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Health Insurance, Access, and Health Status of Children

Findings from the National Survey of America's Families

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Document date: October 24, 2000
Released online: October 24, 2000

The nonpartisan Urban Institute publishes studies, reports, and books on timely topics worthy of public consideration. The views expressed are those of the authors and should not be attributed to the Urban Institute, its trustees, or its funders.

Note: The Portable Document Format (PDF) of this report includes all tables and charts.

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In recent years, the forces that shape private and public health insurance coverage for children have shifted. Economic growth has brought increased employment and higher incomes (Economic Report of the President 2000), which should provide greater access to private coverage. At the same time, however, employees may be bearing a larger share of premiums for family coverage (Ginsburg 1999). Public coverage has been expanding under the new State Children's Health Insurance Program (SCHIP), but most SCHIP programs were not yet mature in 1999 (Kenney, Ullman, and Weil 2000). Finally, federal welfare reform appears to have resulted in unintended reductions in Medicaid enrollment among children (Garrett and Holahan 2000).

This Snapshot uses data from the National Survey of America's Families (NSAF) to describe insurance coverage for children ages 18 and under in 1999 and how coverage changed between 1997 and 1999.1 The NSAF asked families a series of questions about their health insurance coverage at the time of the survey, including whether coverage was provided through an employer (employer-sponsored insurance [ESI]); through Medicaid or a separate SCHIP or another state program (Medicaid/SCHIP/State); by some other source (including private nongroup plans and Medicare); or whether they had no coverage. This Snapshot analyzes coverage by income group, age, and state. Low-income children (those living in families with incomes below 200 percent of poverty) are divided into two groups: those with incomes below poverty, who are most likely to be affected by welfare reform, and those with incomes between 100 and 200 percent of poverty, who were the primary target group for SCHIP during this period. Higher-income children (those with family incomes above 200 percent of poverty) are also divided into two groups: those with incomes between 200 and 300 percent of poverty and those with incomes above 300 percent of poverty. This Snapshot also briefly examines changes in access to care and health status, but it does not attempt to link them to changes in insurance coverage.

Note: The Portable Document Format (PDF) of this report includes all tables and charts.



Topics/Tags: | Children and Youth | Health/Healthcare | Poverty, Assets and Safety Net


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