The Commonwealth Fund, a private foundation that seeks to promote better health care for all Americans, has reported that in the United States both quality and access to health care for children varies greatly by state. At the top of the list are Iowa, Vermont, Maine, Massachusetts, and New Hampshire. The bottom states are Arizona, Florida, Louisiana, Mississippi, New Jersey, Nevada and Texas, which provide poor health care to children.

One of the conclusions of the in-depth report is that the State Children's health Insurance program, better known as SCHIP, should be immediately reauthorized. The Bush administration and Democrats in Congress are at odds about changes in the federal program, which eventually led to it being temporarily extended as it was until next year.

Also, the importance of the "medical home" was underlined, which is a family's primary health care provider.

The Commonwealth Fund also provided some numbers which show the near-criminal negligence in caring for children in the bottom states. It appears that if they would be up to the standards set by the top performers, 4.6 million more children would have health insurance and 11.8 million more children would get their recommended yearly medical and dental check-ups. Also, 800,000 more children would be up-to-date on their vaccines.