The scientific evidence for child health insurance.

A s President-elect Obama and the 111th US Congress assume leadership, we hope that they will work together to put children’s health issues, and in particular, health insurance for children, on the national agenda. The new leadership will likely address 2 critical policy options related to child health insurance: reauthorization and potential expansion of the State Children’s Health Insurance Program (SCHIP), and expansion of health insurance to all children. We hope that policy makers keep in mind the substantial body of scientific evidence about SCHIP and child health insurance. This commentary reviews the scientific evidence for child health insurance and also highlights areas in which more evidence is needed. A growing body of evidence supports the value of paying increased attention to children’s health issues, especially for children who are vulnerable because of chronic conditions or social circumstances. Research has demonstrated the profound and potentially lifelong influence of positive and negative childhood experiences. Nobel Laureate economist James J. Heckman emphasizes that early investment in the education and well-being of disadvantaged children leads to enduring benefits throughout the lifespan. A focus on children and children’s health promises to pay off with substantial downstream benefits. An important component of child health involves health insurance. The Obama proposal for health care reform, as presented during the campaign, included a Medicare-like health plan for uninsured individuals of all ages. The proposal emphasized a choice of insurance options, so that uninsured families or small businesses could opt into the plan. Although it did not mandate health insurance coverage for adults, it included a mandate for health insurance coverage for children through either private or public insurance options.