Los Angeles – Despite a rise in the overall number of Americans without health care coverage, many states have begun innovative programs to ensure that children’s health doesn’t suffer.
In just the past year, 20 states have taken steps to increase access to health coverage for children and their parents and 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.
Also, a landmark federal program begun in 1997 to provide health coverage to poor and working-class children has provided health insurance to millions of children who might otherwise go without.
As a result of these and other steps, there are 350,000 fewer uninsured children in the United States than there were in 2000, the foundation reported. Over the same period, the overall number of uninsured rose by 6 million.
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.
This has created a breach that states have stepped in to fill with new programs and fresh money.
The overall ranks of the uninsured continue to swell, to nearly 46 million Americans at the beginning of this year.
Ambitious steps such as the child health bill just signed in Illinois and the “Dr. Dynasaur” children’s health program in Vermont have broadened coverage for children.
While elected officials cannot agree on how to provide or pay for health coverage for uninsured adults, there seems to be a consensus 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 for eligible children to retain coverage.
The movement to expand coverage for children dates to the mid-1990s, 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 state legislatures to expand coverage.
Alan Weil, executive director of the National Academy for State Health Policy, a nonpartisan research group, said that children’s health was one area of state spending that has consistently risen, at a time when most other programs – including health care for adults – have suffered cuts.
Weil said it was much easier for elected officials to approve spending “for the kids” than to expand welfare programs for adults, even in times of hardship.
At of the beginning of this year, 16 percent of all Americans lacked health insurance, but only 12 percent of children younger than 18 went uncovered, although that still amounts to 9 million children, according to the Kaiser commission.
The picture is somewhat brighter for children than for adults in large part because of 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 at the start, from 897,000 children nationwide in 1998 to 3.95 million in the middle of 2003 before leveling off.
The percentage of uninsured children ranges from less than 5 percent in Vermont to almost 20 percent in Texas.