Children’s Care and Coverage: Where Do We Go from Here?

Despite vigorous efforts in recent years to insure more uninsured children, the number of kids without coverage is stuck at 8.4 million. Public coverage of children is on the rise – up 1.7 million between 2002 and 2003. But employer-sponsored coverage is shrinking – down 1.2 million during the same period. One reason: Firms are subsidizing coverage for individual employees to meet insurers’ minimum participation requirements, but aren’t as likely to subsidize family coverage.

Even when children have coverage, however, they may not get all the care they need. Chronic illness now accounts for the majority of children’s hospitals days and deaths. But the health care system is best at treating acute illness. In fact, analysts find that many health needs of children are simply not being met, as documented in the September-October issue of the journal Health Affairs. The theme of the issue: “Child Health: A Progress Report.”

What does the future hold for children’s coverage? What can we learn from the State Children’s Health Insurance Program (SCHIP) – both its successes and challenges? What are the most important issues in improving children’s health and health care in this country? What do we know about the quality of health care for children? What changes in the health care system would better address the health needs of children? Does public health care spending need to be reallocated to help children?

To help examine these questions and others, the Alliance for Health Reform and Nemours sponsored an October 1, 2004 briefing. Panelists were: Debbie Chang of the Nemours Division on Health and Prevention Services, Lisa Simpson of the University of South Florida and the National Initiative for Children’s Healthcare Quality, and Gail Wilensky of Project HOPE. Genevieve Kenney of the Urban Institute joined the discussion panel, and Ed Howard of the Alliance moderated.