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Study: Children's Coverage Needs to Improve

By Rebecca Adams, CQ HealthBeat Associate Editor

If states had worked harder to get children the medical care they need and to enroll them in available insurance programs, 5 million more youngsters would be covered, 10 million more would have at least one preventive medical and dental visit each year and about 600,000 more would be vaccinated by age three, according to a new study.

Children's access to services varies dramatically depending on where they live, and even the best-performing states could do better, said the report from The Commonwealth Fund, a nonprofit health policy research group.

Coverage for children is seen as one of the health policy successes of the past decade: Roughly 10 percent of children do not have medical coverage, which is significantly better than the overall uninsured rate of about 17 percent.

Using existing data, researchers ranked states on 20 indicators, including access to insurance; the average cost of premiums; doctor visits; hospital admissions for asthma; child mortality, and the percentage of children with health problems, such as obesity or oral health problems. The study found that the top 14 states often did well in several areas, but that no state ranked in the top half of states on every measurement. In many cases, state laws or policies made a difference in improving medical care for kids.

Still, children in top-scoring states such as Iowa, Massachusetts, Vermont, Maine, and New Hampshire fared much better than those in low-performing states such as Florida, Texas, Arizona, Mississippi and, in last place, Nevada. Low-ranked states would have to improve their performance by about 60 percent to reach the level of states who scored best.

The data backing up the report's findings is not uniformly current, the study's authors acknowledged. Much of the data are from 2007 and some are as old as fiscal 2006. And that, said the researchers, is part of the problem. State officials should also do a better job of collecting and analyzing information that will indicate whether they are making progress toward goals to improve children's care, they said.

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