Children's eligibility and coverage: recent trends and a look ahead

Area of Science:

• Health Services Research
• Public Health Policy
• Child Health Insurance

Background:

• Tracking changes in children's public insurance eligibility and coverage is crucial for understanding health access.
• The period 2001-2005 saw stable eligibility but rising public enrollment and declining uninsurance rates among children.

Purpose of the Study:

• To analyze trends in children's public insurance eligibility and coverage using Medical Expenditure Panel Survey data (1996-2005).
• To identify characteristics of uninsured children eligible for but not enrolled in public insurance.
• To estimate the impact of potential State Children's Health Insurance Program (SCHIP) income threshold changes.

Main Methods:

• Utilized data from the 1996-2005 Medical Expenditure Panel Survey (MEPS).
• Analyzed changes in public insurance eligibility and enrollment.
• Estimated the number and characteristics of eligible but unenrolled children and those affected by SCHIP policy changes.

Main Results:

• In 2005, 62% of uninsured children (5.5 million) were eligible for but not enrolled in public insurance.
• Detailed characteristics of these eligible but unenrolled children were identified by age, income, race/ethnicity, health status, and nativity/citizenship.
• Simulations explored the effects of SCHIP income threshold expansions and rollbacks on child coverage.

Conclusions:

• Significant gaps persist between eligibility and enrollment for public health insurance among children.
• Understanding the demographics of eligible but unenrolled children is key to designing effective outreach strategies.
• Policy adjustments to SCHIP income thresholds could substantially affect the number of children with insurance coverage.