗法 raised the bar and required states to streamline eligibility even further by using available technologies to reduce administrative burdens on clients.
Instead of fully embracing the ideas set forth by the ACA, Texas HHSC responded by changing eligibility policy and essenti所有y eliminating continuous coverage for children in 医疗补助计划. This led to 3 years of flat enrollment in the children’s 医疗补助计划 program between 2014 and 2017. Beginning in December 2017, enrollment in 医疗补助计划/芯片 and 提前 has been on a steady decline. Recent declines likely result from lack of funding for outreach and enrollment efforts, fears of mixed-status families to enroll themselves and their children in benefits, and deliberate decisions made by state leaders which stymie enrollment and increase churn.
