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Title: Health Insurance Coverage among Children Ages 3 and Younger and Their Parents

Citation Type: Miscellaneous

Publication Year: 2017

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Abstract: Our main findings are as follows: Medicaid and the Children’s Health Insurance Program (CHIP) are important in insuring all children, but young children especially. Of the nation’s 15.7 million young children in 2015, more relied on Medicaid/CHIP than on any other type of insurance coverage, with nearly half (48.8 percent, or 7.7 million) covered by Medicaid/CHIP. Just 3.5 percent of young children were uninsured in 2015, but 13.2 percent of parents of young children were uninsured, compared with 12.0 percent of parents of older children. Certain family characteristics, such as lower incomes, younger parents, and mixed immigration status, are more prevalent among families of young children, placing them at higher risk of lacking coverage. The Affordable Care Act (ACA) was associated with increased coverage among young children and their families. In the two years after implementation of the major coverage provisions of the ACA, the uninsurance rate for parents of young children fell from 19.7 percent to 13.2 percent—a drop of nearly a third, reflecting gains in coverage through Medicaid and the new Marketplaces. Though the ACA's coverage provisions were not targeted at children, uninsurance also fell for young children; this drop was associated with the ACA's coverage expansions to parents, subsidies for Marketplace coverage, and enrollment and outreach efforts. Nearly half (48.8 percent) of young children had Medicaid/CHIP coverage and over a fifth (20.2 percent) of their parents had Medicaid in 2015—a higher share than among older children (41.9 percent) and their parents (16.7 percent). This represents an opportunity for Medicaid and CHIP programs to reach low-income children at critical early ages. Because young children and their parents rely on Medicaid at higher rates than older children and their parents, contractions of Medicaid funding would have outsize effects on families with young children. Maintenance of eligibility (MOE) protections are particularly important for children ages 3 and younger: if, in the absence of federal MOE protections, all states reduced Medicaid/CHIP eligibility to 138 percent of the federal poverty level (FPL), uninsurance would be as much as six times higher among young children with family incomes between 138 and 200 percent of FPL and three times higher among those with family incomes between 200 and 300 percent of FPL nationally. The insurance status of young children and their parents depends on where they live. In 2015, uninsurance among young children ranged from less than 1 percent in Hawaii, Vermont, and Massachusetts to more than 10 percent in Alaska, and varied even more widely among their parents, ranging from below 3 percent in Massachusetts and Hawaii to over 20 percent in Texas, Georgia, and Mississippi. Likewise, rates of Medicaid/CHIP coverage varied across states for both young children and their parents. In 2015, parents of young children in nonexpansion states were nearly twice as likely to be uninsured as parents in expansion states. This suggests that additional states could achieve coverage gains for parents of young children through Medicaid expansion, with potential positive impacts for both parents and their children.

Url: https://www.urban.org/sites/default/files/publication/95421/pci_report_2.pdf

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Authors: Haley, Jennifer; Wang, Robin; Buettgens, Matthew; Kenney, Genevieve, M

Publisher: Urban Institute

Data Collections: IPUMS USA

Topics: Family and Marriage, Health, Other

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