SCHIP's success, and failure
Number of Uninsured Kids Declines as Enrollees in State Health Insurance Programs Increase
Robert Wood Johnson Foundation
Aug 9, 2006
Even though the total number of Americans without health insurance is on the rise, a new study analyzing government data suggests good news for the nation’s children. The percentage of uninsured kids in America has decreased by 20 percent since the government-funded State Children’s Health Insurance Program (SCHIP) was approved by Congress in 1997.
“The State of Kids’ Coverage” was released today by the Robert Wood Johnson Foundation (RWJF). The report shows that the number of uninsured children has decreased by 2 million since the creation of SCHIP and recent expansions in public programs. In the same period, the number of uninsured Americans has increased by nearly 5 million people.
The percentage of children who have private health insurance has fallen by five percent since 1997-98. That means 1.4 million fewer kids have private health insurance.
The report shows that even though the number of kids with private insurance is declining, public coverage programs have expanded, resulting in more kids being insured. The percentage of kids enrolled in public health coverage programs has increased by 31 percent since SCHIP programs began-meaning at least 5 million more kids now have public coverage.
Despite the success of public programs, millions of children remain uninsured. The latest Census data show that nearly 8.3 million children remain uninsured nationwide. Experts say that more than 70 percent of these children are likely eligible for low-cost or free health care coverage through SCHIP or Medicaid, but have not yet enrolled.
Additional findings show that being uninsured for all or part of the year can have serious consequences for kids:
- Uninsured kids are twice as likely not to receive any medical care in a given year, compared to children with insurance (12.3 percent insured vs.
25.6 percent uninsured).
- More than one in three (35.0 percent) uninsured children do not have a personal doctor or nurse-which is significantly higher than children who have health coverage (13.5 percent).
“This report confirms that uninsured children face a disadvantage in their ability to access health care, compared to children who have health coverage,” said Sarah Shuptrine, national program director for the Covering Kids & Families program. “When children do not make regular visits to the doctor, or receive medical attention when it is needed, they risk minor illnesses becoming major ones. Children need health coverage so that they receive all the care they need, when they need it, to grow and thrive.”
http://www.rwjf.org/newsroom/newsreleasesdetail.jsp?id=10424
Comment:
By Don McCanne, MD
Expanding health insurance coverage for children is good. Program design that results in over 8 million children being left without coverage is bad.
Some of the reasons that not all children are covered include the fact that the programs have a family income limit for eligibility, SCHIP usually requires the payment of a premium, and participation is voluntary and requires action on the part of the parents to enroll. Barriers such as these will always prevent 100 percent participation. In spite of greater efforts to expand enrollment, four-fifths of previously uninsured children remain without coverage.
All barriers should be removed. Health insurance enrollment should as automatic as the recording of a birth certificate, not only for all children, but for everyone.