Despite the poor economy and an increase in the number of adults without health insurance, the uninsurance rate among children has declined from 9.3 percent to 8.0 percent nationally, a report from Georgetown University finds. The researchers are attributing the drop to growing access to the children’s Medicaid program as a result of the Affordable Care Act (states that reduce their eligibility are penalized), President Obama’s re-authorization of CHIP in 2009, and the additional stimulus funds that helped states maintain their safety-net health care programs.

Thirty-four states experienced decreases in the number of uninsured children between 2008 and 2009, with Florida seeing the most significant drop. Massachusetts still leads the nation with the lowest rate of uninsured children, while Nevada continues to have the highest. Seven states are now home to a higher rate of uninsured children, “but in only one state, Minnesota, was that increase significant“:

There are 16 states with a higher rate of uninsured children than the national average, 30 states with lower rates, including D.C., and five states with rates that are not statistically different from the national average.

States with rates that are higher than the national average are concentrated in the West and the South, while the majority of states with rates below the national average are located in the Northeast or the Midwest.

Just six states (Arizona, California, Florida, Georgia, New York, and Texas) account for more than half of the children without insurance nationally.

Look:

For all of the GOP’s efforts to demonize and underfund public health care programs, Medicaid, the Children’s Health Insurance Program (CHIP), and Medicare have played an absolutely crucial role in filling the gaps in America’s very broken health care system. They’ve kept millions of people from becoming uninsured and have helped “offset the continuing decline in job-based coverage”:

As this CDC report demonstrates, children have also greatly benefited from CHIP, which has actually picked up the slack from private insurers:

These are pictures to keep in mind the next time GOP offers drastic cuts to public insurance or argue for the repeal of the Affordable Care Act, which would only strengthen safety-net providers and expand Medicaid eligibility.

President Obama’s new deficit reduction plan attempts to address concerns that blending the federal reimbursement rates for Medicaid and the Children’s Health Insurance Program (CHIP) would shift too much costs to the states by delaying its implementation until 2017 and producing a modest amount of savings relative to earlier versions of the plan. But some in Congress are still concerned that the greater cost shift to states would undermine the programs. Sen. Jay Rockefller (D-WV) — a strong proponent of both the Medicaid and CHIP — denounced the Obama’s modified blended rate proposal yesterday, saying it would devastate CHIP:

The proposal doesn’t specifically call for ending CHIP. But Rockefeller said that’s what would happen because CHIP would be a program where states could cut. Rockefeller was asked about the blended rate proposal when he stopped to talk to reporters after the Senate Democrats’ policy lunch Tuesday. “I hate it,” he said. Asked whether he still thinks it would kill CHIP, a prediction he made when the blended rate idea was floated earlier this year, Rockefeller said “it will do a very good job of that. Yeah, that would be my guess. Governors love CHIP until they have to start paying more for it.”

While the administration claims a blended rate would streamline and simplify the reimbursement formulas, states would receive less under a blended rate proposal because the federal government would average the reimbursement rates for all populations into a single rate. Rockefeller and other Medicaid advocates worry that this could signal the beginning of the end for CHIP. The Affordable Care Act requires states to maintain their current CHIP enrollment through 2019, but as CQ’s John Reichard reports, it “only funds them through 2015,” thus setting “the stage for a debate that year about how well the exchanges are doing in providing coverage and whether CHIP is really needed.”

Rockefeller characterized Obama’s cuts to Medicare and Medicaid as “hard” on seniors and the poor and said he would rather raise taxes on the wealthiest Americans. “You have to raise taxes. It isn’t a question of being a Democrat or of being a liberal. Or not being liberal. It’s just math,” he told Reichard.

Out of the many troubling health care repeal amendments in the Korean trade agreement, Sen. Orrin Hatch’s (R-UT) proposal to repeal the maintenance of effort provision for the Medicaid program — which requires states to maintain their enrollment numbers or risk losing federal funding — is possibly the most egregious. It encompasses the Republican approach of “saving” the program by forcing more people off of it — no matter the consequences to the beneficiaries.

As Sen. Jay Rockefeller (D-WV) pointed out in a recent letter to Hatch, according to the Congressional Budget Office, the provision would result in substantial coverage erosion for children in the CHIP program:

– By 2013, 400,000 people will lose their Medicaid and CHIP coverage. Two thirds of those dropped from coverage will be children.

– Half of all states will end their CHIP programs by 2016. One quarter of states are expected to end their program even earlier, in 2015, while remaining CHIP programs are expected to scale back coverage.

– By 2016, the number of those expected to lose CHIP coverage will climb to 1.7 million people, with 700,000 left uninsured.

Interestingly, as a long-time proponent of extending health care coverage to children and a co-sponsor of the original CHIP bill in 1997, the Hatch of yesteryear would have opposed these cuts. Here he is in 2006, praising the program on its 10-year anniversary: “When we drafted this legislation in 1997, our goal was to cover the several million children who had no insurance coverage. We have gone a long way in meeting that goal, but we are clearly not there yet. Coverage of these uninsured children should still be our top priority.”

The Washington Examiner’s Phil Klein reports that Republican presidential candidate Tim Pawlenty may have an SCHIP problem:

Back in 2007, the newly-elected Democratic majority was in a pitched battle with the Bush White House over the renewal and expansion of SCHIP. Democrats saw it as a down payment on universal health care, but President Bush eventually vetoed the legislation, which raised tobacco taxes and expanded coverage to children from families with household incomes of up to $82,600.

As chairman of the National Governor’s Association at the time, Pawlenty came out in favor of the renewal and expansion of the law. His public statements at the time show a politician who was trying to thread the needle as governor of a liberal state who had future ambitions within the GOP. Though he endorsed the renewal and expansion, he didn’t say how big of an expansion he supported and didn’t specify the funding mechanism. Nor did he explicitly come out against President Bush’s veto.

Klein speculates that Pawlenty will likely argue that he was presenting the position of the NGA and did not endorse a specific funding mechanism (i.e. the tobacco tax) or any other details about how the expansion should occur.

That may be true, but Pawlenty hasn’t exactly shied away from expanding the government’s role in the health care system. In November of 2006 — at the beginning of his second gubernatorial term — Pawlenty said his administration has been “studying very diligently the Massachusetts model about how that would apply to Minnesota,” suggested expanding the state’s Medicaid program, and pledged to “move in stages” toward “universal coverage.” “Everyone should be in a health plan of some sort…but I think as a goal we should start with covering all kids,” he said.

Conservatives are already taking shots at his health care record. On Thursday, fellow Minnesotan Rep. Michele Bachmann (R) told radio host Laura Ingraham that Pawlenty’s health record “will concern the voters.” “We need to have people who have enough foresight and common sense to know these programs aren’t going to work,”she said.

Responding to Republican criticism that expanding SCHIP eligibility to more low-income children would “crowd out” private coverage, Sen. Max Baucus (D-MT) suggested that rather than worrying about more children moving into a public plan, Republicans should focus on reforming private health insurance to insure that it is an affordable option for working class families:

The dilemma is to make sure people in our country have good public health insurance at premiums they can afford, benefits that make sense. The Children’s Health Insurance Program has good benefits and so clearly a mother whose income is quite low, would probably want her child to be enrolled in the Children’s Health Insurance Program. We have to bolster private health insurance in this country.

Watch it:

“We have to take-up health care reform this year, in this Congress,” Baucus said, “it’s so important.” In early November, Baucus released a set of principles for comprehensive health care reform designed to expand health care access and improve affordability.