Jocelyn Guyer Co-Executive Director Center for Children and Families Georgetown University, Health Policy Institute April 4, 2011 Caucus Room, Cannon House Office Building The State of Children's Health, Care and Coverage

The National Landscape o Remarkable progress in covering children o Despite budget challenges, nearly all states holding steady in Medicaid and CHIP coverage; a number of states continuing to move forward o New opportunities and challenges Health reform implementation State budget situation National dialogue over Medicaid Continuing to move beyond coverage to ensure children secure high-quality, effective care

Unprecedented Progress in Covering Children Source: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplements. Lowest uninsured rate since census started collecting data in 1987

How All Children are Covered, 2009 Source: Urban Institute and Kaiser Commission on Medicaid and the Uninsured Total number of children= 79.3 million

How Low-Income Children are Covered, 2009 Data may not total 100% due to rounding. Low-income defined as below 200% of the federal poverty level. SOURCE: KCMU/Urban Institute analysis of 2010 ASEC Supplement to the CPS. Total number of low-income children= 37.3 million

AZ AR MS LA WA MN ND WY ID UT CO OR NV CA MT IA WI MI NE SD ME MOKS OH IN NY IL KY TN NC NH MA VT PA VA WV CT NJ DE MD RI HI DC AK SC NM OK GA TX IL FL AL < 200% FPL (4 states) 250% or higher FPL (25 states, including DC) % FPL (22 states) Note: The federal poverty level (FPL) for a family of three in 2010 is $18,310 per year. IL uses state funds to cover children up to 300% of the FPL; OK has a premium assistance program for select children up to 200% of the FPL. AZs CHIP program is currently closed to new enrollment. Source: Based on the results of a national survey conducted by the Kaiser Commission on Medicaid and the Uninsured and the Georgetown University Center for Children and Families, Childrens Eligibility for Medicaid/CHIP by Income, January 2011

Top Health Conditions Affecting Children Source: Centers for Disease Control and Prevention, "Health, United States, 2010: With Special Feature on Death and Dying" (February 2011). Note: Data on the prevalence of asthma, ADHD, and respiratory allergies reflect ; data on dental carries and obesity reflect

Key Policy Issues for Children o Implementation of early ACA provisions Ban on denying coverage to children with pre-existing conditions Stability protections Increase in Medicaid primary care reimbursement rate o Future of Medicaid o Long-term future of ACA Transitions between Medicaid and Exchange Delivery system reforms that address childrens unique needs Role of CHIP Coverage of parents

Looking Ahead o The progress in covering kids is one of the countrys best-kept secrets o A model for health reform implementation – bipartisan leadership, smart and creative policy ideas, broad-based public engagement translated into policy gains o Key opportunity and challenge ahead is sustaining and building on this success for children o Success will mean better health, reduced disparities, stronger economies, and stronger families

Georgetown Center for Children and Families o Jocelyn Guyer o Our Website: o Say Ahhh! Our child health policy blog: