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Related Experiment Videos

Uninsured children: how we count matters.

Suk-fong S Tang1, Lynn M Olson, Beth K Yudkowsky

  • 1Department of Practice and Research, American Academy of Pediatrics, Elk Grove Village, Illinois 60007, USA. stang@aap.org

Pediatrics
|August 5, 2003
PubMed
Summary

Including children with part-year coverage gaps more than doubles the estimated uninsured child population. This highlights the need to consider short-term uninsured spells in health policy and public insurance program evaluations.

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Area of Science:

  • Health Services Research
  • Public Health Policy
  • Pediatric Health Insurance

Background:

  • Children uninsured for less than a full year are often misclassified as insured.
  • This leads to underrecognition of their healthcare needs and underrepresentation in policy debates.
  • They are also overlooked as potential beneficiaries of public insurance programs.

Purpose of the Study:

  • To evaluate the impact of using alternative definitions of childhood insurance coverage on estimates of the uninsured population.
  • To assess how different measurement approaches affect the perceived scale of childhood uninsurance.
  • To inform health policy by providing a more comprehensive understanding of children's insurance gaps.

Main Methods:

  • Analysis of monthly health insurance coverage data for US children aged 0-18 from the 1999 Medical Expenditure Panel Survey.

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  • Estimation of the prevalence of part-year and full-year uninsured children.
  • Calculation of uninsured gap duration and aggregate uninsured spells.

    • Main Results:

    • In 1999, 6.6 million children (8.4%) were uninsured for the entire year.
    • An additional 11.4 million children (14.4%) experienced periods of uninsurance during the year.
    • Part-year uninsured gaps constituted 41.7% of the total 130 million months of missing health coverage.

    Conclusions:

    • Varying definitions of uninsurance significantly alter the estimated number of uninsured children.
    • Including part-year uninsured children more than doubles the estimated uninsured population and increases aggregate uninsured months by 71%.
    • Children with part-year insurance gaps should be included in evaluations of public insurance programs like the State Children's Health Insurance Program (SCHIP).