texasmonthly.com: Where did the idea for this story come from? Was there any particular issue that prompted doing it now?

Pamela Colloff: I thought it was important to do this story before January, when the next legislative session begins. What prompted me to look into this story was reading in the newspaper that Texas has the highest percentage of uninsured children in the nation. Texas is often in the bottom quarter when it comes to state rankings, but I thought it was pretty remarkable that Texas was dead last when it came to kids and health insurance. As I did my reporting, I started focusing more on the Children’s Health Insurance Program (CHIP).

texasmonthly.com: How did you come into contact with the Garcias, the Botellos, and Michelle Nunez?

PC: I interviewed around 25 families, which I found through doctors, social workers, and advocates around the state as well as through local health clinics and emergency rooms. I focused on the three families that you mentioned because each of their situations illustrated a particular problem that I wanted to address.

texasmonthly.com: What are some of the ways families without insurance are trying to cope with medical issues?

PC: Many families without health insurance use home remedies when their children are sick, or stretch out the intervals between doses of prescription drugs that their children need, or just postpone their kids’ medical care. If those solutions don’t work, they are often seeking out medical attention in emergency rooms.

texasmonthly.com: Did you find Houston to be a particularly good example of the problems county hospitals are facing across the state, or do you think that it’s comparable to other big cities in the country? Were you able to see examples of the same problems in other Texas cities?

PC: Houston is an interesting example because it has a large indigent population as well as world-class medical facilities. The problems that Houston has encountered with the uninsured are no different than they are in other cities and towns around Texas; they are simply taking place on a bigger scale. The doctors and hospital administrators I interviewed in Austin, San Antonio, and Lubbock echoed many of the concerns that Houston doctors expressed in my story.

texasmonthly.com: What did you find to be the most appalling case of a child going without health care?

PC: Rather than pointing to one particular case, I’ll identify what I thought was the most appalling problem: children who need glasses but whose parents can’t afford them. Kids who can’t see the blackboard are not going to learn as well or function in school as well as children who can see. It’s that simple.

texasmonthly.com: What are some of the justifications that legislators had for cutting CHIP in particular?

PC: Proponents of cuts to CHIP have said that they had little choice, because the $10 million budget shortfall made scaling back a variety of programs necessary. Opponents of the cuts say that wasn’t true, and that there were other ways to keep CHIP fully funded, like through a cigarette tax.

texasmonthly.com: How did the physicians you spoke with feel about the current situation for the uninsured in Texas?

PC: Every single doctor who I interviewed expressed dismay over the cuts to CHIP. Not a single doctor I met in two months of reporting said otherwise.

texasmonthly.com: What do you think will happen with CHIP in the upcoming legislative session?

PC: Given that Governor Rick Perry has called four special sessions in which CHIP has never been addressed, I don’t have a lot of confidence that it will be a major priority in the upcoming session. But it will be interesting to see what lesson, if any, legislators take from Arlene Wohlgemuth’s defeat on Election Day.