The number of American children without health insurance declined by about 6 percent last year, according to a new report by Families USA, a nonpartisan organization representing healthcare consumers. But that's largely because the child poverty rate increased, so more children qualified for government-sponsored insurance, the report found.

More than 11 percent of children nationwide - about one in nine - still lacked health insurance in 2007, according to the latest US Census Bureau estimates, the report said. About half a million children gained health insurance between 2006 and 2007 - about the same number as fell into poverty during the same period.

The report also found that most uninsured children - 88.2 percent - come from families with at least one parent working, and more than half live in two-parent households.

The worsening economic situation, the report says, adds new urgency to the need to expand the State Children's Health Insurance Program, a program jointly financed by the state and federal governments to provide health insurance for about seven million low-income children. The program, known as SCHIP, is up for reauthorization in the spring, just when Congress is likely to begin debating proposals for large-scale health reform. President Bush vetoed legislation to expand the program last year, and some states are beginning to run out of money to pay for the program because of swelling unemployment rolls, budget shortfalls, or both.

Massachusetts had the lowest rate of uninsured children in the country - just 4.6 percent - between 2005 and 2007, based on three years of Census data, compared with a national median of 9.2 percent during that period. In 2006, the Bay State passed a landmark health reform law that required all adults to buy insurance and all employers to either offer it or pay a fine. The new law exempted children from the mandate but also expanded income eligibility guidelines for SCHIP.

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