Today, over half of children are covered through private insurance, including parents’ employer-sponsored plans and individual market plans. Medicaid and CHIP are key sources of coverage for our nation’s children. Children have had much larger gains in coverage than adults over the last two decades, largely reflecting the broader availability of Medicaid and CHIP coverage for children compared to adults (Figure 1).įigure 1: Uninsured Rates Among Nonelderly Adults and Children, 1997-2016 These coverage gains have stemmed from new coverage options for children through expansions of Medicaid and CHIP and the ACA Marketplaces and subsidies as well as from streamlining of enrollment and renewal processes and focused outreach and enrollment efforts. The uninsured rate among children has steadily decreased over time, with additional declines since implementation of the ACA in 2014. The uninsured rate among children has reached an all-time low of 5%. Appendix Tables 1 and 2 provide state data on coverage for children and the number of children enrolled in Medicaid and CHIP. This brief reviews children’s coverage today and examines what is at stake for children’s coverage in upcoming debates around CHIP funding, repeal and replacement of the ACA, and restructuring of Medicaid financing to a block grant or per capita cap.
In addition, loss of CHIP funding and reductions in federal Medicaid financing would create funding gaps that would increase financial pressure on states and providers.įollowing decades of progress, bolstered by the ACA, the children’s uninsured rate has reached an all-time low. Research also suggests that reductions in children’s coverage could have broader long-term negative effects on their health, education, and financial success as adults. Reductions in children’s coverage would result in fewer children accessing needed care, including preventive services such as well child visits and immunizations. Reductions in children’s coverage would lead to reduced access to care and other long-term effects for children and increase financial pressure on states and providers. In addition, rollbacks in coverage for parents could contribute to coverage losses among children and increased financial instability among families. Loss of CHIP funding, repeal of the ACA, and capping Medicaid financing all have the potential to reverse the coverage gains achieved to date and increase the number of uninsured children. In addition, the Administration and Republican leaders in Congress have called for repeal and replacement of the ACA and restructuring of Medicaid financing to a block grant or per capita cap. New legislative authority is needed to continue CHIP funding beyond September 30, 2017. There is much at stake for children’s coverage in upcoming debates. CHIP, which had 8.4 million children enrolled in fiscal year 2015, complements Medicaid by covering uninsured children above Medicaid eligibility limits. Medicaid serves as the base of coverage for the nation’s low-income children and covered 36.8 million children in fiscal year 2015. Medicaid and CHIP are key sources of coverage for our nation’s children, covering nearly four in ten (39%) children overall and over four in ten (44%) children with special health care needs. However, these changes will not address adequately the fundamental problems with the system and, ultimately, major changes will have to be undertaken.This brief reviews children’s coverage today and examines what is at stake for children’s coverage in upcoming debates around funding for the Children’s Health Insurance Program (CHIP), repeal and replacement of the Affordable Care Act (ACA), and restructuring of Medicaid financing to a block grant or per capita cap.įollowing decades of steady progress, largely driven by expansions in Medicaid and CHIP, the children’s uninsured rate has reached an all-time low of 5%.
will adopt reforms that require the least change in the current system. It is likely that, in the short run, the U.S. Several criteria for evaluating proposals for health reform are offered and ten such proposals are discussed. spends more per capita on health services than any other country in the world, but lags behind many other countries on such health indicators as life expectancy and infant mortality.
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Reliance on the free market and fee-for-service reimbursement to allocate health resources, to contain costs and to determine who has health insurance has failed. The problems have not been solved because, due to fears of government involvement, we have been reluctant to impose central planning and management on the system. health care system are not new they have been discussed for the last 60 years.
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