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States focusing on reducing numbers of uninsured children

No less than 20 states have taken steps in 2005 to increase access to health coverage for children and their parents. Nine states have reversed actions they took during the 2001-03 economic downturn to limit benefits, according to the Kaiser Commission on Medicaid and the Uninsured, part of the Kaiser Family Foundation, which tracks health care trends. Among them are Illinois, which just enacted a child health bill, and Vermont, with its "Dr. Dynasaur" health program, both of which broadened coverage for children.

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The number of American children without health care coverage has been slowly but steadily declining over the past several years even as health care costs continue to rise and fewer employers provide insurance, creating a breach that states have stepped in to fill with new programs and fresh money.

Since 2000 the average annual increase in inflation has been 2.5 percent while health insurance premiums have escalated an average of 11.4 percent -Kaiser Family

The overall ranks of the uninsured continue to swell, to nearly 46 million Americans at the beginning of this year. But a landmark federal program begun in 1997 to provide health coverage to poor and working-class children and additional measures taken by states have provided health insurance to millions of children who might otherwise go without.

Nearly 82 million -- about one-third of the population below the age of 65--spent a portion of either 2002 or 2003 without health coverage, according to the U.S. Census Bureau.

The percentage of people with employment-based health insurance dropped from 70 percent in 1987 to 61 percent in 2004. This is the lowest level of employment-based insurance coverage in more than a decade, according to the Kaiser Family Foundation.

Kaiser reports that rapidly rising health insurance premiums are the main reason cited by all small firms for not offering coverage. Health insurance premiums are rising at extraordinary rates. Since 2000 the average annual increase in inflation has been 2.5 percent while health insurance premiums have escalated an average of 11.4 percent annually.  This creates a vicious cycle of increasing health insurance premiums, which cause more employers to drop health coverage thus increasing the demand on federal and state Medicaid and other government programs.

One-third (32.9 percent) of uninsured children in America went without medical care for an entire year, a new report from the Robert Wood Johnson Foundation shows. Conversely, nearly 88 percent of their insured counterparts received care during the same period.

There are 350,000 fewer uninsured children in the United States than there were in 2000.  -Kaiser Family Foundation

Even uninsured kids who received medical care did not always see a doctor when they needed one. Uninsured children were 10 times more likely not to receive the medical care they needed, compared to children who have insurance (6.2 percent versus 0.65 percent).  These statistics illustrate clearly the need for increased access to healthcare for America’s children.

As a result of the new efforts to decrease the number of uninsured children, there are 350,000 fewer uninsured children in the U.S. than there were in 2000, according to Kaiser.  At the same time, the overall number of uninsured rose by six million.

While elected officials cannot agree on how to provide or pay for health coverage for uninsured adults, there seems to be a consensus in many states that covering children is medically wise and politically smart.

However, even the situation for children is not uniformly favorable. Eleven states facing political and financial pressure, including Maryland, Pennsylvania and Tennessee, made it more difficult in 2004-05 for eligible children to retain coverage.

The movement to expand coverage for children dates to the mid-1990's, after the Clinton administration devised a complex plan to provide all Americans with health care coverage. That plan failed, and advocates of wider coverage began pursuing more incremental changes at the federal level and lobbying legislatures to expand coverage.

Illinois has taken the most far-reaching step this past autumn, enacting a law intended to provide coverage to all children in the state, extending low-cost or free coverage to the 250,000 Illinois youngsters who are now uninsured.

But even states unwilling to go as far as Illinois are moving to provide insurance to a larger portion of children.

New Jersey, which imposed sharp restrictions on publicly financed health care for families during the economic slowdown, restored eligibility this year to some 75,000 low-income families.

As of the beginning of 2005, 16 percent of all Americans lacked health insurance, but only 12 percent of children under 18 went uncovered.
-Kaiser Family Foundation

In Washington State, where 39,000 children were dropped from state-financed health care programs in 2003 and 2004, officials reversed course this year. The state eased health care eligibility requirements for families and delayed a plan to charge premiums.

Even Texas, which has one of the nation's highest rates of uninsured children, took steps this year to stop a decline in the number of children with health coverage. The state eliminated premiums for the poorest families enrolled in state health care programs and stopped cutting off families with higher incomes that failed to keep up with premiums.

As of the beginning of 2005, 16 percent of all Americans lacked health insurance, but only 12 percent of children under 18 went uncovered, although that still amounts to nine million children, according to the Kaiser commission. That gap has been widening over the years as fewer employers offer health care coverage, federal spending fails to keep pace with rising costs, and states limit eligibility to balance budgets.

The picture is brighter for children than for adults in large part because of the enactment of the State Children's Health Insurance Program, or SCHIP, in 1997. The program provides federal money for child health care to states, which determine eligibility, income limits and covered benefits within federal guidelines. The number of children covered under the federal-state program grew rapidly, from 897,000 children nationwide in 1998 to 3.95 million in the middle of 2003, before leveling off.

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