- Policy Resources
- News & Analysis
- Your State
Health Care for All Kids
Health Care for All
Below you’ll find a menu of model state legislation (most of which has passed in at least one state) as well as guidelines for state legislators and advocates relating to health care programs that can be tailored for use in their own states.
Here are a few key legislative models enacted or proposed in various states (for more details, read below):
- Covering Kids: Illinois AllKids law
- Employer "Fair Share" Requirements: Laws in Maryland and New York City and proposed bills in Chicago and New York State.
- Universal Coverage Proposals:San Francisco Law, California Single-Payer bill and Wisconsin Employer-Based Universal Coverage bill
THE BIG PICTURE OF HEALTH CARE FOR ALL KIDS: Millions of Americans, including children, lost health insurance coverage in recent years-- with the percentage covered by employer-provided coverage dropping from 63.6% in 2000 down to 59.8% by 2004. That was 11 million less than if coverage rates had stayed the same.
In response, states are promoting a variety of models to expand coverage to make sure children and their families have health care, including expanding Medicaid & SCHIP programs, enacting comprehensive plans to cover all kids, reinforcing employer-provided health care coverage, and promoting universal health plans for everyone.
Extending Medicaid and SCHIP: Since 1997 when the State Children’s Health Insurance Program (SCHIP) was established by the US Congress, states have been expanding enrollment, covering roughly 4 million children today. States can either integrate SCHIP funds into their regular Medicaid program and/or run separate SCHIP programs solely for children. States have been building on these programs towards universal coverage in a number of ways, including:
Some states only cover children of families that are just above the poverty line, while others offer more robust coverage. In legislation enacted this year, Massachusetts joined New Jersey, Connecticut, Maryland, New Hampshire, and Vermont as states which have extended subsidized coverage to kids in all families up to at least 300% of the poverty level ($60,000 for family of four).
AllKids Coverage: Taking a step farther, Illinois enacted the AllKids program last year to extend health care coverage to children throughout Illinois. State officials this year finalized the table of premiums for families and launched the program on July 1-- and the results are an impressive model for affordability. A family of four making up to $2500 per month ($30,000 per year) would pay no monthly premiums to cover two children, while families making $2500-$8333 per month (up to $99,000/yr) would pay a sliding scale from $25 to $100 per month per child-- with increasing premiums for families making more than that amount.
What is impressive about the Illinois program is that it converts health care from a quasi-poverty program to a general health plan for all kids, much as Medicare is a general plan for the elderly. Which means that working families will no longer face the dilemma of a raise at work potentially meaning the loss of affordable health coverage for their children.
Reinforcing Employer-Based Coverage: A number of states and local governments are working to reinforce employer-provided health insurance by requiring irresponsible employers who refuse to provide coverage to either expand health care for their employees or pay a fee to either the government or to the employees directly to provide funds to cover the uninsured.
- Maryland, New York City, and Suffolk County have all passed such employer "fair share" laws for large retail establishments.
- A majority of the Chicago City Council voted for an ordinance to require large retail stores to provide a combination of wages and benefits like health care to their employees.
- New York State advocates are promoting a more comprehensive "fair share" bill that would cover most non-manufacturing businesses with 100 or more workers.
- And as part of the more universal proposals discussed below, San Francisco, Massachusetts and Vermont all approved requirements that employers not providing health care pay fees to held fund health care for the uninsured.
Universal Coverage: The most sustained way to extend coverage to all children is to make health care coverage universal for everyone in society, including children and their parents, especially as millions of children are losing coverage as employers drop coverage for their families. A number of states and local governments are promoting programs to achieve that goal with a combination of requirements that employers that don't provide coverage make a contribution to cover their employees, additional funds from coverage, along with reasonable contributions from individuals based on their ability to pay.
- San Francisco in 2006 approved the most comprehensive program in the country, promising to provide health care to every uninsured resident, funded with a combination of public funds and contributions by employers not currently providing care to their employees.
- While not yet enacted, there are campaigns for legislation in both California and Wisconsin to create integrated, universal health care systems that would achieve both the guarantee of coverage and the cost savings.
- Vermont and Massachusetts have approved plans to significantly expand coverage for residents with the goal of universal coverage through both expanded state subsidies and promoting more affordable private insurance-- although the Vermont plan has clearer mandates for what constitutes affordable coverage and both fail to cover all state residents.
Legislative Models on Health Care for All Kids
- Kaiser Foundation on State Policies on SCHIP Enrollment
- Robert Wood Johnson Foundation, State Coverage Initiatives
- Illinois AllKids law summary and text
- Employer "Fair Share" Requirements in Maryland, New York City and proposed in Chicago and New York State.
- Universal Coverage Proposals in SF (Ordinance summary and text), CA (Bill summary and text), and WI (Bill summary and text)
- Broad Coverage Proposals: VT (Bill summary and text), MA (Bill summary and text),
- NCSL Bills on Universal Health Care Coverage
Talking Points on Health Care for All Kids
In 2003, uninsured children were 2.7 times more likely than insured children not to have seen a health care provider in the previous 12 months; uninsured children were more than twice as likely to have gone without a preventive care visit in the past year as children who had insurance.
Uninsured children are 10 times more likely to have an unmet health care need than insured children.
Lack of health insurance is by far the largest contributor to racial and ethnic disparities in treatment and outcomes for minorities compared to whites. Nearly one in five Hispanic children and one in seven African American children are uninsured, compared to about one in 13 white children.
Good health care plays an important role in helping children succeed in school, since good health means a child is less likely to miss classes, is better able to pay attention in school, and can participate in all school activities.
Other Resources on Health Care for All Kids
- Families USA, Medicaid and Children's Health
- Campaign for Children's Health Care
- Americans for Health Care
- UC-Berkeley Labor Center: Declining Job-Based Health Coverage for Working Families in California and the United States
- Center for American Progress Action Fund, Health Progress News
- National Academy for State Health Policy, Premium Assistance Toolbox for States: a survey of legislative models for subsidizing employer-provided health care
- Kaiser Foundation, In a Time of Growing Need: State Choices Influence Health Coverage Access for Children and Families: report on eligibility rules, enrollment in Medicaid and SCHIP programs in 50 states.
Sign up for the Stateside Dispatch from the Progressive States Network to receive ongoing news and analysis of state policy proposals and successes.