N.H. Boasts Nation's Third-Highest Insurance Rate For Children
By Beth Potier, Media Relations
March 21, 2007
Carsey Report Looks at Success of New Hampshire Healthy
New Hampshire boasts the nation’s third-highest
health insurance rate for children (three-year averages
from 2003-2005). A new brief from the Carsey Institute
at UNH, released as the U.S. Congress discusses reauthorization
of State Children’s Health Insurance Program (SCHIP),
finds that the New Hampshire Healthy Kids non-profit corporation
is in part responsible for this success.
The Healthy Kids programs depend upon SCHIP funds, so
reauthorization by Congress will have a significant impact
on the ability of Healthy Kids to reach the remaining 17,000
children – six percent – who are without health
insurance, the brief says.
“We found that New Hampshire Healthy Kids is one
of three factors responsible for achieving and maintaining
the state’s high insurance rate for children,” said
Carsey Institute senior fellow and UNH professor of sociology
Sally K. Ward, who co-authored the report with Carsey research
assistant Sarah Savage and Nena Stracuzzi, post-doctoral
research fellow at the Carsey Institute.
Other factors contributing to New Hampshire’s success
in insuring children were the high rate of employer-sponsored
insurance in the state (77 percent of children were insured
this way, according to 2005 Census figures) and a consensus
among the general public that children should be insured
(86 percent of N.H. residents surveyed indicated that children
without insurance should be covered by a publicly supported
health insurance program).
New Hampshire Healthy Kids currently insures more than
70,000 low- and moderate-income children with three distinct
programs: Healthy Kids Gold, or Medicaid; Healthy Kids
Silver, for low-income families whose incomes exceed Medicaid
eligibility limits; and Healthy Kids Buy-In, a non-subsidized
option for families with moderate incomes. Healthy Kids
Silver is the New Hampshire State Children’s Health
Insurance Program (SCHIP), insuring 7,000 children.
Founded as a non-profit corporation governed by a volunteer
board of directors, Healthy Kids was created in 1993 with
seed money from the New Hampshire state legislature. When
SCHIP was enacted at the federal level in 1997, Healthy
Kids was selected to implement the new program. Since 2001,
the three Healthy Kids programs have given New Hampshire
families greater options than families in many other states.
Current Population Survey data from the U.S. Census and
Healthy Kids enrollment data provided context for New Hampshire’s
success and program scale. Interviews with 29 family and
health professionals helped researchers understand the
nuances of Healthy Kids, and two surveys conducted by the
UNH Survey Center provided an understanding of the awareness,
perceptions and support of Healthy Kids among New Hampshire
residents and school nurses.
The researchers found that the following characteristics
of Healthy Kids help account for its contribution to the
- An established track record that predated the creation
- The integration of different programs under one “brand
name,” creating a seamless approach for families.
- The corporation’s independent, nonprofit status,
facilitating an innovative approach that is mission driven
- An investment in partnerships with organizations and providers
throughout the state, ranging from the Department of Health
and Human Services (DHHS) to individual physicians.
Healthy Kids has distinguished itself as a high performing,
mission-driven nonprofit organization that has developed
effective partnerships throughout the state to further
its goal of providing insurance for all New Hampshire children,” says
Savage. “Yet there are also significant challenges
in the future efforts to identify and enroll the remaining
17,000 children in the state who are estimated to be uninsured.” The
researchers make several policy suggestions to address
- Reauthorize SCHIP at a level adequate to maintain current
coverage and expand coverage for eligible children. The
U.S. Congress will address the issue of the reauthorization
of SCHIP in the current legislative session.
- Provide funds to support aggressive outreach. One of the
success stories of Healthy Kids has been the effectiveness
of its outreach efforts. Funds to support even more aggressive
outreach activities would help to identify and enroll the
remaining 17,000 uninsured children.
- Maintain and advance the integration of Medicaid and Healthy
Kids under the Healthy Kids “brand” to build
on the seamless approach to enroll eligible children and
- Create incentives for employer-sponsored insurance. Although
New Hampshire enjoys a high rate of employer-sponsored
insurance, there are indications of slippage in this type
of coverage. Further reduction in employer-sponsored insurance
could overwhelm the capacity of Healthy Kids programs to
- Provide additional state funds for the coverage of children.
While Healthy Kids has a diverse funding base, it is unlikely
that private sources alone would be sufficient to cover
all eligible children. Given the broad support in the state
for such coverage, additional state funds for health insurance
for children should be a high priority.
The complete brief can be downloaded at the Carsey Institute’s
Web site: www.carseyinstitute.unh.edu.