Uninsured kids in middle class have same unmet needs as poor

Since 1997, the national State Children’s Health Insurance Program has provided health insurance to low-income children who are not eligible for Medicaid and do not have private coverage. Under the federal law, states received grants of federal dollars to help with costs of insurance expansions, and they had several options for how to expand coverage for children using those dollars.

A pediatric research team at the University of Rochester Medical Center has been studying Child Health Plus (New York’s state-specific plan beginning in 1991, which in 1997, received federal approval to become the state’s SCHIP plan) since its inception. Earlier research by this team has shown that the program greatly increases children’s access to primary care, preventive care, as well as other needed health care. SCHIP markedly reduces children’s unmet health care needs and reduces pre-existing racial disparities in access, unmet need and continuity of care. Parents of children with asthma and special health care needs were more satisfied and better able to afford care and medications for their child’s condition once enrolled.

When the program came up for federal renewal last year, there were several sources of disagreement over whether to expand the program. In addition to debating the potential funding source for the expansion, the executive and legislative branches held different expectations as to how often families would leave private insurance for the public program, particularly at the higher income levels (200 to 400 percent of the federal poverty level).

Congress has extended SCHIP at flat funding, with no expansion. Questions remain about whether current funding will continue to cover those already enrolled. Since expansion was vetoed at the national level, New York’s Governor David Paterson has signed state-level proposals to expand Child Health Plus in New York using only state monies. Several other states are considering similar state-level expansions.