Next year, Dallas County will lead the state in the percentage of uninsured children, a rate nearly triple the national average, according to a report Children's Medical Center Dallas is releasing today.

More than half of the 730,000 children in Dallas County have limited access to primary and preventive health care, Children's said in its report, "Beyond ABC: Growing Up in Dallas County."

The report uses state demographic data from 1998 to 2008 to examine the well-being of children.

"It is a tool to better understand children's needs through objective data and to encourage active involvement in making our community a better place for children," said Christopher Durovich, president and CEO of Children's Medical Center.

Children's and other hospitals support covering the uninsured because it places children in the care of a regular physician and eliminates costly emergency room visits, which often result in debt for the hospital.

Thirty-one percent of Dallas County children will be uninsured by 2010, the highest rate among counties with a population greater than 100,000, according to the study. It is significantly higher than the Texas average of 24 percent and nearly triple the national rate of 11 percent.

More than 238,000 children enrolled in Medicaid or the state's Children's Health Insurance Program have limited access to primary care because of an inadequate network of primary care physicians, according to Children's research. CHIP is government-provided insurance designed for families who earn too much money to qualify for Medicaid, yet cannot afford to pay for private insurance.

In July 2009, CHIP enrollment in Texas was 63,245, including 11,249 in Dallas County.

But low reimbursement rates for CHIP health care providers have weakened the network of physicians who accept CHIP and make it less likely for enrolled children to have timely access to a doctor and to specialty care when needed, according to the report.

Only a limited number of pediatricians in Dallas County will accept children enrolled in Medicaid or CHIP, according to the report.

The Center for Public Policy Priorities, a liberal-leaning Austin think tank, released a similar study in July. In looking over the past decade, Dr. Frances Devainey, director of the study, said that even during strong economic times, children fell through the cracks.

"The question remains: Will Texas continue to be one of the worst states for child outcomes, or will we make the necessary investments in public structures that encourage child health and economic security?" Devainey said.