ABSTRACT
While the Clinton administration successfully sponsored the 1997 State Children’s Health Insurance Program (S-CHIP), the largest expansion of coverage for low-income children since the enactment of Medicaid, important gaps in coverage remain for significant numbers of American families, especially in the current environment of high and accelerating health insurance premiums. Indeed, in 2002, the number and percent of non-elderly uninsured Americans stood at 43.6 million and 15.2 percent respectively, an increase of nearly 3.4 million persons over the prior year (Mills and Bhandari 2003). With large federal budget deficits forecast for at least the next decade, it remains questionable at best whether the federal government can be an effective catalyst for enhanced access to private or public coverage, let alone comprehensive health care reform.
