Most Uninsured Children Have Parents With Jobs

Most of the 9 million uninsured children in the U.S. live in homes where at least one parent works full time. In more than one-quarter of the cases, there are two working parents.

The advocacy group Families USA, which promotes universal health coverage, says that finding goes against the stereotype that many people have of the uninsured.

"I think they believe these are low-income people who don't work, who are very different from themselves," said the group's executive director, Ron Pollack. "These are people who work, who are doing the right thing."

In a report being released Thursday, the group said about two-thirds of the families would qualify for government-sponsored coverage for their children if parents would apply.

"The reason these children are not participating is that, No. 1, many don't know about it, and No. 2, the enrollment process is cumbersome," Pollack said.

Mark McClellan, who oversees federally subsidized health insurance programs at the Centers for Medicare and Medicaid Services, said the Bush administration knows that outreach can be improved. He testified recently that President Bush wants to spend $100 million annually to help states, schools and faith-based groups improve enrollment rates.

Overall, 88.3 percent of uninsured children age 18 and under live in households with a working parent. About 70 percent live in households where a parent works full time, year-round, according to the report.

If a worker has access to employer-sponsored coverage, he will pay about $226 a month for family coverage. But many have jobs that do not offer health coverage.

The government has two programs that provide health insurance for children:

--Medicaid primarily covers children living in poverty.

--The State Children's Health Insurance Program covers children who live just above the poverty level. That level is typically between 100 percent and 200 percent of poverty. The poverty level for a family of four last year was $19,971.

The government spends about $4 billion annually on the latter program. Families USA says an additional $12 billion will be needed over the next five years to maintain current enrollment, now at about 6.1 million children.

Each state receives block grants from Washington and then determines who is eligible and how much families will pay. Last week, a bipartisan group of a dozen governors told Bush that 18 states could face shortfalls in this budget year.

"Congress must address the short-term funding shortfall or states will be forced to drop children from their program or move SCHIP eligible children into already stretched-thin Medicaid programs," the state leaders said.

The five states with the highest rates of uninsured children are Texas, 20.4 percent; Florida, 17 percent; New Mexico, 16.7 percent; Nevada, 16.4 percent; and Montana, 16.2 percent.

Vermont had the lowest rate of uninsured children — 5.6 percent. Michigan, Hawaii and New Hampshire were next at 6.4 percent. The national rate is 11.6 percent.

Families USA said that about 3.4 million of the uninsured children in the U.S. are white, about 1.5 million are black, and about 3.5 million are Hispanic. The organization did not note how many of the uninsured Hispanic children are illegal immigrants.

The group used Census Bureau figures, which did not report on immigration status. Other studies have pointed to immigration as a major cause for the growing number of uninsured in the United States. The Employee Benefit Research Institute, for example, said last year that immigration accounted for 86 percent of the growth in the uninsured between 1998 and 2003.

The institute did not attribute the increase in uninsured to illegal immigration. It attributed the increase to a five-year ban on access to public health programs for most new legal immigrants.

Pollack said that he believes illegal immigration contributes only slightly to the ranks of uninsured children