The Scores Are In

State-by-state scorecard reveals improvements in children's health care, yet disparities remain

(RxWiki News) A new state scorecard on health care for children found that millions of children could become insured, gain access to preventive care, and get vaccinated if all states did as well as the top-performing states.

Researchers at the Commonwealth Fund evaluated how well the health care system is working for children in each US state. They found that children's access to health care has improved in the United States as whole because of federal expansions to Medicaid and the Children's Health Insurance Program (CHIP). However, the report also reveals wide disparities in health insurance coverage from state to state.

Drawing information from 20 indicators that show how the health care system is working for children, researchers ranked the performance of individual states. The results revealed that children who live in the best performing states (Iowa, Massachusetts, Vermont, Maine, and New Hampshire) were more likely to be insured and receive regular preventive medical and dental check-ups compared to children from lower ranked states such as Florida, Texas, Arizona, Mississippi, and Nevada.

According to the authors, if all states performed as well as the best states, an estimated 5.6 million children would be covered by health insurance; 10.2 million children would receive the recommended medical and dental check-ups; almost 600,000 additional children would get vaccinated; and 8.8 million more children would have a medical home (a family-centered approach to primary care that looks at the medical and non-medical needs of a child).

While access to health care has improved for children over the past few years because of Medicaid and CHIP, many parents have lost coverage because of unemployment and rising health insurance costs. According to Cathy Schoen, Senior Vice President of the Commonwealth Fund and co-author of the report, the recent improvements in health insurance coverage for children show how policy can positively affect our children's health, even in tough economic times.

Yet many children still lack access to many basic health services. If near-universal coverage for children in Alabama is possible, says co-author Edward Schor, M.D., then it should be possible in other states like Texas and Mississippi.

An overview and full version of the report can be found at the Commonwealth Fund's website (

Review Date: 
February 4, 2011