Coverage

Providing access to health care coverage remains an acute and difficult challenge.

Today more than 46 million Americans, including more than 8 million children, go without health insurance. This lack of coverage is the single greatest barrier to obtaining timely, appropriate health care services. Therefore, focusing on insuring children has been an important strategic choice for the Foundation—an essential step toward ensuring that all Americans have access to quality health care.

We have been working to enroll uninsured, eligible children in public health care coverage programs and are tracking progress toward that goal. Even though the total number of Americans without health insurance is on the rise, a recent study by the State Health Access Data Assistance Center shows that the proportion of kids who are uninsured in America has decreased by 20 percent since the creation of the State Children's Health Insurance Program (SCHIP). States with the biggest decline in the percentage of uninsured kids are Arkansas (–60 percent), Maine (–50 percent), Alabama (–47 percent), South Carolina (–46 percent) and North Dakota (–44 percent).

Despite this progress, the latest census data (2005) show that nearly 8.3 million children remain uninsured nationwide. Experts say that more than 70 percent of these children are likely eligible for low-cost or free health care coverage through SCHIP or Medicaid, but have not yet been enrolled.

Therefore, we will continue to promote enrollment of uninsured children in SCHIP and Medicaid as one way to help achieve the goal of ensuring that all Americans have access to quality care. We will also work with the National Academy for State Health Policy to explore opportunities to expand coverage within Medicaid and SCHIP.

In addition to supporting children's coverage, we will conduct research and evaluate state reforms, while continuing to explore how burgeoning efforts on the part of states to improve coverage might influence a national approach to ensuring access to care.

For additional information about our initiatives and objectives, visit www.rwjf.org/coverage.

Public Insurance Coverage Change Among U.S. Children from 1997–1998 to 2003–2004

SOURCE: State Health Access Data Assistance Center, University of Minnesota School of Public Health, using data from the U.S. Census Bureau's Current Population Survey 1998, 1999, 2004 and 2005, The State of Kids' Coverage, August 2006.