Children Without Health Insurance

How many children lack health insurance coverage?

According to Urban Institute tabulations of the Current Population Survey, 9 million children were uninsured in 2004. This represents 11.6 percent of the entire child population.

How has coverage changed for children?

Health insurance coverage rates improved for children following expansions in public coverage under the State Children's Health Insurance Program, known as SCHIP, in 1997. Between 1998 and 2003, the number of uninsured children dropped by 2 million, while the number of uninsured parents increased by more than a million.

Minority children and children in low-income families experienced the greatest gains in insurance coverage over this period. The share of black and Hispanic children without health insurance coverage fell by 5 and 6 percentage points, respectively, between 1998 and 2003. In recent years, reliance on public programs has been growing, which has protected children from losing health insurance coverage.

Who are they?

Low-income children are more likely to be uninsured than those in other income brackets:

• Children in low-income families: 19.5 percent uninsured
• Children with family incomes between two and four times the federal poverty level: 7.6 percent uninsured
• Children with family incomes more than four times the federal poverty level: 3.6 percent uninsured
• All children: 11.6 percent uninsured

Uninsurance rates also vary by ethnicity:

• Hispanic children: 21.1 percent uninsured
• Black children: 13 percent uninsured
• Asian children: 9.4 percent uninsured
• Non-Hispanic white children: 7.6 percent uninsured

Why are they uninsured?

Most uninsured children live in low-income families and lack access to affordable employer-sponsored health insurance.

While most uninsured children are eligible for public coverage, their parents often do not know about the programs or do not know that their child is eligible for coverage. Only 6.8 percent of low-income uninsured children have parents who say their child does not need health insurance.

• "Five Things Everyone Should Know about SCHIP"
• "Going Without: America's Uninsured Children" (prepared for the Robert Wood Johnson Foundation)
• "Evaluation of the San Mateo County Children's Health Initiative: Second Annual Report"
• "Changes in Economic Conditions and Health Insurance Coverage, 2000-2004" (link to Health Affairs journal)

• "Congressionally Mandated Evaluation of the State Children's Health Insurance Program: Final Cross-Cutting Report on the Findings from Ten State Site Visits" (prepared for the U.S. Department of Health and Human Services)
  
• Awareness and Perceptions of Medicaid and SCHIP Among Low-Income Families with Uninsured Children (prepared for the U.S. Department of Health and Human Services)