1. National: States Ranking High in Children's Health Have Lower Uninsured Rates Children in states with higher rates of insured children are more likely to receive higher-quality health care, according to a Commonwealth Fund study. Researchers used data on 13 health care indicators to rank all 50 states and Washington, D.C., in five subcategories: health care access, quality, cost, equity and health outcomes. The study, titled "U.S. Variations in Child Health System Performance: A State Scorecard," found that expanded insurance coverage through programs such as Medicaid and CHIP is critical for improving quality of care for children in every state. According to the study, 4.7 million additional U.S. children would have health insurance and 11.8 million more would receive recommended yearly checkups if all states achieved the coverage rates of the highest-ranking states. In addition, nearly 800,000 additional children would be current on their vaccinations. U.S. Census Bureau data show that 8.7 million U.S. children were uninsured in 2006. The report also found states with higher rates of insurance were more likely to have higher health care costs per child. Hawaii ranked seventh nationally in the study. [Kaiser Daily Health Policy Report, 05/28/08] 2. Mississippi: Children's Health Insurance Report There has been considerable debate about children's health coverage at the national level. The debate has been stimulated in large part by legislation to reauthorize the State Children's Health Insurance Program (CHIP). Many states have initiated programs to reduce the numbers of uninsured children. Recently, some states have set a goal of universal coverage for children. Given the significance of this health policy issue, the Center for Mississippi Health Policy has researched the status of health insurance for children in Mississippi. This research includes a review of options that policymakers may wish to consider for reducing the number of uninsured children in the state. The major findings in the report include: * Approximately 124,000 children in Mississippi lack health insurance; * 3 in 4 uninsured children in Mississippi are eligible for coverage (Medicaid or CHIP); * 1 in 3 potentially eligible but uninsured children in Mississippi had been covered by Medicaid or CHIP in the past year; * Trends show declines in private coverage and in public coverage; * Trends show an increase in the number of uninsured children; * The decline in public health insurance and the increase in the number of uninsured children occurred in low-income families; * 3 in 4 uninsured children live in a household where at least one adult is working full-time; * The average employee contribution for family coverage increased 12 times faster than average worker earnings from 2001 to 2005, consuming 94 percent of the increase in worker earnings; * The average employee contribution toward a family premium in Mississippi, $2,811, is about 8 percent of the family income for a family of three at 200 percent of the Federal Poverty Level; * Less than half of private sector employees have insurance coverage through their employer; * Only 28 percent of small employers offer health insurance coverage for employees, and 74 percent of private establishments are small (< 50 employees); and * Only 15 percent of private sector workers have family coverage. The profile that emerges shows a continuing enrollment decline in employer-sponsored insurance coverage. At the same time, there are sharp increases in premiums for employer-sponsored health insurance. The situation has disproportionately affected low-income families. One result has been an increase in the numbers of low-income children left uninsured. The decline in public coverage indicates that many low income uninsured children are not enrolling in the public programs designed to provide them with health insurance. 3. Iowa: Children Losing Health Insurance As companies trim their health-insurance plans to compensate for rising costs, two new studies highlight the slackening economy's effects on children's health care. Researchers at the Cincinnati Children's Hospital Medical Center conducted the two studies. The first, based on two years of data from the Medical Expenditure Panel Survey, found 16 percent of the children's parents lost their jobs and 14 percent lost health-insurance coverage. The survey collects data from hospitals and pharmacies as well as families and individuals from across the country. It asks how much and for what services workers pay for health insurance. Children whose parents lost or simply changed jobs were twice as likely to lose their health insurance. Those who had private insurance fared worse; they were three times more likely to lose health coverage, according to the study. Using the Ohio Family Health Survey, the second study looked at 15,447 children for the effects of on-and-off insurance coverage. The youngsters faced unfilled prescriptions, delayed care, and lack of doctor visits similar to their completely uninsured peers. "This is a particularly disturbing finding, coming at a time when job loss is becoming more common because of the economy," said Gerry Fairbrother, a researcher in health policy and clinical effectiveness at the Ohio children's hospital, in a May 3 release. But Iowa, high on the list of children's health insurance rates in the nation, doesn't seem to be hurting yet. In 2006, 93.7 percent of Iowa's children under age 18 had insurance, and most were covered by employment-based private plans, according to the State Data Center of Iowa. And Iowa is an "interesting" case: High numbers of self-insured and self-employed individuals (e.g., farmers) are "doing a good job of covering their families," said Peter Damiano, a UI professor and the director of the Public Policy Center. "We're in better shape, but we need to keep an eye on that," he said. Study authors concluded that without universal health insurance for children, much more must be done to provide a smooth transition to public coverage if indeed their parents face job loss or change. Damiano said a factor other than economy is the federal government's philosophy toward Medicaid and other public programs--namely, resistance to the latter. Last year, President Bush twice vetoed bills to expand the State Children's Health Insurance Program, which covers doctor visits, vaccinations, hospitalizations, and emergency-room visits for children whose families earn too much to qualify for Medicaid but not enough to afford private plans. Next to employer-based coverage, CHIP and Medicaid are the second-most popular health insurance methods, according to the Centers for Medicare and Medicaid Services. But around two weeks ago, the Iowa Legislature passed measures to cover approximately 54,000 uninsured children in the state by 2010. "In the face of economic crisis, Iowa acted in a manner that will bring working families some much needed help," said Andrew Mertens, the communications director of Iowa for Health Care. The group is part of the Service Employees International Union. [Zhi Xiong, The Daily Iowan, 05/12/08]