Isles among top in rate of insured kids

Hawaii's uninsured rate is the second lowest at 6.4 percent

WASHINGTON » Hawaii is tied with two other states with the lowest rate of uninsured children.

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

In a report released last week, the advocacy group Families USA, which promotes universal health coverage, said about two-thirds of the families who aren't insured 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.

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

Families USA 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."

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 were a parent works full time, year-round, according to the report, which is based on Census data.

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 a block grant from Washington and determines who is eligible and how much families will pay. Last month, 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.