The number of children without health insurance in the United States has declined for the past three years despite a weak economy and an increase in the overall number of uninsured Americans, according to research released Thursday (7/31) by the Urban Institute.
The decline occurred mostly among low-income children and is attributed to increased enrollment in the State Children's Health Insurance Program (SCHIP) and Medicaid, public programs that provide low-cost and free health coverage. According to the Urban Institute's 2002 National Survey of America's Families (NSAF), the number of uninsured children fell 1.8 million in the past three years to 7.8 million. The overall number of uninsured people has risen to 41 million.
Vermont had the lowest number of uninsured children at 3.7 percent. Texas was the highest, with over 22 percent of children uninsured.
The survey, which was funded by The Robert Wood Johnson Foundation (RWJF), found that nearly 4 million uninsured children are eligible for free or low-cost health coverage but are not enrolled. More than 80 percent of low-income families surveyed said they would enroll their children if they knew they were eligible.
"Despite a weak economy, the number of uninsured children in America has declined, (but) with unemployment at its highest level in almost a decade, the number of uninsured children could rise over the next year... We need to redouble our efforts to enroll each and every one of the more than 4 million uninsured children," Risa Lavizzo-Mourey, president and CEO of RWJF, said.
The survey was released at a press conference to kick off Covering Kids and Families, a nationwide RWJF program to enroll children in SCHIP and Medicaid.
A separate report released this week (7/29) by the Kaiser Commission on Medicaid and the Uninsured (KCMU) found that some states are cutting back efforts to increase enrollment in these programs.
Since April 2003, Texas, Maryland, Washington and Florida have passed legislation to reduce eligibility, reinstate administrative obstacles to enrollment and freeze enrollment. Connecticut, Indiana and Nebraska withdrew a guarantee of 12-month continuous health coverage for enrolled children, increasing the likelihood children will lose coverage if their parents fail to meet reporting requirements.
In some cases, states like Ohio, Minnesota and Missouri were able to postpone proposals that would have reduced access to SCHIP and Medicaid by using their share of $20 billion for state fiscal relief made available in the recent federal tax-cut package.
"In place of monitoring expansions (of children's health coverage), we expect to have to begin assessing erosions in coverage," Diane Rowland, executive director of KCMU, said.
The NSAF, an annual survey of the economic and health characteristics of 40,000 households, found that uninsured children were three times more likely than those with health coverage to lack medical care and 1.5 times more likely to have an unmet medical, dental or prescription drug need.
African-American and Hispanic children made the most gains in obtaining health insurance coverage, the survey found, but are still uninsured at a much higher percentage than non-Hispanic white children.
Hispanics have the largest percentage of uninsured children with 2.9 million (21.1 percent) lacking coverage. At least 1.8 million of those children, nearly two-thirds, are eligible for low-cost or free health coverage, but are not enrolled due to language and cultural barriers, the survey found.
More than 1 million (9.5 percent) African-American children lack health coverage, 800,000 of which are estimated to be eligible.
About seven percent of white children (3.4 million) are uninsured, with about 1.7 million eligible for SCHIP or Medicaid.
At the press conference releasing the new survey, Dr. Louis Sullivan, former secretary of the U.S. Department of Health and Human Services under the first President George Bush, said that expanding enrollment of low-income children in SCHIP and Medicaid is necessary to close the "racial disparities that plague our nation."
"It is clear that enrollment in SCHIP or Medicaid is one step toward reducing racial disparities in health care coverage among America's children," Sullivan said.
"The fact remains, millions of working families in the United States, be they Hispanic, African-American, Asian-American, Caucasion, or other ethnicities, have children who could be enrolled in these programs but are not. Let's enroll America's children," he said.
Low-income working families are almost three times more likely than higher-income families to be uninsured, the survey found. Many parents of low-income uninsured children who were aware of SCHIP and Medicaid said they thought they had to be on welfare to get health care coverage.
"Many families don't know they can earn up to $36,000 or more and still be eligible for SCHIP or Medicaid," Lavizzo-Mourey said.
Speaking at the press conference, Charmaine Muhammad of Miami, Fla., a single mother who makes $8-per hour working for a health insurance company, said that she could not afford the $220 per month premium for her company's health insurance.
Muhammad said she didn't learn that her 12-year-old son, Shavon, was eligible for free health coverage until she was asked by her employer to volunteer for the state's Florida Healthy Kids, a program aimed at boosting insurance enrollment for low-income children.
After enrolling in SCHIP, Shavon received glasses and was prescribed Ritalin, which helped him go from flunking most of classes to getting straight A's, Muhammad said.
"I no longer have to worry about being able to take him to the doctor when he is sick for fear I won't be able to pay the medical bills," Muhammad said.
Parents can find out if their children are eligible for low-cost and free health care coverage by calling toll-free 1(877) KIDS-NOW. Callers will be connected to their state program.