AUSTIN (AP) – More than a million Texas children remain without health insurance, and those kids are not getting the care they need.

The startling condition of the state’s children came into vivid focus last week with the release of the annual Kids Count survey. The analysis of official state and federal data by the non-partisan Center for Public Policy Priorities found that 1.2 million Texas children have neither private nor public health insurance.

Almost 40 percent of Texas mothers received little or no prenatal care and one in seven babies were born premature, statistics show. The difference between being insured and uninsured is stark: 90 percent of insured kids are healthy, while only 58 percent of kids without insurance are considered healthy.

It comes as no surprise that the percentage of children covered by health care is directly related to the employment rate and the parent’s economic status.

With 25 percent of Texas children living in poverty, a rate that consistently runs 5 percent above the national average, Texas ranks 41st in the nation in number of uninsured kids, even though the unemployment rate is lower than the national average.

When uninsured kids get sick, their parents have no place to take them other than a public hospital’s emergency room, which by law cannot turn them away. And if those parents cannot pay the extremely expensive bill? The taxpayer picks up the tab.

Ask anyone who knows anything about health care, conservative or liberal, and they will tell you this is the most inefficient way to care for children. Neither is it the best care.

“A large percentage of those kids will end up in the emergency room as their primary source of care, which is hugely inefficient and ridiculously expensive,” said Dr. Skip Brown, a medical professor and director of a pediatrics center at the University of Texas Medical Branch. “When you go to the emergency department, those guys are not there to be primary care providers.”

Brown said the children also miss out on the most important factor in getting good care: a doctor who knows the patient and their medical history. Children with asthma and diabetes — chronic diseases best treated by a family doctor on a routine basis — comprise many, if not most, of the kids who show up in the emergency room.

“There are kids missing out on care,” he added.

About half of the uninsured children would qualify for Medicaid or the Children’s Health Insurance Program, if they applied, according to the Annie E. Casey Foundation. Many of the parents don’t know they are eligible, have not bothered to apply or the state has not finished processing their applications.

From 2007-2010, Texas Medicaid and the Children’s Health Insurance Program, for kids not quite poor enough to qualify for Medicaid, grew by 10 percent and did a good job of treating kids, according to an official review released last week. Texas’ programs consistently scored above the national average in treating asthma, diabetes and mental health issues. Customer satisfaction was consistently high, according to the independent assessment by the University of Florida.

Unfortunately, though, the Legislature cut state spending on Medicaid and the Children’s Health Insurance Program by $2.03 billion for 2012-2013, according to a budget analysis by the Center for Public Policy Priorities. More than $800 million of those cuts will be to reimbursement rates for doctors who agree to treat poor or disabled children.

The reduction in payments to doctors treating Medicaid patients will make it harder for patients to find care. Doctors can only afford to have about 25 percent of their patients on Medicaid to keep their business viable. Lower reimbursements means that fewer doctors will accept Medicaid patients, and more people will end up in the emergency room.

Brown, who has practiced medicine for more than 30 years, said he remembers the era before Medicaid and CHIP were widely available and the entirely preventable emergency cases that would turn up in emergency rooms.

“I have seen the change in my practice-lifetime that giving good basic care will do,” Brown said. “I am really concerned we’re going to see that back-slide a good bit.”

Many lawmakers have promised to restore funding for programs that help kids stay healthy when they meet again in 2013, but officials at the Department of Health and Human Services warn of more budget deficits ahead. When the Kids County survey comes out next year, it’ll offer Texans another check on the health of Texas kids.

(Copyright 2012 by The Associated Press.  All Rights Reserved.)