Marcus Pickett
In the two years following the reauthorization of the Children’s Health Insurance Program (CHIP), the U.S. health care system has expanded coverage for children. Yet within that nationwide improvement are vast regional disparities.
The Commonwealth Fund recently released its 2011 “Scorecard” report on children’s health care. The report ranks states based on four categories:
- Access and affordability.
- Prevention and treatment.
- Potential to lead healthy lives.
- Equity (equal access to treatment across all income levels and ethnicities).
Regional differences
Certain regions of the country perform better than others when it comes to children’s health:
- Iowa leads the pack in all four categories, but the Northeast dominates overall, with five states (Massachusetts, Vermont, Maine, New Hampshire and Rhode Island) in the top 10.
- The Midwest and Great Plains states make up the middle of the pack. Michigan, for example, ranks low for children’s potential to lead health lives, as well as for prevention and treatment, but it’s No. 9 in the country when it comes to equity. Meanwhile, Ohio ranks among the best for prevention and treatment, but it’s No. 29 for equity.
- The South generally performs poorly in all categories, especially Mississippi, Florida, Georgia, Arkansas and Louisiana.
- The Southwest is the worst region, with California, New Mexico, Arizona and Texas all on the bottom rung. Nevada is in last place overall, getting the lowest rankings possible for both prevention/treatment and equity.
Some states fail in some categories, while shining in others. Children in West Virginia, for example, suffer when it comes to leading healthy lives. Yet the state ranks in the top 10 for both access/affordability and equity. According to the study, the state has made great strides in insuring disadvantaged children, reducing the number of kids without health insurance by 50 percent over the past decade.
Utah, meanwhile, makes the top five for healthy children. But it receives a poor equity ranking (No. 42), suggesting that children from low-income families lack access to quality, affordable health care.
Children’s Health Insurance Program
The Commonwealth study coincides with the two-year mark of the reauthorization and expansion of the Children’s Health Insurance Program (CHIP). CHIP is a federal program administered by states to help provide health insurance to children in low-income families who do not qualify for Medicaid. States receive a federal match to fund their CHIP projects.
CHIP has been reauthorized by Congress through Sept. 30, 2015. Through September 2019, states are prohibited from imposing eligibility standards that are more restrictive than those in place as of March 23, 2010, according to the National Conference of State Legislatures.
Moving forward
While the Commonwealth report illustrates which states have room for improvement, it also highlights individual local programs for their innovation and effectiveness — children’s medical homes in Colorado, community care programs in North Carolina, mental health services in Massachusetts and pay-for-performance health collaboratives in Ohio.
These rankings help point out which states’ systems are working best, and how states can improve children’s health programs and access to health insurance in responsible, cost-effective ways.