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Table 8. Texas SCHIP Policy Changes, 2003-2004Legislation in 2003 Changes in 2004Continued coverage for all currently covered populations,including state-funded populationsMaintained income eligibility at 200% of Federal PovertyLevel ($36,800 for a family of four)Eliminated deductions to income so that eligibility is basedon gross incomeRestricted eligibility for families at or above 150% ofFederal Poverty Level to those with assets withinallowable levels (no assets test previously)Allowed establishment of cost-sharing (i.e., co-pays andmonthly premiums) at federal maximum levelsChanged term of coverage (continuous eligibility period)from 12 months to 6 monthsEstablished a 90-day waiting period between eligibilitydetermination and coverage (no waiting period previously)Reduced provider payment rates by 5%Directed that a Preferred Drug List (PDL) beimplemented, with prior authorization required forprescribed drugs not on the PDLLimited the benefit package to coverage of basic healthcare servicesMost behavioral health services were discontinued, exceptfor one outpatient diagnostic visit per enrollment period,six medication management visits per enrollment period,and consultation in an inpatient or emergency setting afterstabilization of an emergency conditionSome rate cuts have been changed from 5% to2.5%Notes: HHSC has limited authority to expand thebenefit package if it remains budget-neutral;HHSC is also authorized to develop alternatefinancing and service delivery methods forbehavioral health services.Some substance abuse and mental health serviceswere restored in 2004 (effective retroactively toSept. 1, 2003) due to concerns from the federalgovernment.*These services were discontinued: dental, hospice care,skilled nursing facilities, tobacco cessation programs,vision benefits (including eyeglasses and exams),chiropracticSources: Texas Health and Human Services Commission, CHIP Policy Changes, 78th Legislature, Regular Session,2003 (September 2003), available at http://www.hhsc.state.tx.us/news/post78/CHIP_Policy_Changes.html,accessed January 2, 2004; and Center for Public Policy Priorities, Update on Medicaid and CHIP Cuts: WhatWas Restored in Recent Actions? (September 2004), available at http://www.cppp.org/products/PP217.html,accessed January 2, 2005.* For more on substance abuse and mental health cuts in SCHIP, see Kaiser Family Foundation, Daily Health PolicyReport, State Watch: Texas To Partially Restore CHIP Program Coverage of Mental Health, Substance UseTreatment (October 22, 2003), available at http://www.kaisernetwork.org/daily_reports/rep_index.cfm?hint=3&DR_ID=20489, accessed January 5, 2005.A number of groups have been working to restore the cuts made to SCHIP, such as TexasImpact and the Community Action Network. 124,125 Recommendations have been made and billshave been filed for the 79th Texas Legislature in 2005 that aim to restore previous cuts, changeother aspects of the program, or to maintain some of the previous changes. For example, theB-28