State |
Percent of uninsured children (age 0-18), 2004/2005 |
Alabama |
5.5% |
Alaska |
9.3% |
Arizona |
15.9% |
Arkansas |
9.4% |
California |
13.2% |
Colorado |
14.2% |
Connecticut |
7.8% |
Delaware |
11.8% |
Florida |
16.8% |
Georgia |
11.7% |
Hawaii |
4.8% |
Idaho |
10.6% |
Illinois |
10.8% |
Indiana |
9.5% |
Iowa |
6.1% |
Kansas |
6.5% |
Kentucky |
7.8% |
Louisiana |
8.2% |
Maine |
6.5% |
Maryland |
8.9% |
Massachusetts |
5.2% |
Michigan |
5.8% |
Minnesota |
6.2% |
Mississippi |
12.9% |
Missouri |
7.9% |
Montana |
14.1% |
Nebraska |
5.8% |
Nevada |
15.7% |
New Hampshire |
5.9% |
New Jersey |
10.5% |
New Mexico |
17.6% |
New York |
7.6% |
North Carolina |
11.4% |
North Dakota |
9.1% |
Ohio |
8.1% |
Oklahoma |
14.1% |
Oregon |
10.8% |
Pennsylvania |
8.5% |
Rhode Island |
7.4% |
South Carolina |
9.3% |
South Dakota |
8.7% |
Tennessee |
9.4% |
Texas |
20.0% |
Utah |
11.7% |
Vermont |
5.7% |
Virginia |
8.3% |
Washington |
7.8% |
Washington D.C. |
7.2% |
West Virginia |
8.4% |
Wisconsin |
6.3% |
Wyoming |
10.0 |
United States |
11.0% |
Source: Robert Wood Johnson Foundation
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Of
the 47 million uninsured Americans, about 8.7 million are children,
according to the U.S. Census Bureau. Sadly, many of these children
could be insured if they were enrolled in the State Children's Health
Insurance Program (SCHIP) or Medicaid program for which they're
eligible: More than six in 10 uninsured children who qualify for SCHIP
or Medicaid are not enrolled, according to a 2007 report in Health Affairs.
SCHIP programs provide health insurance for children to low-income families who don't qualify for Medicaid and can't afford private health insurance.
Some states have been able to expand SCHIP to also cover pregnant women
and certain other adults in an attempt to further reduce their
uninsured populations.
Since its inception in 1997, SCHIP has made
significant inroads: The percentage of uninsured children has dropped
by 24 percent. But there's still much to be done, both in getting the
word out about SCHIP to families with eligible children and finding new
ways to expand coverage.
Health insurance coverage is vitally important for
children, and going without it can have long-term consequences. The
Robert Wood Johnson Foundation says that uninsured children are more
than three times less likely than insured children to visit a doctor in
the course of a year (10 percent for insured children versus 33 percent
for uninsured children).
Further, more than half (54 percent) of all
uninsured children did not have a "well-child" checkup in the past year
— more than double the rate of children with insurance (25 percent),
according to analysis of 2006 data.
Children's coverage varies by race and ethnicity,
according 2004/2005 data from the University of Minnesota School of
Public Health of uninsured kids age 0 to 18:
- 21.6 percent of Hispanic children are uninsured.
- 11.8 percent of Black children are uninsured.
- 11.4 percent of other ethnic group children are uninsured.
- 7.2 percent of White children are uninsured.
In recent years states have ramped up their
outreach programs and simplified the SCHIP application process in order
to encourage applicants. What about the more than six in 10 children
who remain uninsured but eligible?
According to a November 2007 article in the Journal of Policy Analysis and Management,
SCHIPs are more successful at covering eligible families when the
programs remove asset tests, make applications and renewals easier,
provide continuous coverage during the year without monthly income
verification, and offer parent benefits. On the other hand, mandated
waiting periods for coverage lowered "take-up" rates. Also, variations
in state outreach programs can mean a difference of 25 percent in
take-up rates.
A September 2007 report from The Urban Institute,
titled "Eligible but Not Enrolled: How SCHIP Reauthorization Can Help,"
says that SCHIP and Medicaid should borrow strategies from other
programs in order to increase their coverage of those eligible. The
report recommends ideas such as:
- "Automatic enrollment" without forms to fill in, such as Medicare Part B's default enrollment of seniors unless they opt out.
- "Express lane" eligibility, where states can grant coverage based on the applicant's eligibility for other programs.
SCHIP will need long-term funding in order to
continue to help children and expand coverage, which depends on
Congressional support. According to an August 2007 poll by the Robert
Wood Johnson Foundation, 86 percent of voters say they support
reauthorizing SCHIP and 63 percent say they support expanding SCHIP's
budget by an additional $35 billion over five years in order to cover
more children. The U.S. Senate and House of Representatives approved
bills expanding SCHIP in 2007. President Bush has said he would veto
any expansion.
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