A survey of US health care opinion leaders suggests there is wide agreement that the State Children’s Health Insurance Program (SCHIP) has been successful in increasing access to health care for low income children and reducing the numbers of ininsured children. They also agree that coverage should be expanded.
The 10th Commonwealth Fund Health Care Opinion Leaders Survey found widespread support for SCHIP from a diverse group of experts.
Most respondents felt the program has been successful in meeting its aim to extend health insurance and access to health care to low-income children.
Commonwealth Fund President Karen Davis said:
“Leading health care and health policy experts have clearly stated that SCHIP is a success and should be expanded.”
“These opinion leaders have also expressed strong support for leveraging that success to create more value, and they make it clear that SCHIP should ensure high quality standards to ensure that children receive the preventive and developmental services that contribute to their healthy growth and development,” she added.
They would also support measures to improve enrollment, change the way the scheme is funded and extend cover to include more low-income children, including legal immigrant children.
The opinion survey was conducted online by Harris Interactive earlier this month. 1,467 experts in health care policy, delivery and finance were approached, and 170 responded (12 per cent).
Among the respondents were representatives from academia, research, health care delivery, business, insurance, other health industry sectors, government, and advocacy groups. No elected officials or media representatives were approached.
The Commonwealth Fund is a private foundation started in 1918 that carries out surveys, provides information and grants and supports improvements in health care.
The results were in four main areas: Success of SCHIP, Expansion, Funding, and Quality of Care.
Success of SCHIP
Most respondents felt SCHIP has met its goals to extend access and improve quality of coverage for children:
— 71 per cent said SCHIP has succeeded in reaching low-income children.
— 65 per cent said it has been successful in reducing numbers of low-income children who are uninsured.
— 56 per cent said it has been successful in improving preventive care and service quality for children.
— 52 per cent said SCHIP has succeeded in giving working families peace of mind about their children’s coverage.
There was less support for other goals, suggesting these are areas for future attention:
— 34 per cent said SCHIP has succeeded in stimulating new ways to deliver health care to children.
Expanding Coverage of SCHIP
There was strong support for extending coverage of SCHIP for low-income children and other groups:
— 88 per cent support allowing states to cover children up to 300 per cent of the federal poverty line figure.
— 91 per cent support making SCHIP available to legal immigrant children.
— 73 per cent said that once children are covered, childless adults under the federal poverty level figure should be covered.
— 80 per cent said parents of children in SCHIP should also be covered if there is no other comprehensive effort to cover the uninsured.
There was little support for the government’s suggestion on limiting SCHIP coverage:
— 14 per cent supported the Administration’s recommendation to limit coverage to children under 200 per cent of the federal poverty level.
Funding
— 80 per cent were in favour of states adopting best practice for outreach and enrollment.
— 67 per cent were in favour of federal matching funds for SCHIP to cover all eligible children.
Quality of Care
All proposals regarding quality of care were strongly supported:
— 84 per cent in favour of states desiging packages that “wrap around other coverage” (eg translation services).
— 78 per cent in favour of states having to reward managed plans/providers who meet performance benchmarks on developmental screening, preventive care and follow-up treatment.
— 69 per cent support for measuring and reporting on frequency and quality of developmental screening and growth, and developmental counselling to parents of SCHIP covered children.
About SCHIP
In 1997 US Congress passed The Balanced Budget Act which included the authorization of Title XXI of the Social Security Act, otherwise known as the State Children’s Health Insurance Program (SCHIP).
SCHIP was designed to expand health care coverage to uninsured, low-income children.
Within its first seven years, by the end of 2004, SCHIP had enrolled 4 million children in all 50 states and the District of Columbia.
SCHIP’s current period of authorization ends this federal fiscal year, 2007.
There are currently many debates about SCHIP in the lead up to its reauthorization, and high on the agenda is how it should be funded in the future, particularly if it is to be expanded.
Click here to learn more about SCHIP (National Academy for State Health Policy, US)
Written by: Catharine Paddock
Writer: Medical News Today