More children are going without health insurance 12.3% of Maryland's 1,272,061 children thought to be uninsured


WASHINGTON -- The proportion of American children without health insurance is growing, and current trends in health care and welfare reform threaten to accelerate that dangerous trend, researchers and child-care advocates say.

About 10 million American children under 18 were uninsured in 1994 - the latest year for which numbers are available, according to a recently released General Accounting Office report. That was 14.2 percent of all kids, up from 12.4 percent in 1992.

"It is a large and growing problem, and it appears that prospects for the future are even bleaker," Edward Howard, executive vice president of the nonpartisan Alliance for Health Reform, at a seminar on children's health coverage, said. "While we can't predict actual numbers, we can quantify a steady decline," he added.

Children are losing their insurance as employers cut back or phase out health insurance coverage for their parents. And experts say that issue is affecting all children, not just the poor.

"The uninsured are a dynamic population that cuts across a wide sector," said Paul Fronstin, a research associate at the Employee Benefit Research Institute, which sponsored Friday's seminar. "Decreases in employee-based coverage mean that children from all economic levels are affected."

In 1980, 74 percent of American workers had their insurance plans fully paid by their employers, Fronstin said. By 1993, that number had dropped to 21 percent, and many families are

finding it harder and harder to pay their required portions of health plans.

Employment-based coverage for children has decreased every year since 1987, dropping to its lowest level of 46.3 million in dTC 1994. In that year alone, 1 million children joined the ranks of the uninsured.

While a 1990 expansion of Medicaid increased health insurance coverage for poor children, it didn't bring an overall increase of insured kids. That's because nearly a third of uninsured children came from families that lost private coverage, but weren't eligible for Medicaid.

Two-thirds of those newly uninsured children had a father who was employed by a small firm, Fronstin said. As more small businesses become vulnerable to economic stresses, either ending health plans or closing, children lose out.

Pending welfare revisions could contribute to the negative trend, some experts say.

"Welfare reform as presented does not meaningfully provide for the health care of low-income families," said Douglas Nelson, executive director of the Annie E. Casey Foundation, a Maryland-based philanthropic organization. "Not only are there not enough jobs available, but most low-income work today does not allow low-skilled workers to provide the minimum health needs of their children."

While most kids are relatively healthy, they need lots of preventive care. And a significant minority develop acute disabilities like asthma, sickle cell anemia, spina bifida and mental retardation.

Children with these disabilities consume a vastly disproportionate amount of health care dollars, and a lack of health insurance with such illnesses can spark a family crisis.

Consider, for instance, the recent plight of the Brandt family. Both Scarlet Brandt and her husband, Richard, were employed when medical problems hit their children. But in 1993, health insurance was terminated at the Tarentum, Pa., beauty salon where she worked. Richard's truck driving job offered no insurance.

Soon, son Chad, then 4, developed serious ear infections. Nine months of prescription medicine they barely could afford didn't help, and he faced costly surgery.

"It's times like that when you have to decide, should I pay my rent or pay for medicine," Brandt said. "Can we eat, or should we take him to the emergency room?"

Dealing with the problems of people like the Brandts should be central to solutions to health-care reform, said Charles LaVallee, executive director of the Western Pennsylvania Caring Foundation, a public-private partnership which provides health insurance for children of lower-income families.

"These are the working poor, the people who don't want to accept public assistance and who want to provide for their families," LaVallee said. "If they don't have support, society pays a higher price down the line."

Together, the Caring Foundation and the insurance program provide 80,000 Western Pennsylvania children with health-care basics like immunization and dental care, as well as specialty and emergency care.

Pub Date: 9/22/96

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