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to three-year-olds in high-need communities . The next step is to realize the goal of achieving universal access to all four-year-olds by investing needed funding to reach the 90,000 four-year- olds outside of New York City who still lack access to any type of preschool program .
Access to affordable health care coverage: Affordable health insurance coverage provides families direct relief from the full costs of medical services and fosters greater economic self-sufficiency . A study by the National Bureau of Economic Research found that children in states with more generous Medicaid and Children’s Health Insurance Program eligibility levels earned more as adults, on average, than their peers in states with lower eligibility levels, and these adults paid more in taxes offsetting much of the government investment in expanded eligibility levels .37
New York has a strong track record of providing robust, affordable health care coverage to all children regardless of immigration status or family income . Before the full implementation of New York’s health insurance marketplace, NY State of Health (“The Marketplace”), fewer than 4 percent of New York children were uninsured .38 Since then, thousands of children have newly enrolled in Medicaid, Child Health Plus, or private coverage .39 New York recently expanded affordable coverage to families and working adults by deciding to implement a Basic Health Program (“BHP”) . 40 The BHP will help bring financial stability to working low- and moderate- income families who earn too much to qualify for Medicaid but still find the costs of private health insurance out of reach . By offering more affordable coverage through new programs like the BHP, the Marketplace, and existing programs like Medicaid and Child Health Plus, New York is sparing families the burden of potentially bankrupting health care costs, and protecting them from the anguish of choosing one necessity, such as food and shelter, over another .
School-based health delivery: For New Yorkers to fully realize the economic benefits of improved access to health care, coverage must directly lead to the receipt of high-quality care, which, in turn, must result in improved health status . One of the most unique and promising vehicles for connecting newly insured children to care is the delivery of health care services within schools .
In recent years, schools have swiftly developed the capacity to provide preventive and primary care services along with robust chronic disease management, all while keeping a child from missing precious academic seat time . Each year, children miss about 14 million school days because of problems associated with asthma alone .41 School-based health services can effectively treat issues like asthma and reduce the number of school days a child has to miss . Children who are absent less often are more likely to graduate and attain higher levels of education . Improved educational outcomes better position children for lifelong success and boost their future earning potential, all while equipping them to escape the cycle of poverty .
37 david w. Brown eT al., nBer, medicaid as an invesTmenT in children: whaT is The long-Term impacT on Tax receipTs? (Jan. 2015), available at http://www.nber.org/papers/w20835.
38 children’s defense fund, supra note 7, at 57 (Table F–3, “Children Uninsured, Enrolled in Medicaid/CHIP, or Eligible but not Enrolled”), available at http://www.childrensdefense.org/library/state-of-americas-children/2014-soac. pdf?utm_source=2014-SOAC-PDF&utm_medium=link&utm_campaign=2014-SOAC.
39 new york sTaTe of healTh, 2014 open enrollmenT reporT (2014), available at http://info.nystateofhealth.ny.gov/sites/ default/files/NYSOH%202014%20Open%20Enrollment%20Report_0.pdf
40 Press Release: NY State of Health Announces the Expansion of Private Health Insurance Coverage through Innovative New Program, new york sTaTe of healTh, April 17, 2015, http://info.nystateofhealth.ny.gov/news/press- release-ny-state-health-announces-expansion-private-health-insurance-coverage-through.
41 u.s. hhs, u.s. doe, managing asThma: a guide for schools (revised July 2003), available at http://www.nhlbi.nih. gov/files/docs/resources/lung/asth_sch.pdf.
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