How many children in the United States do not have health coverage? The Census Bureau estimates that there are 9 million uninsured children.

What are the consequences of not having insurance? Uninsured infants are more likely to die because they lack health coverage according to the National Academy of Sciences. Children without insurance are less likely to have a pediatrician, less likely to get prompt dental, vision and mental health care they need. When sick they go untreated, receive care late or rely on emergency rooms. Uninsured children are more likely to be hospitalized for conditions that could have been treated by pediatricians. Untreated conditions, from asthma to hearing loss, impair their development and reduce their life chances.

What happens when uninsured children obtain health coverage? Many states and local governments have found ways to expand childrenÕs health care over the past decade. The good news is that when uninsured children do finally get coverage they receive better health care and have better health outcomes.

What are the reasons why so many children are still uninsured? There are three main reasons why children lack coverage: (1) they are eligible for public health coverage but have not enrolled, due to barriers or lack of awareness by their parents; (2) they live in families that are not poor enough for public coverage but cannot obtain affordable family coverage through work; or (3) they are recent immigrants who are barred from coverage under federal policies and whose states have decided not to provide coverage.

What can local, state and national leaders do to reach the goal of covering every child in America? Local and state officials and organizations need to reach out to uninsured children, reduce red tape and remove barriers that block access. Waiting lists, waiting periods, high co-pays and complex applications cost everyone money by discouraging needed care. The federal governmentÕs role is to make sure that states have the resources and incentives to expand coverage.

Why is the State ChildrenÕs Health Insurance Program out of funds? The SCHIP program was created as a block grant program that provides states with a fixed amount of money each year. The program has been a victim of its own success. In 2007 14 states face shortfalls in the amount of money they receive from Washington, DC and the amount they need to cover currently enrolled children. The number of states facing shortfalls will rise to 33 by 2012.

What will it cost to provide health coverage to all children in the United States? Ultimately the Congressional Budget Office is responsible for determining what it will cost to expand health coverage to all children. PICO is advancing a plan that would provide support and financial incentives for states to cover all children by 2012. We estimate that this initiative in SCHIP reauthorization will cost $40-50 billion over five years Ð or $8-10 billion annually. Some estimates put the cost of covering all children at $60 billion over the next five years.

Can we afford to cover all children? Letting children go without treatment or treating them in emergency rooms is far more costly to the nation than the cost of making sure that every children has coverage. Congress and the President have found funding for other priorities, such as the prescription drug benefit, which costs upwards of one trillion dollars, and ongoing operation in Iraq, which cost an estimated $6 billion per week. We can afford to cover all children if our elected officials make it a priority.

What about adults? All children and adults in the United States need access to affordable health coverage. PICO is organizing at the local and state level to expand health coverage for adults and support federal policies to reduce the number of uninsured. In 2007 our best hope to move forward on reducing the number of uninsured is in the area of children's coverage. SCHIP reauthorization may be the only chance that Congress has to move the ball forward on health care before the 2008 presidential elections.

What about Medicaid? Medicaid is by far the largest and most important safety net for families who lack access to affordable health coverage. Medicaid covers 25 million children, compared to the 6 million who depend on SCHIP. Medicaid serves the poorest children in the United States and provides important preventative services that help the most vulnerable children develop successfully. It is important that the nation protect and strengthen Medicaid as it works to cover all children.

Aren't the states solving this problem on their own? States from California, to Illinois and Massachusetts have proposed or moved forward with plans to expand health coverage. Yet all of these plans depend on federal funding, which provides the majority of funding to provide coverage to uninsured children and families. For example, one-half of the funding for Governor Schwarzenegger's new health plan for California would need to come from Washington, with a significant amount from expanding the SCHIP program. Past experience has been that states that have expanded coverage without adequate federal support, later face overwhelming fiscal pressures to retrench and reduce access. Adequate and predictable federal financing is critical to states being able to move forward on expanding coverage.

What is PICO's track record on health care? PICO's San Jose affiliate People Acting in Community Together led the campaign to create the Santa Clara Children's Health Initiative in California, the first in the nation program to provide seamless access to health coverage to all children in a county. PICO federations in California have helped spread ChildrenÕs Health Initiatives into more than half the counties in the state. They have also helped develop Express-Lane eligibility programs that sign up children for health coverage when they submit forms for school lunches and other programs. In 2006 PICO California won improvements in state policy that extended health coverage to approximately 94,000 additional children. PICO federations and state networks in Colorado, Louisiana, Missouri, Florida, Pennsylvania, New Jersey, Vermont and Massachusetts are working on similar campaigns to expand health coverage for working families and their children.