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Here’s a good news story on health coverage that the public is largely unaware of. The number of uninsured children continues to decline to historic lows – a remarkable accomplishment given the high childhood poverty rate and tough economic times. Yet a majority of Americans are unaware of this achievement.

In a poll CCF commissioned by PerryUndem Research and Communications, we found only 13% of Americans realize that children are gaining coverage. In fact, a majority of Americans think the number of uninsured children is rising. That’s understandable given the slow economic recovery. Many don’t realize that, behind the scenes, Medicaid and the Children’s Health Insurance Program have been hard at work meeting the health coverage needs of children.

Today we are releasing our annual look at children’s coverage rates. The report, entitled Children’s Health Coverage on the Eve of the Affordable Care Act, finds that the uninsured rate for children continues to decline reaching 7.2% in 2012. Adults age 18-64 lag far behind with 20.6% uninsured. Coverage expansions coming in 2014 will start moving the adults’ coverage rate in the right direction, but the lesson from our nation’s experience with covering children is that it takes time and a sustained commitment.

The Children’s Health Insurance Program Reauthorization Act of 2009 paved the way for continued improvements in children’s coverage. The Affordable Care Act, passed in 2010, helped reinforce those gains for children by requiring states to hold steady in their commitment to children’s coverage.

This success story for children reflects years of hard work on the part of federal and state leaders, and other stakeholders — including the philanthropic community, children’s advocates, community leaders and health care providers, that worked cooperatively to streamline a path to coverage for uninsured children through Medicaid and CHIP.

Our country’s success is a testament to what states can accomplish when they “lean in,” have adequate funding, and work with the federal government to meet the needs of families.

Speaking of states, our report found some regional disparities that should give policymakers in certain parts of the country pause. An estimated 45.5% of uninsured children live in the South, 29.4% in the West, 15.6% in the Midwest and only 9.4% in the Northeast. Children living in the South and West are at risk of falling further behind in coverage rates if they live in a state that rejects the Affordable Care Act’s Medicaid funding to offer coverage to more uninsured parents and other low-wage earners. That may sound counterintuitive but research shows that putting out the welcome mat for uninsured parents is the single most effective strategy states can employ to bring uninsured children in the door to coverage.

Our report also found that Latino children continue to be disproportionately uninsured and that school-age children are more likely to be uninsured than younger children. Interestingly, children living in rural areas were one of the few groups that showed no improvement in their coverage rates – and their coverage rate of 7.8% is higher than the national average of 7.2%.

Full implementation of the Affordable Care Act holds the promise of reducing the number of uninsured children by as much as 40%. The lessons learned from years of sustained effort on improving Medicaid and CHIP for children shows that our country can make this work. And let’s not forget Medicare – which has been at it for even longer – resulting in virtually universal coverage rates (99%) for seniors.

We are not there yet for children and their families, but on the eve of the Affordable Care Act, the success of Medicaid and CHIP reminds us to stay the course for a better tomorrow. When children’s health needs are met, they show up to school better able to learn. When parents don’t have to worry about unpaid medical bills, the whole family is more financially secure. And investing in our children today creates a stronger workforce for tomorrow.

Cross posted from Georgetown University's Center for Children and Families Say Ahhh! blog.

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