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Editorial
December 2002

The State Children's Health Insurance ProgramEffective but Vulnerable

Arch Pediatr Adolesc Med. 2002;156(12):1175-1176. doi:10.1001/archpedi.156.12.1175

CLINICIANS DO not need studies to convince them that insurance coverage makes a difference. However, many policy makers do. The article by Slifkin et al1 in this issue of the ARCHIVES articulates just such a fundamental message through a purposeful evaluation of a North Carolina child health insurance plan supported by the State Children's Health Insurance Program (SCHIP). The SCHIP was established by Congress in 1997 to provide funds for state efforts to provide child health insurance for families with incomes too high to be eligible for Medicaid yet too low to realistically afford private insurance. In the analysis of the North Carolina program, parental surveys were conducted soon after a child's enrollment in the plan and then again a year later. Although the authors report a number of interesting results, of central importance was the finding that the percentage of children with unmet health care needs fell dramatically after entering the program. Parents reported that the program greatly enhanced access to physicians, eyeglasses, and prescription drugs. Few in the program reported that their children's health care needs were going unmet. These are important findings that speak directly to one of the principal questions regarding SCHIP: can such a health insurance plan reduce barriers to recommended care for children? This study suggests that, at least for the North Carolina case, the answer is yes.

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