Nearly 30% Of Eligible Children Uninsured

By KEVIN SACK The New York Times

Published: Aug 22, 2007

GREENSBORO, N.C. - During the four years that her children were uninsured, Cassie O. Hall used the emergency room as their pediatrician. When Tayana had an asthma attack or Darren developed a stubborn rash, they would head to the hospital and settle in for a long wait.

The children never got physical exams or booster shots. As the unpaid hospital bills stacked up, the threshold for a visit grew higher. "They would have to be half-dead before I would take them," said Hall, a day care operator who could not afford private insurance.

It was only in May that Hall learned her family qualified for the State Children's Health Insurance Program, which provides subsidized insurance to children of the working poor. That she had never heard of the joint state and federal program made her typical of countless parents of the estimated 8 million uninsured American children.

Despite a decade of marketing efforts by governments and private foundations, nearly 30 percent of children who are eligible for the health insurance program and are not covered by private plans have yet to enroll, according to a new government study.

Although the Bush administration published new standards last week aimed at preventing states from expanding eligibility for the program to cover children from middle-class families, a more fundamental debate over the program has raged in Washington for months: how to find and enroll the 1.7 million low-income children who are already eligible but have not signed up.

The challenge of enrolling those who are already eligible demonstrates how difficult it will be for states to meet the federal standards. The new policy says that states can only expand eligibility for their programs, by raising income limits above certain levels, if they have first enrolled 95 percent of those who now qualify. Few states have come close to doing that; the national enrollment rate in 2004-05 was 72 percent, according to the study.

The House and Senate passed bills this month vastly increasing funding for the program, which expires Sept. 30. Most of the new money is dedicated to finding and covering children already eligible.

President Bush, who proposed a much smaller increase of $1 billion a year, has vowed to veto them.