While the committee supported the versatility under the act, it is concerned about how to evaluate the results. Performance measures should be established by HHS to provide comparable information for all approaches used to implement the programs, and a new national survey is needed to track these measures, the committee said. Moreover, the agency should develop systems to improve the availability of information on the national and state levels about how many children are covered by insurance, their use of health care services, and the status of their health. Presently, these data are not available for most states.
11 Million Uninsured
More than 11 million children, or one in seven, are estimated to be uninsured in the United States. Most are in families with working parents who have jobs that do not provide insurance and who cannot afford to buy it on their own. Nationally, one out of six African-American children and one out of four Hispanic children is uninsured, compared with one in 10 white children.
The problem has been exacerbated in the last decade by changes in the benefits that employers provide for their workers. The percentage of children who are covered by employer-based insurance has declined in the past decade; this decline has been partially offset by an increase in the number of children enrolled in Medicaid, which now reaches a quarter of all children in the United States.
The committee's examination of the relationship between insurance coverage and
health revealed that uninsured children are more likely to be sick as newborns,
less likely to be immunized as preschoolers, and less likely to receive medical
treatment for injuries or for illnesses such as acute or recurrent ear
infections, asthma, and tooth decay. Untrea
Contact: Dan Quinn, Dumi Ndlovu
The National Academies