Skip Navigation

Mr. Chairman and Members of the Committee, I appreciate the opportunity to discuss issues that the Congressional Budget Office (CBO) would consider in evaluating proposals to expand health insurance coverage for children. Despite recent expansions of the Medicaid program, about 14 percent of U.S. children are uninsured at any point in time. Many more low-income children are uninsured at some time during the year, because shifts between insured and uninsured status are constantly occurring. Because of the number of children involved and the changing composition of the insured population, a policy that would substantially reduce the number of uninsured children could be both expensive and complicated to design.

Policymakers are considering three broad approaches to increase health insurance coverage for children:

• Enrolling more children in Medicaid, both by expanding eligibility and by extending outreach to uninsured children who are eligible but not enrolled;
  
  
• Providing direct subsidies to low-income families with uninsured children to help them pay for insurance; and
  
  
• Providing refundable tax credits to low-income families who purchase health insurance for their children.

The costs of such proposals would depend on the number of children who are uninsured, the extent to which they and children who would otherwise have private insurance would participate in a subsidized program, and the average cost per child.

This document is available in its entirety in PDF.