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More Kids Insured; Trouble Ahead?

Health coverage for children in the United States reached a four-year high in the first half of 2001, the Centers for Disease Control and Prevention (CDC) reported last month. But with the State Children’s Health Insurance Program (SCHIP) facing decreased funding through 2004, the number of uninsured children may soon rise.

According to the CDC, only 11.2 percent of children under 18 were without health coverage during the first half of 2001, down from 13.9 percent in 1997. The number of children covered by public insurance, such as SCHIP and Medicaid, increased from 20 percent in 1998 to 23.1 percent in the first half of 2001.

But SCHIP, which covered 4.6 million low-income children in 2001, is to receive less federal funding over the next three years. At the same time, many states are facing budget deficits and an increased demand for children’s health coverage as parents become unemployed and lose benefit plans. SCHIP proponents worry that the result will be a drop in coverage under the program.

Dennis Johnson, vice president of policy and external affairs at The Children’s Health Fund, a New York-based network of pediatric programs, hopes states will take the initiative to enroll more children. “SCHIP is so critically important,” Johnson said. The states “need to look at some of the more creative solutions at getting kids enrolled in SCHIP that have been suggested and proven to work.”

Steadily increasing enrollment in SCHIP drove spending from $200 million in fiscal 1998 to $1.8 billion in 2000. While the Department of Health and Human Services expects that 2002 costs will reach $3.6 billion and will continue to rise in the future, available state and federal combined allocations for 2002-04 are less than $3.2 billion a year.

Some states still have unspent SCHIP funds. Although that money is due to be returned to the federal treasury, President George Bush has proposed that states be given until 2006 to spend it.

“States need to make sure that these funds are spent, because a lot of kids, especially in low-income families, are not getting health care,” Johnson said. “It would be a shame to see those funds return to the treasury.”

The CDC report, “Early Release of Selected Estimates from the National Health Interview Survey,” January – June 2001, is available at


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