One in four uninsured children either uses the hospital emergency room as a regular source of health care or has no regular source of care.1 Talking to parents about the importance of health insurance, as well as explaining the process involved in signing a child up for SCHIP or Medicaid, can have a significant impact on their children’s health and well-being.
According to the US Census report, of the nation's nearly 74 million children under 18, about 8.3 million, or 11.2%, lacked health insurance coverage in 2005. This is up from 10.8 percent in 2004, marking the first increase in uninsured children since 1998.2
The Campaign for Children’s Healthcare (CCHC), made up of organizations who represent health care providers, educators, parents, advocates, and others, coordinates public education efforts across the country to demonstrate the importance of health insurance for children and families. CCHC claimed, in a September 2006 report entitled “No Shelter from the Storm: America’s Uninsured Children,” that 9,069,000 children in the United States are uninsured, and more than 60% of these children are racial or ethnic minorities. Most surprising is that the majority of these uninsured children live in two-parent families where both parents work.3
Data from CCHC also indicates that most of the uninsured children are in low-wage working families. More than two out of every three (70.8%) uninsured children are in families with incomes below 200 percent of the federal poverty level— $33,200 in annual income for a family of three. Only 8.5 percent of uninsured children are in families with incomes above four times the federal poverty level. This is significant in most states because children are eligible for the State Children’s Health Insurance Program (SCHIP) if their family incomes are below 200 percent of the federal poverty level.4
SCHIP and Medicaid provide health care to low-income children up to age 18. Typically, Medicaid serves children with incomes below the poverty line ($20,000 for a family of four in 2006) or slightly higher, while SCHIP serves children from families with incomes too high to qualify for Medicaid but too low to be able to afford private health insurance. Each state sets its own guidelines for SCHIP eligibility. For 2005, the most common income limit for a separate SCHIP program was $32,180 for a family of four annually, but states’ limits range between $22,526 and $56,315. 50. These programs are vital for children of disadvantaged backgrounds.5
Doctors can advocate in many different ways for all children to have health insurance. Often times children are qualified for programs such as SCHIP and Medicaid but their parents are unaware of eligibility requirements or have difficulty filling out the forms. Some of these programs only cover part of a year or require re-enrollment at different times throughout the year to ensure continued coverage. Having information on public insurance enrollment procedures available to parents is a good way to ensure all of your young patients have access. You can also determine your state’s enrollment guidelines and supply enrollment forms in your office or take them to local schools with a note attached “prescribing” health insurance.
Ensuring that all children have access to health care through health insurance is vital to children and families. Doctors can contact their local legislative officials to advocate on behalf of uninsured children or write an op-ed for local papers.
Contact dft@docsfortots.org to receive support from Docs For Tots in your efforts to advocate for health care access, or visit the Docs For Tots fact sheet on “What Doctors Should Know about Public Health Insurance” for further information. (http://www.docsfortots.org/resources/talkingPoints/documents/PublicHealthInsurance.pdf)
1 Simpson, G., et al. (1997). Access to Health Care. Part 1: Children. National Center for Health Statistics. Vital Health Statistics, 10, 196.
2 Lee, Christopher. “Number of Uninsured Children Rises” The Washington Post. 5 September 2006: A06.
3 Campaign for Children’s Health Care, “No Shelter from the Storm: America’s Uninsured Children.” 2006 Campaign, Publication No. CCHC-0601.
4 Ibid.
5 Kaiser Family Foundation. (2005). Income Eligibility Levels for Children’s Separate SCHIP Program by Annual Incomes and as a percent of Federal Poverty Level, 2005. http://www.statehealthfacts.org/cgi-bin/healthfacts.cgi.
