US PUBLIC-SCHOOL ENROLLMENT-BASED HEALTH-INSURANCE INITIATIVES AND AMERICA UNINSURED

This article reviews current literature on school enrollment-based hea lth insurance programs underway or pending in the United States. This model of affordable family health insurance delivery was first propose d in a 1988 New England Journal of Medicine Sounding Board article, bu t only a few states - Arkansas, Florida, New Hampshire, and Texas - ha ve begun public sector-driven programs in the 1990s that use school en rollment as a pooling mechanism to purchase group insurance policies f rom the private sector. Public support of this model is strong, intere st is currently growing, and other states, including North Carolina an d lo,ca, are exploring or have enacted legislation that supports estab lishment of school enrollment-based health insurance programs. After s ummarizing these public-sector initiatives, additional information is presented on uninsuredness in America; risk factors for uninsuredness among children; and national public and private initiatives in child h ealth insurance using eligibility criteria other than or including sch ool enrollment that were examined by the GAO in 1994/95.