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Report: Most Uninsured Children Live in Homes Where at Least One Parent Works

By Mary Agnes Carey, CQ HealthBeat Associate Editor

September 28, 2006 -- Nearly 90 percent of America's 9 million uninsured children age 18 and younger live in families where at least one parent works, according to a report released Thursday by the Campaign for Children's Health Care.

The study also found that 30 percent of those uninsured children live in families where both parents work but cannot afford to purchase health care coverage.

While two-thirds of uninsured children qualify for health care coverage under either Medicaid or the State Children's Health Insurance Program (SCHIP), a variety of obstacles often prevent that coverage from happening, Campaign for Children's Health Care officials said at a news conference.

"The story of uninsured children is a story of children in families where parents are working," said Ron Pollack, executive director of Families USA, one of the coalition's more than 50 organizations representing health care, consumers, and children.

Going without health coverage can have devastating effects on children because it often means they do not receive preventive care, which helps avoid medical problems. Uninsured children are three times as likely as children with health insurance to not have seen a doctor in the last year, the report found, and are 13 times as likely as insured children to not have a regular physician to call for both routine and emergency medical care situations.

The coalition's report follows Census Bureau figures released earlier this month, which found that the number of children under 18 without access to health coverage grew in 2005 for the first time in seven years. Last year, 11.2 percent of children in that age group had no coverage, compared with 10.8 percent the previous year, according to Census figures.

The Coalition report analyzed the recent Census data and other federal statistics to determine the extent and scope of uninsured children in America.

The study found wide variations in uninsured children among states—Texas was the highest at 20.4 percent and Vermont the lowest at 5.6 percent. The study also concluded that more than 60 percent of uninsured children are racial or ethnic minorities, and more than two out of every three are in families with incomes below 200 percent of the federal poverty level, or $33,200 in annual income for a family of three. Only 8.5 percent of uninsured children are in families with incomes above four times the federal poverty level.

While many of the nation's uninsured children qualify for coverage from either Medicaid or SCHIP, sometimes states' outreach efforts are not as aggressive as they should be, Pollack said. He also said state enrollment procedures are "not always the simplest" and that children can sometimes lose benefits unless their parents re-enroll them each year. "We have enormous churning and turnover at the end of the enrollment period," he said.

Pollack and other coalition members said they will continue to monitor how states implement the Medicaid provisions of a budget savings bill, signed by President Bush in February (PL 109-171), to see how they impact coverage for the 25 million children now enrolled in Medicaid.

The advocates also said they plan to keep a close eye on Congress' reauthorization of SCHIP next year, in particular how lawmakers plan to deal with a funding shortfall of as much as $900 million for fiscal 2007. Average SCHIP enrollment is about four million children and more than six million enrolling for some part of the year.

Centers for Medicare and Medicaid Services spokeswoman Mary Kahn said Thursday that Congress would have to take action to correct any shortfalls, much like they did in the budget-savings package. Kahn also added that states will have new SCHIP allotments when the 2007 fiscal year begins Oct. 1. Also on Thursday, Senate Finance Committee Chairman Charles E. Grassley (R-Iowa) introduced legislation that he said would appropriate new funds and redistribute unspent money from states with an SCHIP surplus to states expected to run out of money. The redistribution, Grassley said, would apply for only half of the fiscal 2007 year.

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