America's Children Health Insurance and Access to Care (1998) / Chapter Skim
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2 Health Insurance and Children in America
2 Health Insurance and Children in America
Pages 23-43
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From page 23... ...
~ I Other sources of public insurance include military health care anc3 Medicare; together, however, these other sources provide coverage for fewer than 5 percent of insured children.
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From page 24... ...
Percent Adults' Health Insurance Source 1987 1988 1989 1990 1991 1992 1993 1994 1995 Total private 77.1 76.2 76.2 74.8 73.8 72.3 72.4 73.1 72.7 Employer-based 70.4 70.1 69.8 68.3 67.8 65.9 65.4 66.1 66.1 Self-pay 6.7 6.2 6.3 6.4 5.9 6.4 7.0 7.0 6.6 Total public 10.7 10.6 10.4 11.1 11.7 11.9 12.3 12.8 12.2 Medicaid 5.6 5.6 5.7 6.4 7.0 7.3 7.8 7.9 7.8 Military health carea 4.6 4.4 4.1 4.2 4.0 3.8 3.8 4.3 3.7 Medicare 2.1 2.0 2.1 2.2 2.3 2.4 2.3 1.8 2.0 Uninsured 15.6 16.4 16.6 17.4 17.8 18.9 18.8 18.5 19.0 Total 103.4 103.2 103.2 103.3 103.3 103.1 103.5 104.4 103.9 Table 2.2 Trends in Health Insurance Coverage among Adults, Ages 18-64, United States, 1987-1995 NOTES: Columns do not add to 100 percent because individuals may receive coverage from more than one source during 1 year. Military health care also includes the Civilian Health and Medical Program of the Uniformed Services and health care through the U.S.
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From page 25... ...
Depending on the methods used to collect anc3 analyze information from these funding streams, estimates of insurance coverage vary. For example, estimates of Meclicaic3 coverage from the Health Care Financing Administration differ substantially from those proclucec3 by the Bureau of the Census anc3 the Agency for Health Care Policy anc3 Research.
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From page 26... ...
Health Insurance Source1987 19881989 1990 19911992199319941995 Total private47.3 47.548.1 46.9 46.647.247.046.347.0 Employer-based43.1 43.243.3 42.5 42.242.641.541.041.7 Self-pay4.2 4.24.8 4.4 4.34.65.55.35.4 Total public12.4 12~612.8 14.8 16.317.318.718.618.8 Medicaid10.0 10.310.5 12.5 14.015.116.716.116.5 Military health cares2.6 2.52.4 2.4 2.42.42.32.72.3 Medicareb0.1 0.10.0 0.1 0.10.10.00.20.3 Uninsured8.5 8.78.9 8.8 8.78.79.610.09.8 Total, children 0-1764.6 65.065.8 66.4 67.468.769.870.571.1 NOTE: Columns may not add to totals because individuals may receive coverage from more than one source during 1 year. Military Health Care includes the Civilian Health and Medical Program for the Uniformed Services and health care through the U.S.
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From page 27... ...
Some policy analysts anc3 health services researchers interpret the larger number of Meclicaic3- insured younger children as evidence that the Meclicaic3 expansions have effectively reached the intenciec3 age group. Race and Ethnicity As inclicatec3 in Figures 2.6 anc3 2.7, the patterns of chilciren's health insurance coverage among children by race anc3 ethnicity are not uniform.
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From page 28... ...
. Medicaid 1991 1992 1993 1994 1995 Year FIGURE 2.2 Trends in health insurance coverage among adults, ages 18-64, United States,19871995.
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From page 29... ...
, 18`', 1 6 14 12 ' 1 0 ~ 8 ~ 6 ·~ 4 ~ 2 o 29 1990 1991 1992 1993 1994 1995 Year Children, 0-17 _ · - __ ~ , 2. 0~ 1987 1988 1989 1990 1991 Year Adults, 18-64 ~ _ _ 1992 1993 1994 1995 Adults, 18-64 Children, 0-17 1987 1988 1989 1990 1991 1992 1993 1994 1995 Year FIGURE 2.3 Comparison of trends in health insurance coverage for adults, ages 18-64, and children, ages 0-17, United States, 1987-1995.
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From page 30... ...
Percent \~ ae.~% By Ages 0-5 3.2 33.2 Ages 6-12 3.8 38.4 Ages6-12 Ages 13-17 2.3 23.4 Total 9.8 ~ 00.0 FIGURE 2.4 Patterns of children's health insurance coverage by age, for employer-based insurance, Medicaid, and children without coverage, United States, 1995. SOURCE: EBRI, 1997, special tabulations.
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From page 31... ...
Uninsured 2.8 15.3 Total 18.3 100.0 FIGURE 2.5 Children's health insurance coverage within age groups, for employer-based insurance, Medicaid, and uninsured children, United States, 1995.
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From page 32... ...
2.8 28.2 / Native American, Eskimo, Aleut 0.1 0.9 ><17.5% / Asian, Pacific Islander 0.4 4.0 Black ~ Total 9.8 100.0 FIGURE 2.6 Health insurance coverage among children by race and ethnicity, United States, 1995.
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From page 33... ...
I:, 33.3°~\ <44.4°/Oy Medicaid \ 60 1% I Employer Employerbased FIGURE 2.7 Patterns of health insurance coverage among children by race and ethnicity, United States, 1995.
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From page 34... ...
In other words, children who are uninsurec3 are more likely to be poor anc3 to be from a racial or ethnic minority (Newacheck et al., 1996~. Along with the growing diversity of the American population throughout all regions of the country, the availability of culturally appropriate health care services also varies.
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From page 35... ...
High school High school Less than high school College Graduate school Total 24.5 3.3 8.5 5.0 41.3 59.3 8.0 20.6 12.1 1 00.0 FIGURE 2.8 Characteristics of families of children with emclover-based insurance coverage. aces 0-17 United States, 1995.
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From page 36... ...
0 poverty level ~0-133% poverty level 11.971.8 /W a\ ~\ 134-199% povertylevel 2.213.2 134-199% [3 2O ~0-133% 200-299% poverty level 1.4 8.5 poverty level poverty level :~ 71.8% ~ 300% pave level or more 1.2 6.4 Total 16.5 100.0 Parents' Education Number College Gra uate school , 3.6 1.5% Parents Education (in millions) Percent A\ High school 8.855.2 Less than l \ | \ Less than high school 6.339.7 high school 1397% 55.2/ High school College 0.63.6 \ / / Graduate school 0.21.5 ~ Totalb 15.9100.0 FIGURE 2.9 Characteristics of families of children with Medicaid coverage, ages 0-17, United States, 1995.
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From page 37... ...
high \ / school \ / _~ 54.9% Parents' Education Number (in millions) Percent High school Less than high school College High school Graduate school 5.1 3.2 0.7 0.3 54.9 34.5 7.5 3.1 Totalb 9.3 100.0 FIGURE 2.10 Characteristics of families of uninsured children, ages 0-17, United States, 1995.
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From page 38... ...
are in the northern tier. Moving from east to west, the rates of uninsured children are lowest in Pennsylvania, West Virginia, Ohio, Michigan, Illinois, Wisconsin, Minnesota, North Dakota, South Dakota, Nebraska, Montana, anc3 Washington.
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From page 39... ...
SOURCE: Bennefield (1996~. TABLE 2.6 Number and Percentage of Children Without Health Insurance Coverage, Ages 0-17, by Number of Consecutive Months Without Coverage, United States, 1992-1994 Percentage Number Time (months)
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From page 40... ...
SCHIP was ciesignec3 to give states flexibility anc3 choice, anc3 the flexibility appeals to most states. The national patterns of coverage are likely to change as a result of SCHIP, but it is too early to tell whether the states with the highest rates of uninsured children will develop programs that are most successful in expanding insurance coverage.
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From page 41... ...
Some researchers suggest that the decline in employer~basec3 coverage is clue primarily to the increases in health care costs, making employers less willing to offer coverage or more likely to shift the costs to employees, who in turn are less likely to accept the cost~sharing arrangements because of national declines in average real family incomes (Holahan et al., 1995~. Others have suggested that the reductions in employer coverage may be largely attributable to the shift in jobs from the manufacturing sector to the service sector, where insurance is less likely to be offered as a benefit (Newacheck et al., 19951.
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From page 42... ...
Although states are free to design their own enrollment procedures anc3 eligibility criteria, they are required to describe the procedures they will use to prevent substitution of coverage in the state SCHIP plans they submit to the Department of Health anc3 Human Services for approval. A recent study by the Urban Institute estimates that only about 2.9 million uninsured children will meet the income eligibility criteria set by SCHIP, anc3 that the available fiancis could insure a total of nearly 6 million children (Ullman et al., 1998~.
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From page 43... ...
1989. Overview of International Comparisons of Health Care Expenditures.
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