Report Highlights States' Efforts to Expand Health Care Coverage

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States are modifying and adjusting the way they provide health care coverage in an effort to decrease the number of uninsured children and families, according to a report released recently by the Academy of Health Services Research and Health Policy under The Robert Wood Johnson Foundation's State Coverage Initiatives. The report reviews efforts states have made to expand health care coverage and acknowledges that these efforts have translated into a growing number of children and families with health care coverage.

Increasing State Children's Health Insurance Program (SCHIP) enrollment, higher rates of private insurance coverage resulting from the strong economy, and stabilized Medicaid enrollment declines have also contributed to a reduction in the uninsurance rate of children and families, the report states.

According to the report, states have implemented various strategies to increase the enrollment of children and families in SCHIP. These strategies include launching school-based promotions; distributing printed materials; airing public service announcements; making Web-based enrollment available; and offering training programs for providers, school personnel, and employers. The authors of the report also point out that various states have used provisions such as the Medicaid Section 1115 Research and Demonstration waivers and Section 1931 of the Social Security Act to eliminate certain traditional Medicaid program requirements; this has reduced costs and expanded program eligibility to include working families. Additionally, newly introduced SCHIP regulations regarding employer buy-in will enable states to establish their own employer-contribution levels, which could increase enrollment among working adults.

The report states that expanding services to children, parents of eligible children, and other adults, as well as identifying funding sources for insurance coverage, will continue to require the attention of the states and policymakers. The authors conclude that "further progress in reducing the ranks of the uninsured will depend on the ongoing creativity of many states as they address this problem, learn from each other, and explore new options."

Alberga J, DeFrancesco L, Molinari S, et al. 2001. State of the States 2001. Washington, DC: Academy for Health Services Research and Health Policy. Report available at http://statecoverage.net/publications.htm.

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MCH Alert. 2001. Arlington, VA: National Center for Education in Maternal and Child Health. http://www.ncemch.org/alert.