The National Academy of Sciences Committee on Children, Health Insurance, and Access to Care was assembled to address questions about health insurance for children, evaluating the strengths and limitations of insurance as a means of improving children's health from a variety of approaches and policies. Meeting between March 1997 and January 1998, the committee reported on trends in health insurance coverage for children; health insurance and access to care; safety net providers; Medicaid; state and private initiatives; children's health care needs; and the State Children's Health Insurance Program (SCHIP). The major finding of the committee was that insurance coverage is the major determinant of whether children have access to health care. Other studies have found that access to health care is positively correlated with children's success in school. The committee reached five conclusions: (1) all children should have health insurance; (2) public and private insurers should be encouraged to develop affordable products that address the specific needs of children, including children with chronic conditions and special health care needs; (3) non-financial barriers to care should be reduced through the provision of assistance with child care and transportation, through the provision of culturally appropriate services, and through the use of information technology; (4) outreach and enrollment procedures and coordination efforts should be designed so that all programs achieve the highest enrollment possible, particularly when states offer multiple programs with different eligibility requirements; and (5) information generated from children's health care and insurance programs should be designed to be useful in evaluating short-term trends and making program adjustments, and should be made widely available. (Five appendixes include: market-based approaches to insurance reform, information for accountability, public workshop agenda and participants, members of liaison panel, and committee and staff biographies. Contains references at the end of each chapter, an index, and 53 tables & figures.) (DLH)