It has been reported that too many of America’s children do not have health insurance, with the state of Montana having one of the highest rates of uninsured children in the country, despite having one of the strongest state economies. Montana's 35,000 uninsured children come from all household income levels and are at a developmental and educational disadvantage compared to kids who have a regular doctor or medical home. Healthy children achieve better educational outcomes with a higher likelihood of becoming productive citizens prepared for work, public service, and overall life experiences.

Research available at montanakidscount.org, on the benefits and costs of expanding health insurance coverage to more Montana children shows dramatic economic returns to all Montanans. Healthy Montana Kids, an ongoing ballot initiative collecting voter signatures throughout the state, is a good example of the high economic returns from more investment in children's health. This ballot initiative, if passed by Montana voters, would add uninsured children to both public and private insurance programs maintaining a mix of government and employer sponsored health insurance coverage and leaving 60% of insured kids covered by private insurance.

Approximately 30,000 uninsured children in Montana would be covered by Healthy Montana Kids by offering health insurance coverage to children by increasing the income-eligibility level for the Children's Health Insurance Program and the Montana Medicaid program and by helping eligible families cover their children under employer-sponsored plans.

Benefits and costs are based on the difference between state budget spending for the initiative compared to the cost savings from extending coverage to more of Montana's uninsured children. The yearly state budget cost of $20.3 million for Healthy Montana Kids financed by a portion of Montana Insurance Licensing fees would be more than offset by annual savings to employers and workers with employer-based health insurance of $45 million plus another $5 million in reduced federal taxes for government reimbursement for uncompensated care costs. An additional $5.5 million in state income tax revenues every year would be generated from the matching federal dollars flowing into the state economy from more insured children in Medicaid and CHIP.

The initiative's approach to insuring more Montana children offers a positive economic payback of more than $2.50 to Montanans for every state $1 expended, a rate of return that compliments other positive impacts of more health investment in the state's future workforce. Other returns include better school performance with more than 20 percent gains on measures of attention and concentration in the classroom for CHIP enrolled children compared to their performance before enrollment and on keeping up with school activities.

Heath care expansion initiatives for Montana's children is consistent with providing children with access to safe schools and a proper education and is no less important.

The American public education system has ensured that children are provided with a good free education, but the same social and community commitment for American children’s health has not been instituted. Providing the children with health insurance is arguably just as fundamental to their growth and livelihood as their education is; and requires the same political commitment, while also offering high economic returns to all Montanans. This is the argument behind the Healthy Montana Kids scheme, and its supporters claim it is convincing.

The scheme is beneficial not just to children and parents, but its economic returns mean the whole state will be affected, including all of its citizens as beneficiaries of the scheme. For this reason, they argue, it is crucial that the votes support it so that it can be put into action, for the protection of children and benefit of all.