Published online November 1, 2004
PEDIATRICS Vol. 114 No. 5 November 2004, pp. 1338-1340 (doi:10.1542/peds.2003-0941-L)
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COMMENTARY

Gains in Children's Health Insurance Coverage but Additional Progress Needed

Lisa Dubay, ScM and Genevieve Kenney, PhD

Health Policy Center, Urban Institute, Washington, DC 20037

Abbreviations: SCHIP, State Children's Health Insurance Program

The first 20% of the full text of this article appears below.

Health insurance coverage for children has improved in recent years.1 Between 1999 and 2002, the proportion of children with insurance coverage increased by 2.6%. In all, 1.8 million fewer children were lacking coverage in 2002 (Table 1). These gains were concentrated among children in low-income families (those with incomes of <200% of the federal poverty threshold) and were driven by increases in public coverage. By 2002, 48% of all low-income children were relying on public health insurance coverage, through either Medicaid or the State Children's Health Insurance Program (SCHIP).


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  		TABLE 1. Insurance Coverage of Children, According to Income, in 1999 and 2002

 
These recent improvements in coverage followed expansions of public programs for children under SCHIP, which was created in 1997 as Title XXI of the Social Security Act. SCHIP gave states the option of using Medicaid programs, separate state programs, or some combination of the 2 to cover low-income children in families whose incomes were too high for qualification for Medicaid under Title XIX. States received higher federal matching rates under Title XIX than under Title XXI, but federal allotments were capped in a block grant.

When eligibility for public coverage was broadened, states began publicizing the availability of coverage under both Medicaid and SCHIP and simplifying enrollment. It appears that these efforts were successful. Awareness of and familiarity with Medicaid and SCHIP . . . [Full Text of this Article]

Address correspondence to Lisa Dubay, ScM, or Genevieve Kenney, PhD, Health Policy Center, Urban Institute, 2100 M St, NW, Washington, DC 20037. E-mail: ldubay@ui.urban.org


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