State-at-a-Glance Coverage and Financing Charts
Entire US
Number of children 78,645,220
Children as a percentage of the total population 26%
Source : Kaiser Family Foundation (2009).
Percentage of children, by race/ethnicity
White alone 60.9%
Black/African American alone 14.7%
Hispanic/Latino alone 17.1%
American Indian/Alaska Native alone 0.9%
Asian alone 3.3%
Native Hawaiian/Other Pacific Islander alone 0.2%
Another race/ethnicity alone 0.3%
2 or more races/ethnicities 2.6%
Source : U.S. Census Bureau (2002).
Among households with children, percentage of households with one, two, or three or more adults
1 adult 12.3%
2 adults 64.5%
3 or more adults 23.2%
Source : National Survey of Children with Special Health Care Needs (2005-2006).
Percentage of population living in urban areas 72.7%
Source : U.S. Dept of Education, Office of Special Education and Rehabilitative Services (2003).
Percentage of children who have special health care needs 13.9%
Percentage of children with reported special health care needs, by age group
0-5 8.8
6-11 13.2%
12-17 14.6%
Percentage of households with one or more children with special health care needs 21.8%
Source : National Survey of Children with Special Health Care Needs (2005-2006).Tip : These figures reflect parent responses to "screener" questions about the child's use of or need for services, rather than an objective assessment of health status. Be cautious in comparing rates across states and subgroups. Differences may reflect parental perceptions rather than real differences in child health needs. It is especially important not to assume that higher reported prevalence of special health needs is evidence of worse health conditions for children.
Percentage of live births that are low birth weight 8.2%
Source : U.S. Dept. of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau (2005).
Percentage of public school students enrolled in Special Education 13.8%
Source : The National Center for Education Statistics (2006).Tip : The Chartbook has no basis for implying that a particular level of participation in special education is a good or bad thing from an educational perspective. What is important is that special education is often a source of developmental services that complement health services for some children with special needs. States vary widely in the nature and extent of services provided.
Per capita income $21,587
Source : U.S. Census Bureau (2002).
Percentage of children in families with income below 200% of the federal poverty level 40.8%
Source : National Survey of Children with Special Health Care Needs (2005-2006).Tip : Per capita income is a useful, rough measure of the financial well-being of state residents. However, it may mask wide disparities between rich and poor in a state. And even in a state with high per capita income, children may be over-represented among poor and near-poor households
Source : Kaiser Family Foundation (2009).
Percentage of families who report they have reduced work hours to care for their CYSHCN 23.8%
Source : National Survey of Children with Special Health Care Needs (2005-2006).
Distribution of employers, by number of employees
<20 89.3%
20-99 8.9%
100+ 1.8%
Source : U.S. Census Bureau (2006).
Percentage of employers offering private sector health insurance 55.8%
Percentage of employers offering private sector health insurance, by number of employees
<50 42.6%
50+ 95.6%
Source : Kaiser Family Foundation (2006).
Maximum allowed income for Medicaid enrollment, as a percentage of the federal poverty level, compared to the federal minimum requirement
Pregnant women Required minimum: 133%
Children, aged 0-1 Required minimum: 133%
Children, aged 1-5 Required minimum: 133%
Children, aged 6-19 Required minimum: 100%
Source : Kaiser Family Foundation (2009).
Federal Medical Assistance Percentage (FMAP) Range = 65.0%-83.0%
Source : Kaiser Family Foundation (2009).
Per pupil education expenditures $9,154
Per pupil IDEA expenditures for children aged 3-21 in Special Education $1,607
Source : U.S. Dept. of Education, Office of Special Education and Rehabilitative Services (2003).
Number of children’s hospitals 224
Source : National Association of Children's Hospitals and Related Institutions (2006).
Number of pediatricians per 1,000 children 0.71
Percentage of pediatricians participating in Medicaid 89.2%
Source : American Academy of Pediatrics (2000).Tip : Pediatricians who do not accept Medicaid payment may disproportionately exclude CYSHCN, who are eligible for Medicaid in most states at higher incomes than other children. A less obvious implication is a weakened link between pediatric care and state public health programs and initiatives in a state. Note that family practice physicians, who can be particularly important to access to care in rural communities, are not represented here.
Eligibility for Early Intervention services includes infants and toddlers “at risk” of developmental delay Yes= 8
Source : U.S. Dept. of Education, Office of Special Education and Rehabilitative Services (2006).
Number of children served by state mental health authority, rate per 1,000 population
Aged 0-3 2.7
Aged 4-12 21.0
Aged 13-17 32.6
Aged 18-20 19.0
Source : SAMHSA National Mental Health Information Center (2005).Tip : No one figure easily captures access to or utilization of mental health services. One challenge is that many insurance policies place limits on mental health care benefits, so that coverage among children in a state is not necessarily an indicator of access. This indicator, children per thousand receiving state mental health services, is one marker for access to mental health care. It is most useful in relation to children with serious emotional disturbance (SED), who are most likely to need the intensive services states generally provide.
Percentage of children receiving preventive dental care in the past year 72.0%
Percentage of children with teeth in excellent or very good condition 68.5%
Source : National Survey of Children's Health (2003).Tip : These statistics from the National Survey of Children's Health reflect the overall child population. Unmet dental needs are undoubtedly more common among CYSHCN, since many conditions contribute to dental impairment (e.g., by causing teeth grinding) or pose barriers to dental treatment (e.g., by making it difficult for a child to control mouth position).
Number of children in foster care 508,446
Percentage of children in foster care 0.7%
Source : U.S. Dept. of Health and Human Services, Administration for Children and Families, Children's Bureau (2008).Tip : Use caution in comparing rates across states. Absent knowledge of the strengths and weaknesses of a state's system, it is difficult to tell if a high rate is the result of a vigilant attitude towards abuse and neglect or the result of a system that keeps children lingering in foster care for undue periods.
Percentage of children without health insurance at some point in the past year 12.8%
Percentage of CYSHCN without health insurance at some point in the past year 8.8%
Source : National Survey of Children with Special Health Care Needs (2005-2006).Tip : This is a cumulative figure reflecting experience of all children in a state over a full year. It is higher than the figure for children without coverage at any one point in time but is more informative, since it washes out seasonal variation and includes children who have off and on coverage, which does not permit high quality care.
Percentage of children with private health insurance coverage 72.9%
Percentage of CYSHCN with private health insurance coverage 60.3%
Source : National Survey of Children with Special Health Care Needs (2005-2006).
Number of children enrolled in Medicaid 29,386,100
Source : Kaiser Family Foundation (2008).
Percentage of children with public health coverage 28.6%
Percentage of CYSHCN with public health coverage 28.6%
Maximum allowed income for SCHIP eligibility as a percentage of the FPL N/A
Source : National Survey of Children with Special Health Care Needs (2005-2006).
Number of children enrolled in SCHIP 4,411,890
Percentage of children enrolled in SCHIP 6.0%
Source : Kaiser Family Foundation (2008).
Percentage of Medicaid and SCHIP enrollees in capitated health plans
Medicaid 32.4%
SCHIP 31.6%
Source : American Academy of Pediatrics (2000).
Number of children enrolled in Supplemental Security Income (SSI) 1,121,017
Percentage of children enrolled in Supplemental Security Income (SSI) 1.2%
Source : Kaiser Family Foundation (2007).
TEFRA Medicaid Option/Katie Beckett Waiver for children Yes = 26
Source : Maternal and Child Health Policy Research Center (2005).Tip : Figures for number and percent of Medicaid-enrolled children reflect different data sources and different enrollment years. The number of children enrolled in Medicaid cannot be combined with the number enrolled in SCHIP, as these also reflect different years. The number and percentage of children enrolled in SCHIP are from one source, however, and can be looked at together. SSI data reflect a different year and source from those related to Medicaid and SCHIP enrollment figures. Applying these rates to the enrollment figures in order to figure out what percentage of children with publicly funded coverage are in managed care will yield informative but imprecise estimates.
Percentage of children with a combination of public and private health insurance 3.8%
Percentage of CYSHCN with a combination of public and private health insurance 7.5%
Source : National Survey of Children with Special Health Care Needs (2005-2006).
Premium Assistance Programs Yes = 19
Source : Premium Assistance Toolbox for States, National Academy for State Health Policy (2004)
Percentage of CYSHCN with inadequate health care coverage 33.1%
Source : National Survey of Children with Special Health Care Needs (2005-2006).Tip : Relatively few CYSHCN lack insurance completely. Thus, in many states, underinsurance is the major financial barrier to access for CYSHCN.
Autism Yes= 10
Bone Marrow Transplants Yes= 11
Cleft Palate Yes= 14
Congenital Bleeding Disorders Yes= 2
Dental Anesthesia Yes=30
Diabetes Self-Management Yes=27
Diabetic Supplies Yes=47
Source : Center for Affordable Health Insurance (2007).
Early Intervention Yes = 6
Source : Catalyst Center communications with state agency contacts and review of state statutes (2006).
Emergency Services Yes=44
Hearing Aids Yes=9
Home Health Care Yes=18
Hospice Care Yes=11
Kidney Disease Treatment Yes=1
Mental Health, General Yes = 40
Source : Center for Affordable Health Insurance (2007).
Mental Health Parity Yes=44
Source : Kaiser Family Foundation (2008).
Neurodevelopment Therapy Yes=1
Newborn Hearing Screening Yes=17
Newborn Sickle-Cell Testing Yes=3
PKU/Formula Yes=32
Port-Wine Stain Elimination Yes=2
Prescription Drugs Yes=2
Rehabilitation Services Yes=8
Wilms Tumor Yes = 1
Source : Center for Affordable Health Insurance (2007).
Catastrophic Coverage or High-Risk Pools Yes = 33
Source : Kaiser Family Foundation (2007).
Percentage of Title V Block Grant Partnership Budget from State Funds 46.2%
Source : U.S. Dept. of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau (2007).
Family Participation in Title V CYSHCN Program Score (Maximum Possible = 18) 13.9
Source : U.S. Dept. of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau (2007).
