GOVERNMENT & MEDICINE

Kids getting more public insurance, less private coverage

An increase in the number of uninsured children from low-income families is fueled by employer cutbacks in dependent coverage and rising insurance costs.

By Susan J. Landers, AMNews staff. May 8, 2000.

Washington -- Although the number of low-income children enrolled in public health insurance programs grew during the past few years, the percentage of children covered under private insurance plans decreased sharply, says a new study.

The result has been no net change in the rate of uninsured low-income children, according to the study by the Center for Studying Health System Change, a Washington, D.C.-based research group funded by the Robert Wood Johnson Foundation.

"We were expecting to see some gains in public coverage for low-income children given recent expansions [of public programs], but were surprised to see the decline in private insurance, which is, unfortunately, working in the opposite direction," said Peter J. Cunningham, PhD, the study's author and a senior researcher with the center.

The number of children receiving private insurance and whose families earned less than 200% of the poverty level dropped from 47% in 1996 and 1997 to 42% in 1998 and 1999. Public insurance rates for children in the same income level increased from 29% in 1996 and 1997 to 33% in 1998 and 1999.

The number of uninsured children grew from 19% in 1996 and 1997 to 20% in 1998 and 1999.

The center based its findings on data collected by its Community Tracking Study, which includes information on about 10,000 children younger than 18.

The study also found that coverage rates were declining for parents. Although 31% of parents lacked health insurance in 1996 and 1997, 35% were uninsured in 1998 and 1999.

Dr. Cunningham called the drop in parental coverage a particularly "troubling trend" because, unlike their children, parents do not have access to the same public programs.

Children who were living in families earning incomes greater than 200% of the poverty level did not experience a decline in private insurance, said the study, and the rate of childless adults without insurance remained constant over the past two years.

The decline in private coverage for low-income children stems from fewer parents being offered family coverage through employers and fewer parents enrolling in family plans when they were offered, said the study.

Increases in the cost of private insurance may explain some of the decline, said Dr. Cunningham. Premiums rose 4.8% in 1999, up from a 3.3% increase in 1998. The cost of family coverage rose from $122 per month in 1996 to $145 per month in 1999.

Commenting on the study, Jeff Lemieux, PhD, director of economic studies at the Progressive Policy Institute, said covering the uninsured should be a "top priority."

"There is an emerging consensus across the political spectrum that tax credits provide flexibility without the bureaucracy of public programs," he added.

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