Raleigh News & Observer

By Barbara Bradley

RALEIGH - The question for North Carolina parents who can't afford health insurance for their children is whether policy-makers will expand state health insurance programs to cover them. In its budget proposal the state Senate has answered with a resounding "no." Now the House, which supports insuring children, must prevail.

Ask your neighbor. Ask small business. Our health insurance coverage system is shrinking as costs rise.

While our country has built a series of modern networks that provide for utilities, education and retirement security, the United States is stuck in a bygone era with regard to health insurance. Historically the health system has relied largely on employer-provided insurance, but hard-pressed employers are finding it increasingly difficult to afford such coverage as part of their benefits package.

North Carolina has faced the second-highest loss of employer-based coverage in the country, explaining why the number of uninsured children here has risen to one in eight. That's 264,000 children, enough to fill UNC's Dean Dome 12 times.

What is needed is a long-term plan to assure healthy futures for all our children. The governor and House of Representatives both took action this spring. In his 2008-09 budget proposal, Governor Easley included funding for NC Kids' Care, an affordable health insurance program for children of families earning up to 300 percent of the federal poverty level. Under this plan, parents making between $42,000 and $62,000 annually for a family of four -- who are above the income threshold for Medicaid and Health Choice -- could pay premiums for their otherwise uninsured child to be covered. Families with higher incomes pay more of the premium.

Rep. Verla Insko and the state House then did their parts. Insko introduced House Bill 1476, which essentially makes the governor's NC Kids' Care available to all families, with the highest-earning families paying the full premium.

This plan was designed by a coalition of business leaders, insurance providers and health professionals brought together by Action for Children North Carolina.

The House included NC Kids' Care in its proposed budget -- $4 million this year and $7 million next year -- to cover children up to 300 percent of poverty level. For a mere $7 million out of a $20 billion budget, 38,000 uninsured children would have access to affordable health insurance.

The Senate decided only to study the issue and not address the top concern of a majority of working families: how to pay for health care.

But there are many cost-effective reasons the Senate and House should agree to a final budget that includes NC Kids' Care.

• Insurance expansion is attainable and affordable. Children are less costly to cover than adults. The NC Kids' Care proposal would cost the state just $7 million annually once fully implemented and would earn the state another $14 million from the federal government to help fund it. This is a small cost to provide a big benefit to 38,000 children.

• Insurance expansion improves children's health and enhances school readiness. Assuring consistent, continuous preventive and primary care for children is a wise investment. Studies indicate that children with health insurance are more likely to receive preventive care, have fewer and shorter hospital stays and miss fewer days of school due to illness. Enhanced health status, in turn, enhances school readiness and success. It also sets the stage for a healthier adulthood.

• Insurance expansion benefits employers. Since healthier children mean less work lost by parents who need to care for them, employers also reap benefits.

• Insurance Expansion benefits both providers and the insured. Health care providers will give less uncompensated care, and since the cost of much uncompensated care is transferred to those who can pay, all of us who have insurance will benefit.

Gaps in children's health coverage mean missed opportunities for our children. The cracks in the insurance system can be fixed, and the healthy futures of North Carolina's children assured by expanding the current public health insurance system to provide access to care for all children.

The time for greater expansion and greater attention to children's health and well-being is now.

(Barbara Bradley is president and CEO of Action for Children North Carolina.)