The blog of the Urban Institute
June 19, 2020

Millions of Dads Won’t Have Health Insurance This Father’s Day

Insuring Fathers Can Help an Entire Family’s Well-Being

For many dads, Father’s Day is a time to relax and enjoy time with their children. But for about four million dads without health insurance coverage, their celebration may be overshadowed by worries about their own and their family’s health and well-being.

Health insurance coverage increases access to health care and improves both physical and mental health. For parents, the benefits of coverage extend to their children (PDF). When parents have coverage, children’s coverage and health care access increase, and family material well-being (PDF) improves.

Using data from the National Health Interview Survey, we estimate that approximately 4.3 million custodial fathers living with children younger than 19 were uninsured in 2017–18.

Percent uninsured among custodial fathers, by selected characteristics, 2017-18

Dads with incomes below 138 percent of the federal poverty level were nearly four times more likely to be uninsured than dads with higher incomes (figure 1). Compared with white fathers, Black fathers were about twice as likely to be uninsured, and Hispanic fathers were more than four times as likely to be uninsured. Further, nearly one in five dads living in the South lacked health insurance coverage. Dads with children younger than 6 were also more likely than those with only older children to be uninsured.

Uninsured dads face challenges beyond health care—and the pandemic exacerbates their challenges

Uninsured dads experienced high rates of unmet health care needs (35.6 percent) and no usual source of care (45.9 percent, figure 2), and about one-quarter reported that they or their family members had problems paying or were unable to pay their medical bills.

Health Care Access, Affordability, and Family Material Hardship among Uninsured Custodial Fathers

And the challenges uninsured dads face extend to areas of material hardship that hurt them and their families. For example, in 2017–18, 14.8 percent of uninsured dads experienced low or very low food security in their family, 40.6 percent were very or somewhat worried about paying housing costs, and 45.9 percent were very or somewhat worried about paying monthly bills.

Both uninsurance and material hardship have likely worsened since the start of the pandemic and economic crisis, and dads who lost jobs and insurance coverage will likely struggle to access health care and could face mounting financial hardships. Early evidence indicates steep increases in unemployment because of the coronavirus outbreak, with more than 4 in 10 parents reporting their family lost a job or work-related income as of late March and early April 2020, and millions of workers are at risk of losing employed-sponsored insurance and becoming uninsured.

Expanding access to coverage and increasing enrollment could help dads and their families

Parental Medicaid eligibility thresholds vary widely across states, which is based partly on their decisions whether to expand Medicaid under the Affordable Care Act. In nonexpansion states, the average eligibility level is just 41 percent of the federal poverty level (about $8,900 per year for a family of three), which leaves many uninsured fathers in these states without affordable coverage options. We calculate nearly half (49.5 percent) of uninsured fathers live in the South, where few states have expanded Medicaid.

To broaden dads’ coverage options and reduce uninsurance, federal, state, and local governments could consider the following actions:

  • expanding (PDF) Medicaid in every state
  • removing Medicaid eligibility restrictions related to immigration status
  • reversing the administration’s public charge rule, which could boost enrollment in publicly subsidized coverage among immigrant dads
  • increasing access and affordability of marketplace and COBRA coverage to help fathers who lose their jobs or whose work hours are reduced during the pandemic
  • supporting community organizations to make information about coverage and enrollment assistance (PDF) more widely available to uninsured dads and, because dads may prioritize their children’s needs over their own, emphasizing the benefits (PDF) of health insurance coverage for the entire family

To honor dads this Father’s Day, providing more and better information about available coverage options and their benefits, offering enrollment assistance to connect more uninsured dads to coverage, and, ultimately, expanding affordable coverage options would be a good start. 

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