Policy Factsheet

Access to Quality Healthcare for Children

Reasons for Policy

  • 37% of Hispanic, 23% of African American, and 20% of white children do not have health insurance.1
  • Fewer than half of eligible children for State Children’s Health Insurance Program (SCHIP) are enrolled.1
  • There are low levels of quality healthcare for children in Medicaid and commercial programs alike.1
  • Low-income areas have 44% fewer physicians than high-income areas.2

Community Groups

  • Local Government
  • Local Public Health Department
  • Non-profits/Community Organizations
  • State Government

Policy Components

  • Make the SCHIP application process faster and easier
  • Include parents of low-income children in healthcare coverage
  • Distribute eligibility information more widely in locations where eligible enrollees may be found (e.g. food stamp and WIC offices, Head Start programs, local community centers)
  • Physicians participate in cultural competency, development, and behavioral pediatrics training

Desired Outcomes

  • Primary prevention of disease and reduced cost of care
  • Higher enrollment rates of children and low-income families in SCHIP and Medicaid programs
  • Better quality and availability of healthcare services
  • Reduced health disparities between children of low- and high-income families

Level of Evidence Available to Evaluate Effectiveness of Policy

For all policies we describe on this website, we have applied the Standards of Evidence as defined by Flay et al. (2005) in the Standards of Evidence document published by Prevention Science.

The effectiveness level of this policy is 2: Policies with Consistent Evidence from High-Quality Observational Studies.

The levels of effectiveness as noted are:

  1. meets criteria for policy effectiveness (consistent, positive outcomes from at least two high-quality experimental or quasi-experimental trials using a comparison group or interrupted time series design);
  2. consistent evidence available linking policy with positive outcomes from high-quality observational studies only;
  3. insufficient evidence available for policy or policy components.

Achievable Results

  • States are able to effectively reach eligible enrollees at provider locations, community health centers, schools and adult education centers, beneficiaries’ homes, and social service agencies.2
  • 55% decrease in incomplete SCHIP applications after streamlining the verification process.2
  • 28.6% increase in SCHIP enrollment after coverage was expanded to parent.2
  • 30% increase in SCHIP enrollment after simplifying their application form.2

Community Examples

Links to Policy Examples


  1. Beal AC (2004). Policies to reduce racial and ethnic disparities in child health and health care. Health Affairs, 23(5), 171-179.  

  2. Zambrana RE, Carter-Pokras O (2004). Improving health insurance coverage for Latino children: A review of barriers, challenges, and state strategies. Journal of the National Medical Association, 96(4), 508-523.  

  3. Flay, BR, Biglan, A, Boruch, RF, Ganzalez Castro, F, Gottfredson, D, Kellam, S, Moscicki, EK, Schinke, S, Valentine, JC, & Ji, P (2005). Standards of evidence: Criteria for efficacy, effectiveness and dissemination. Prevention Science, 6(3), 151-175.