As the debate over reauthorization of the State Children?s Health Insurance Program (SCHIP) heats up in Washington, a new survey of leaders in health policy and health care finds that large majorities feel the program has been successful in increasing access to health care for low income children (71%) and in reducing the rate of uninsured, low-income children (65%).
Across the board, leaders feel that coverage should be expanded. In fact, 91% of respondents think SCHIP should be made available to legal immigrant children whose families meet income requirements. Eighty-two percent favor allowing families with higher incomes to buy into SCHIP, and 80% believe that states should be allowed to extend coverage to parents of children covered by SCHIP in states where there is no comprehensive coverage for the uninsured
While health care opinion leaders favor expansion of the program, they also support new provisions to the program?s structure that would help the U.S. provide high-quality health care for all children. Four of five survey respondents (81%) were in favor of establishing federal performance standards and outcome measures for all children in SCHIP, and 69 percent favored measuring and reporting on the frequency and quality of developmental screening. Health care opinion leaders also support innovative mechanisms to encourage insurance plans and health care providers serving SCHIP families to provide higher-quality care. Seventy-eight percent of respondents favored requiring states to reward managed care plans and providers that meet benchmark levels of performance on developmental screening, preventive care, and follow-up treatment.
“Leading health care and health policy experts have clearly stated that SCHIP is a success and should be expanded,” said Commonwealth Fund President Karen Davis. “These opinion leaders have also expressed strong support for leveraging that success to create more value, and they make it clear that SCHIP should ensure high quality standards to ensure that children receive the preventive and developmental services that contribute to their healthy growth and development.”
It would cost an additional $12 billion to $15 billion over five years to maintain the current level of services provided under SCHIP. When asked how additional SCHIP expenditures should be financed, there is no clear favorite. About a third (37%) of opinion leaders say financing should come from raising federal taxes or fees, 27% say funds should be redirected from other programs and 25% say an exception should be made to the “paygo” rule for coverage of children. However, only 3% support retaining the current allocation as a financing solution.
The survey of leading health care experts with a diverse range of professional and ideological perspectives is the tenth in a series from The Commonwealth Fund, and the second conducted in partnership with the publication Modern Healthcare. Commentaries on the survey findings by New York Governor Eliot Spitzer and Secretary of Health and Human Services Michael Leavitt, and a data brief authored by Fund staff, Health Care Opinion Leaders? Views on Priorities for the State Children?s Health Insurance Program Reauthorization, are posted on the Fund?s web site.
Opinion leaders surveyed include experts from four broad health care sectors: academia and research organizations; health care delivery; business, insurance, and other health industry; and government and advocacy groups. Elected officials and media representatives were excluded. The online survey was conducted by Harris Interactive? on behalf of The Commonwealth Fund and focused solely on SCHIP. The survey was completed online by 170 experts.