U of M study: More kids in U.S. have health insurance

Thursday, April 10, 2014

[News release adapted from Robert Wood Johnson Foundation]

A new report compiled by the University of Minnesota’s State Health Access Data Assistance Center (SHADAC) shows the percentage of U.S. children who lack health insurance fell to 7.5 percent in 2012, the most recent year of data available.

The percentage of uninsured children nationwide dropped from 9.7 percent in 2008.

The report also shows significant gains in coverage among children who historically have been most likely to be uninsured —including non-white and Hispanic children and kids in low-income families.

The report was funded by the Robert Wood Johnson Foundation (RWJF) and appears on the SHADAC site.  

“This report provides an important baseline for measuring the effects of the Affordable Care Act on uninsured children over time and across states,” said Lynn Blewett, Ph.D., director of SHADAC, and professor in the University of Minnesota’s School of Public Health, Division of Health Policy & Management. “As eligible parents sign up for free or low-cost health insurance, more children will also gain coverage.”

Unfortunately, Minnesota was not among the states where the rate of uninsurance declined for children. Like other states, however, public insurance coverage offset declines in private coverage to help keep the overall rate of uninsurance from rising.

While for the overall population Minnesota has historically had one of the lowest rates of uninsurance in the nation, this isn’t true for kids. In 2012, 22 states had lower rates of uninsured kids than Minnesota. Among low-income children, 31 states have lower rates of uninsured kids than Minnesota (up from 21 in 2008) – this despite the state’s historically generous eligibility for coverage in Medicaid and MinnesotaCare.

The analysis shows that despite more children obtaining insurance during the country’s recession and ongoing economic recovery, how kids obtained coverage has changed. In 2008, 64.5 percent of children were covered through private insurance. By 2012, just 59 percent had private insurance. Researchers say an increase in public coverage—including Medicaid and the Children’s Health Insurance Program—more than offset the difference. In 2008, 25.8 percent of children received public health insurance coverage, compared to 33.6 percent nationally in 2012.

Additional findings:

Differences in children’s insurance status by household income were reduced.
Children in households with family incomes below 138 percent of the federal poverty line were most likely to be uninsured, but also experienced the greatest gains in coverage (15.5 percent uninsured in 2008 vs. 10.4 percent in 2012). Researchers say the gap between uninsured children in lower- and higher-income households is narrowing. In 2008, children in the lowest-income households were 5.3 times more likely than children in higher-income households to be uninsured; by 2012 this gap narrowed to 4.5 times.

Racial and ethnic disparities in insurance status among children were reduced.
While the percentage of children with insurance coverage rose across the board, Hispanic children experienced the greatest gains. In 2008, 18.3 percent of Hispanic children were uninsured; in 2012, 12.6 percent of this group was without coverage. 

The increase in kids having insurance coverage was widespread across the nation.
No state showed an increase in its percentage of uninsured kids between 2008 and 2012. The percentages of uninsured children varied considerably, however, by state—from a high of 17 percent of children in Nevada to a low of 1.4 percent in Massachusetts.

"It's encouraging to see these improvements in coverage for children, especially the gains for low-income and minority children,” said Julie Sonier, deputy director of SHADAC. “We expect to see continuing improvements over the next few years, as the effects of the Affordable Care Act's coverage provisions become apparent.”

Six states saw their rates of uninsured children decline by five or more percentage points: Oregon (-6.4 points), Florida (-6.1 points), Delaware (-5.2 points), Mississippi (-5.2 points), South Dakota (-5.1 points) and Idaho (-5.0 points).

Although the health insurance provisions of the Affordable Act (ACA) impact adults more than children, the researchers say that children will be affected as well. For example, some uninsured children will gain coverage through the premium tax credits available on insurance exchanges. Also, children who were eligible, but not enrolled in Medicaid/CHIP, could gain coverage if their parents sign up for public or exchange coverage under the ACA.

“Reducing the number of children who lack health insurance has been a focus of state and federal policy-makers for years, and it’s encouraging to see that tremendous progress has been made,” said Risa Lavizzo-Mourey, M.D., president and CEO of RWJF. “Having stable, affordable insurance is a precursor to receiving health care. More American children now have health coverage, and that means they can get the care they need to learn and grow.”

SHADAC analyzed the most recent data available from the American Community Survey, an annual survey conducted by the U.S. Census Bureau that includes questions on a wide range of topics, including health insurance.