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Which children are still uninsured and why
Insights
A strong economy reduced child uninsurance rates, but 12% of children remain uninsured. Identifying at-risk groups like poor children and Hispanics is crucial for improving health coverage access.
Area of Science:
- Health Services Research
- Public Health Policy
- Socioeconomic Determinants of Health
Background:
- Economic growth and expanded public health programs (Medicaid, SCHIP) contributed to reduced uninsurance in low-income children.
- Despite progress, a significant percentage of American children remained uninsured, necessitating further investigation into contributing factors.
Purpose of the Study:
- To analyze trends in children's health coverage between 1998 and 2000.
- To identify demographic and socioeconomic factors associated with children lacking health insurance.
- To inform policy recommendations for increasing health coverage access.
Main Methods:
- Utilized U.S. Census data from 1994, 1998, and 2000.
- Analyzed national trends in health insurance coverage for children.
- Examined disparities in uninsurance rates across different child populations.
Main Results:
- Uninsurance rates among low-income children decreased from 15.6% to 13.3% between 1998 and 2000.
- Poor children, Hispanics, adolescents, and children of foreign-born parents were disproportionately represented among the uninsured.
- Employer-sponsored health insurance growth was a more significant factor in reducing uninsurance than public program expansions.
Conclusions:
- The strong economy and increased employer-based coverage were primary drivers of reduced child uninsurance.
- Low program participation, rather than eligibility limits, is the key policy challenge.
- Recommendations focus on increasing participation in existing health coverage programs for eligible children.
Abstract:
A strong economy and increased enrollment in employer-sponsored health insurance coverage, together with expansions in Medicaid and State Children's Health Insurance Program (SCHIP) led to reductions in uninsurance among low-income American children between 1998 and 2000 (from 15.6% to 13.3%). Nonetheless, 12% (about 9 million) of children remained uninsured. Identifying these children and understanding the factors that contribute to their continued lack of health coverage is key to providing them access to health care. Using 1994, 1998, and 2000 census data, this article analyzes recent trends in children's health coverage, as well as the groups that make up the population of uninsured children. The picture that emerges from these analyses is one of tremendous variation in coverage for different groups of children, with some groups having a higher risk for lacking health insurance. For example, poor children, Hispanics, adolescents, and children with foreign-born parents (particularly those whose parents are not U.S. citizens) are overrepresented among the uninsured. The authors conclude that the strong economy and concomitant increase in employer-based coverage played a bigger part in reducing uninsurance rates than did expansions in public programs. They also argue that lack of participation by eligible children rather than inadequate eligibility levels is the key policy issue, and conclude with several recommendations to increase program participation.
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