What We Think
The success of the SCHIP program is evident:
- Children are at greater risk than adults to be uninsured, because children are more likely to be poor (they have no control over their income).
- While 33% of adults live in low-income households (those households making less than twice the FPL, or $44,100 for a family of four), nearly 40% of children come from low-income families.
- Between 1997 and 2001, the number of uninsured children dropped by more than 2 million. This occurred after the creation of SCHIP.
- In 2007, 11% of children were uninsured, compared with 20% of adults.
And – there is still a long way to go.
There are 9 million uninsured children today in the United States, and even under this expansion, there would presumably be 5 million uninsured remaining.
Who are these children and what are the barriers to getting them covered?
The majority of uninsured children come from low-income households:
- 40% of all children live in households classified as poor or low-income (households making less than twice the FPL). And – 70% of uninsured children come from these same income brackets.
- Medicaid and SCHIP cover 60% of all “poor” children (those living in households that make less than the FPL, or $22,050 for a family of four) and 40% of all low-income children.
- Despite this assistance, 1 in 5 (20%) of poor children remain uninsured, and 16% of low-income children go without coverage.
- Most of the uninsured kids from these groups are eligible for Medicaid or SCHIP, but face two barriers:
- There is often confusion about who qualifies for the program, and about how to enroll.
Increasing funding for the program will primarily benefit poor and low-income children:
- The Congressional Budget Office (CBO) estimates that 83% of the 4 million children who would gain access as a result of the reauthorization are in families with incomes below current eligibility levels.
- Increased funding will help states to target this population through community-based outreach.
- There are also initiatives underway to make the enrollment process easier, by making forms available online and at a wider variety of locations.
So you might be wondering why Congress would bother to expand the eligibility limits for SCHIP.
If the majority of uninsured children are low-income, and if they will be the primary beneficiaries of this insurance program anyways, then why let middle-income kids sign-up?
Isn’t that just encouraging families to leave their private plans at the government’s expense?
Surprise – a significant number of middle-income children are uninsured, and would benefit from, and depend on, the expansion and renewal of SCHIP.
- 45% of children from middle-income families (households making between 200-399% of the FPL, or up to $88,200 for a family of four) lack access to insurance, mostly because their parents are not offered employer-sponsored health benefits.
- Of those middle-income families with an uninsured child who did have access to insurance coverage through their place of employment, 81% could not afford the premium.
- There is just not enough money left over to pay for insurance premiums once the monthly bills are paid and groceries are purchased.
- 70% of uninsured children live in families with at least one full-time worker.
The number of middle-income, uninsured children is expected to rise as people lose their jobs.
This Kaiser Family Foundation report offers anecdotal evidence about the recession’s impact.
- Said one participant: “I am just starting a part-time job. If I were to participate in insurance for myself, my husband and my children, it would be $589 a month. It would take most of the part-time pay that I am making…”
- With the loss of jobs and coverage, survey participants reported difficulty in paying for COBRA benefits or in purchasing an individual health plan due to cost.
- Many are turning to Medicaid and SCHIP for the first time to provide insurance for their families. Without this assistance, they would most likely go without coverage.
This chart from the Kaiser Commission on Medicaid and the Uninsured (2008) shows that with every 1% increase in the unemployment rate, Medicaid and SCHIP enrollment grows. States are struggling to keep up with the demand for services.
Making sure that American children are insured should be always be a top priority in healthcare reform. Looking out for this vulnerable population is a moral imperative AND it helps us to save health dollars in the long-run.
Not only does insurance protect children in the case of an emergency, it is also contributes to their healthy development, which prevents more costly conditions from developing later in life.
Uninsured children do not have a usual source of care, well-child visits, access to a needed specialist or mental health care, and dental visits in the course of a year.
Without access to these services, uninsured children are more likely to pick up and expose other children to preventable and treatable diseases, and to learn health habits that lead to problems later on.
And as the recession continues, families are more likely to depend on SCHIP so that their children can have care.
The reauthorization of SCHIP is a common sense solution to an unhealthy situation!
This article was written by Julia Nagle.