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Texas possesses the worst uninsured rate in the nation not just for adults, but children. One in five Texas children lacks health benefits, even though many qualify for Medicaid and the Children's Health Insurance Program. If the Texas Legislature gives its blessing, the Lone Star State could attempt an innovative method to insuring more children. The Senate will consider legislation that would create a health insurance pool in the state's child support system. Other initiatives designed to get more people onto insurance rolls are rolling out this year in Austin and Houston as 3-share programs. Texas insurers, meanwhile, are beginning to feel the effects of the economy even though commercial enrollment had been holding relatively strong in 2008. In pharmacy utilization management, Blue Cross and Blue Shield of Texas has made strides in getting members to stick to statin therapy. By using pharmacy and medical claims to target members who have had cardiovascular events yet not taking statins, the Texas Blue plan increased generic statin utilization by 15 percent.

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